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Urinary and Genital Disorders (Children)

4 year old having potty accidents constantly?



My 4.5 yo son has been potty trained since 3 years old (but never w/o any accidents but at 3 accidents were not every day).Since about 4 these accidents have really increased. They are always peeing accidents and now are literally all day.I would say I can`t remember the last day when he didn`t have wet undies,we go through 4-5 pairs a day. It is never full out peeing in a puddle,more like wet in front but not through pants but then must hold rest in till he runs and goes rest in toliet.It has been like this for many months now and he gets a clean bill of health w/pedi.We have tried rewards and he seems motivated,but will literally have an accident 2 hours after the last one and realizing he doesnt get the prize. I talk to him about it and he says things like the `pee is sneaky` or it `comes out too fast`. He says he doesn`t know when he has to go. But I watch him and see him do things like squats in a chair,bends over a coffee table and I will say I think you have to go. He usually fights me on it that he does not and 5 min later is running to potty and then comes out saying he had an accident. So my next approach was making a deal w/ him he had to come when I asked.I pointed out the positions he was doing and that I believe those meant he did have to pee,he agreed. Now he will come to bathroom w/o a fight but if I miss his signs he will then just have the accident,nothing has improved. He is extremely intelligent and verbal, I know he understands what he needs to do and I also don`t think he is conciously training to fail,he seems bummed when he does realize he didnt get reward,etc. Thanks for any ideas.


What you are describing is quite common and may be normal childhood behavior. Often kids have more important things to do then go to the bathroom. He may simply be ignoring the urge to go until he cannot wait anymore.

Occasionally children can have overactive bladders that lead to these symptoms. Overactive bladders can be related to mild constipation. Cleaning out the bowel with a laxative may help with the bladder. If not, you may wish to talk to your doctor about whether a trial of a medication called an "anticholinergic" would be appropriate.

These problems can be quite frustrating but rarely are major medical issues.

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Go to the Urinary and Genital Disorders (Children) health topic, where you can:

Response by:

Rama   Jayanthi, MD Rama Jayanthi, MD
Clinical Assistant Professor of Urology
College of Medicine
The Ohio State University