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Urinary and Genital Disorders (Children)

Bed wetting and urinating in pants

02/07/2007

Question:

My 7 year old son is urinating in his pants during the day. When asked why, he says he is busy doing other things and forgets. He is also urinating in his bed every night. His blood has been tested for diabetes--he was not fasting at the time. His pediatrician tested his urine for a missing enzyme. The test was negative. He has had this problem on and off for the last 2 years. It has gotten worse the last 4 months. Which should be my next step?

Answer:

This is a question about a 7 yr old boy who has been reportedly urinating in his pants during both the day and during sleep. He reportedly was dry at 5 yrs of age and has had this problem on and off for the past 2 yrs, but it has gotten worse in the last 4 months.

This problem is called polysymptomatic (because it occurs both daytime and during sleep), secondary (because it is developed in a child who was formerly continuously dry even during sleep for at least 3 months) enuresis . Children who develop this type of enuresis should be carefully evaluated for several medical problems including renal disease and diabetes insipidus. Psychological causes are common in secondary enuresis and including situational stress and anxiety.

I would suggest that you discuss this further with your pediatrician. The next step may be referral to either a pediatric urologist or pediatric psychologist.

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Response by:

Mark   Splaingard, MD Mark Splaingard, MD
Clinical Professor of Pediatrics
College of Medicine
The Ohio State University