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Urinary and Genital Disorders (Children)

Urinary frequency 6 year old male

06/03/2011

Question:

My 6 year old son has urinary frequency. His kindergarten teacher states he`s going 5-6 times daily at school (845am-1130am) for the past number of weeks. He denies discomfort there has been no life changes or stressors. He does not have night time control and has heavy wet overnight diapers. We went on an after lunch hike yesterday and he had to stop to urinate twice in less then one hour. Can this be a frequency issue or do we need to check for diabetis, I am a type one diabetic? Polydipsia, polyuria and polyfagia might be more appropriate.

Answer:

This is a fairly common issue around this age group. A simple urine test called a "urinalysis" can assess for infection as well as glucose in the urine. If this test is negative, then another common cause for intermittent urinary frequency at this age would be constipation. When the rectum is distended or even impacted with stool, it can push on the bladder (located right in front of the rectum) and cause an involuntary bladder contraction (termed "urinary urgency"). Sometimes the child will have a sudden, strong urge to urinate and not be able to make it to the bathroom in time and have an accident. Other potential causes for urgency at this age include bladder irritants in the diet such as caffeine, carbonation, chocolate (which has caffeine in it), and citrus (like orange juice), termed the "4Cs".

A typical initial treatment plan would be to try an over the counter laxative appropriate for his age (such as glycolax), have him urinate on a timed schedule (every 2-3 hours), increase his daytime fluids (water is best), and avoid the 4Cs as mentioned above. If there is no improvement or if he has had problems with urinary tract infections, discussion with the pediatrician regarding referral to a pediatric urologist for further evaluation may be appropriate. If he has a good response to this treatment regimen, then typically no further testing is necessary.

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Response by:

William Robert DeFoor, MD, MPH William Robert DeFoor, MD, MPH
Associate Professor of Surgery
College of Medicine
University of Cincinnati