Girls consider urethral-vaginal reflux with leakage of urine from the vagina after voiding (when they stand up).Symptoms: voiding frequency, incontinence, urgency, nocturia, polyuria, holding manoeuvres (eg standing on tiptoes, crossing of the legs, or squatting with the heel pressed into the perineum), straining, weak stream, intermittency, dysuria Previously ever been dry during the day? If there has never been a period of dryness noted, or child has continuous incontinence/dribbling (not intermittent) strongly consider anatomical abnormalities Dysfunctional voiding (non-neurogenic) - an inability to relax the urethral sphincter and/or pelvic floor musculature during voiding, resulting in an interrupted urinary flow and prolonged voiding time.Underactive bladder- infrequent urination and overfilling leading to overflow incontinence.Voiding postponement- habitually delayed urination, with overfilling and leakage.Over active bladder (OAB)- urgency being the most important feature.Normal bladder capacity can be estimated prior to adolescence by the formula (age + 2) x 30 = capacity in mLįunctional causes of incontinence in children include:.Day wetting occurs in around 10 percent of 5-6 year olds, decreasing with age Daytime urinary continence is usually achieved by 4 years of age.Urinary incontinence is defined as day wetting in a child over 5 years of age that occurs more than once per month for ≥3 months The most common treatment for urinary incontinence is behaviour modification.A thorough history of voiding symptoms and a Bladder diary are essential components to assessment, directing targeted investigation and treatment.The goal of evaluation of daytime incontinence is to distinguish neurological and anatomical causes from functional causes of bladder dysfunction.Daytime urinary incontinence in school aged children is distressing and requires timely assessment and management. ![]() Constipation Nocturnal Enuresis Urinary Tract Infection Key points
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