Enuresis Daytime Wetting is the involuntary discharge of urine. It is considered to be a problem after the age of five by which time it is generally accepted that bladder control should have been established.

3-4% of children between the ages of 4-12 years of age present with daytime wetting. Two thirds of these have combined day and night time wetting. It is important to address the daytime wetting first.

  • First step – Please have your child assessed by their GP.

Management

  • Ensure the child drinks well during the day. The recommendation for children is 6-8 glasses of water or water based cordial evenly spaced throughout the day (including 3-4 glasses while at school).

Drinking less does not help as the bladder fills more slowly making it harder for the child to recognise a full bladder, reducing bladder capacity and causing the urine to be more concentrated, irritating the bladder wall.

  • Once the child is drinking more, encourage the child to pass urine at regular intervals (2.5 – 3 hourly) throughout the day. ‘Time Toileting’ or bladder retraining may be helpful to support this.
  • If the child is at school it is important to communicate with the child’s teacher about management during school hours.
  • If using rewards/incentives these need to be for something the child has control over e.g. drinking well, using the toilet. Reward them for sitting on the toilet regardless of the result as they will not be able to achieve dry pants initially.
  • Encourage them to take time to empty the bladder. Children whose legs don’t reach the floor will be able to relax the pelvic floor more effectively if they have a low stool for their feet. Ideally boys should stand on a low stool (if needed), make sure their pants are down properly and point the penis downwards into the toilet.
  • Double voiding can be useful. The child counts to 10 or 20 and tries to empty their bladder again.