Revised terminology for the time of incontinence has been suggested 1 , 2 βsee also the International Continence Society web site :. For urinary incontinence during the day: Diurnal incontinence or diurnal wetting. For urinary incontinence at night: Enuresis or bed-wetting. Diurnal daytime incontinence is usually not diagnosed until age 5 or 6. Nocturnal nighttime incontinence that is, enuresis is usually not diagnosed until age 7. Before this time, enuresis is typically referred to as nighttime wetting 3.
These age limits are based on children who are developing typically and so may not be applicable to children with developmental delay. Both nocturnal and diurnal incontinence are symptomsβnot diagnosesβand necessitate consideration of an underlying cause.
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Nighttime continence takes longer to achieve. About 0. Enuresis is more common among boys and when there is a family history of it 4. Incontinence is classified as. Secondary incontinence: Children developed incontinence after a period of at least 6 months of urinary control. An organic cause is more likely in secondary incontinence. Even when there is no organic cause, appropriate treatment and parental education are essential because of the physical and psychologic impact of urine accidents 5.
See also Urinary Incontinence in Adults. Neurourol Urodyn β, Austin PF, Bauer SB, Bower W, et al : The standardization of terminology of lower urinary tract function in children and adolescents: Updated report from the standardization committee of the International Children's Continence Society. Neurourol Urodyn 35 4 β, Wright, AJ: The epidemiology of childhood incontinence.
Horowitz M: Diurnal and nocturnal enuresis. In Campbell-Walsh Urology , ed. Philadelphia, Elsevier, , pp. Bladder function has a storage phase and a voiding phase. Abnormalities in either phase can cause primary or secondary incontinence 1. In the storage phase, the bladder acts as a reservoir for urine. Storage capacity is affected by bladder size and compliance. Storage capacity increases as children grow. Compliance can be decreased by repeated infections or by outlet obstruction, with resulting bladder muscle hypertrophy.
