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Friday, December 6, 2013
Urinary and Genital Disorders (Children)
Ten year old wearing diapers
I am desperate to find help for my 10 year old granddaughter. She seems content to wear a diaper. She uses it all day and seems to make no attempt to actually use the toilet. She will then attempt to hide the very full diaper. She smells of urine and when you ask her about it she simply says "I don`t care". She will not have a bowel movement in the diaper so I know she can make a conscience effort to get to a toilet. Her mother has had her to doctors who can not find a physical reason for this behavior. All attempts at a mental evaluation have resulted in my granddaughter getting in the fetal position and refusing to speak. Any advice you can give on how to proceed will be so appreciated. I am very concerned for her well being.
This is a very difficult situation. She should probably be evaluated by a pediatric urologist and a behavioral medicine specialist. I assume there are no other medical issues. Ongoing incontinence at this age is common, but wanting to stay in a diaper is not. The urinary tract needs to be screened for abnormalities and to be certain that she is emptying the bladder satisfactorily, as well as to check for infection. Contributing psychosocial factors need to be explored also.
Jack S Elder, MD, FACS, FAAP
Clinical Professor of Urology
School of Medicine
Case Western Reserve University