Overactive Bladder In Children: Causes And Treatment

Overactive bladder in children

Overactive bladder in children is a syndrome that manifests as the urgency of the need to urinate, that is, the child feels a sudden and strong need to urinate. Normally, this syndrome is also associated with an increase in urinary frequency. It is also the second most common cause of bladder dysfunction in children immediately after nocturnal enuresis.

Usually, in this syndrome, the child’s need to flow is so strong that in many cases it is almost impossible to control. In this way, the child may experience unintentional loss of urinary retention. This, in turn, can cause serious problems in a child’s daily life and negatively affect a child’s social interaction rather than his or her emotional life.

In fact, if the loss of urinary incontinence is due to the inability to control the sudden need to urinate, the child may begin to avoid or refuse to participate in various activities because he or she fears losing his or her incontinence in a social situation or public place with lots of other people. For this reason, it is important that parents are aware of the symptoms caused by the syndrome and consult with a specialist about possible diagnosis and treatment as early as possible and before the overactive bladder begins to limit the child’s social life.

Symptoms of an overactive bladder in a child

First, we should not confuse the overactive bladder with other conditions, such as nocturnal enuresis, where the child loses urinary retention only at night. In this case, urinary incontinence due to an overactive bladder can occur at any time of the day, regardless of place and time.

In general, a child with an overactive bladder will show the following signs or symptoms:

• Need for frequent flow, more than 8 times a day.
• Difficulty managing bladder and restraint.
• Possible loss of urinary retention.
• Movements made by the child, such as sitting with legs crossed or other positions through which he or she seeks to improve urinary retention.
• In extreme cases, constant urinary incontinence.
• The symptoms cause discomfort and malaise or affect the child’s normal life.

Causes of overactive bladder

Current theory suggests that an overactive bladder could be associated with late maturation of the central nervous system. Therefore, in cases where the bladder fills with fluid, the anti-urinary reflex is not activated effectively enough.

This problem may be related to the child’s own physical conditions, such as abnormalities in the structure and function of the urinary tract, bladder or kidney infections, and lack of central nervous system maturation, as we mentioned earlier. However, it can also be related to other conditions such as constipation.

In some cases, the hyperactive bladder may also be due to the child not having learned to properly control their urination. This is a normal process that usually begins at the age of 3-5 years. That is, the child has not learned to orthodontically control the sphincter muscles of the urinary tract.

Likewise, among others, some mental, behavioral, learning, or anxiety disorders, among many others, may include an overactive bladder as one of their symptoms.

Diagnosis of overactive bladder

In order to diagnose a child with an overactive bladder, the doctor may prescribe the following examinations and tests, among others:

• Whole patient history: Both parents and child (if able) should define their own urination habits in detail. In fact, the doctor may ask the whole family to keep a so-called “urination diary” for a few days, during which each family member should report both the frequency and intensity of urination. In addition, the physician examines the patient’s history for the possibility of possible triggering events or factors.
• Physical Examination: This examination is performed both in the urinary tract and using tests that measure the patient’s nervous system function.
• Urine Sample: This way, your doctor can determine if there is any urinary tract infection behind the overactive bladder.
• Based on the results of the above tests and examinations, your doctor may also recommend that you have an ultrasound or other urodynamic examination to eliminate more serious problems, such as urinary tract malformations or dysfunction.

Treatment of overactive bladder in children

The treatment of an overactive bladder in children always depends on the causes. Thus, for example, in cases where it is due to constipation, where the stools press on the bladder, the goal of treatment is to treat and prevent constipation.

In any case, the most common treatments for overactive bladder in children are:

• Exercising bladder function: These exercises may include, but are not limited to, so-called urine programming (every x hours), double urination while a child is in the toilet, or relaxation of the pelvic floor muscles.
• In some cases, your doctor may recommend medication (usually oxybutynin). In this way, the symptoms are relieved until the child learns to control his sphincter muscles more effectively. This will also help prevent any possible urinary tract infections in the child.
• Parental support: Parents should under no circumstances provide the child with urinary incontinence, as this is by no means a voluntary activity; on the contrary, parents must be supportive and safe for the child. In this sense, parents can build a so-called motivational therapy for the child, which will help them stimulate the child with rewards and praise if he or she follows the program successfully.

Summary

It is important that parents remain alert to the symptoms of an overactive bladder. An overactive bladder, as we have seen, can have really negative effects on a child’s social life, schooling, or emotional life, as difficulties in withholding urine can also impair his or her self-esteem.

For this reason, it is essential that parents seek medical attention as soon as possible after the first signs of an overactive bladder are detected. In this way, the doctor can first help rule out physical problems and then begin resolving individualized treatment even before the syndrome begins to affect the child’s physical and mental well-being.

In any case, parental support is always essential. For this reason, we must emphasize that constant visits to the toilet or unintentional loss of urinary incontinence should never be a reason to set or reprimand a child. On the contrary, it is the parents ’job to provide support, security, and understanding so that the child can get over this nasty nuisance in a healthy way.