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Children's Health

Child Wetting Psychological?

10/21/2010

Question:

My daughter is 4 1/2 yrs old and trained herself at 2 1/2, she was always dry until she started pre-school where she was dry for half the yr, she started wetting herself a few times a day would not care if she stayed wet. Eventually we realized she had a UTI which we treated but the accidents stayed. We have tried bribing her, ignoring it, punishing it etc... nothing has seemed to help, on the contrary it seems worse. She has not had another UTI. Is this a psychological case?

Answer:

Secondary enuresis is the name of the condition you are describing. That is, a child is fully toilet trained and has a relapse. There can be a familial tendency (chromosomal linkages; if both parents 77%, if one parent 50%), the result of inappropriate toilet training, stress, family disruptions, small bladder capacity, deep sleep patterns, physical changes (detrusor instability) and /or hormonal regulation, chronic constipation, stress incontinence. The condition is rarely pathological, but an appointment with a pediatric urologist can offer insights into management of the condition.

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Response by:

Sarah Sauntry, RN, MS, CPNP-PC
Assistant Professor of Clinical Nursing
College of Nursing
University of Cincinnati