Daytime Wetting

Daytime Wetting

How do Bladders Work?

Your bladder is a bag-like organ that stores and empties urine. Pelvic floor and sphincter muscles control the opening and closing of the bladder and nerves send messages between your muscles, bladder and brain.

When your bladder is filling up, your pelvic floor and sphincter muscles gently contract to hold in the urine. When your bladder starts to stretch, a message is sent from your bladder to your brain to let it know, “I’m full!” When you go to the toilet, your brain tells your bladder to squeeze out the urine and your pelvic floor will relax to let the urine out. When your bladder is empty, your pelvic floor contracts again.

What is Daytime Wetting?

Loss of bladder control during the day may be caused by problems with your bladder, pelvic floor and sphincter muscles or nerve messages. This can be called daytime wetting or daytime incontinence. Loss of bladder control during sleep can be called bedwetting or enuresis. Children can have problems with just daytime wetting, just bedwetting or both.

Most children have gained daytime bladder control by the age of four, BUT 3 – 12% of children aged 5 – 17 years have a daytime wetting problem. One third of these children will also have a problem with bedwetting. Day wetting is more common in girls than boys and boys have more problems with bedwetting than girls. Both these problems tend to improve with age, but children do not necessarily ‘grow out of it’.

Wetting can cause distress for children, teenagers and their families. The underlying bladder, muscle or nerve problem can lead to kidney problems later in life. If your school-aged child wets during the day, it is essential to seek professional advice.

What Causes Daytime Wetting?

Most wetting occurs because the bladder, muscles or nerve messages are not working normally. Common causes of daytime wetting include:

  • Overactive Bladder: This occurs when the bladder has problems storing urine. Symptoms include: wetting, urgency (‘busting’) and frequent toileting (more than ten times per day).
  • Underactive Bladder: This occurs when the bladder is large and the bladder muscle is floppy. Symptoms include: infrequent toileting (less than four times a day) and occasional wetting without any warning as the bladder overfills. Urinary tract infections are common.
  • Dysfunctional Voiding: This occurs when your bladder and pelvic floor muscles are not co-ordinating well together and you develop habits such as not emptying your bladder completely. This can led to wetting and urinary tract infections.
  • Voiding Postponement: This occurs if you are in the habit of putting off going to the toilet and small leaks escape when the bladder is overfilled.
  • Constipation: This occurs when you are not able to empty your bowel, or are having difficulty doing so. Bowel habits can have a significant impact on bladder function.
  • Structural Problems: These issues related to your bladder, kidneys, muscles, nerves and urethra are rare. A medical specialist should be consulted if your child is identified as having an anatomical or neurological cause for wetting.

Assessments and treatments at the Mars Clinic are provided by advanced-trained Physiotherapists. The type and duration of treatment for daytime wetting will vary, depending on the cause of the wetting and the needs of the individual. Treatment may include:

  • Teaching correct bladder and bowel habits
  • Practical advice and strategies for management at home
  • Timed voiding and drinking programs
  • Urostym biofeedback™ computer games to teach pelvic floor muscle control and relaxation
  • Uroflow voiding biofeedback to encourage correct voiding habits
  • TENS neuromodulation to retrain nerve pathways
  • Referral to a medical specialist, or other allied health professional, as required