Urinary Retention Issues in Children: A Parent's Guide

Children's urinary retention issues?

My daughter is 8 years old and often exhibits behaviors of holding in her urine.
This occurs both at home and outside.
When she feels the urge to urinate, she often cannot sit still or stand comfortably.
When asked if she needs to go to the bathroom, she always replies no.
Then, after about ten minutes, she urgently rushes to the restroom.
When I ask her why she holds it in, she always says she doesn't feel the need to go.
Sometimes she can go 5 to 6 hours without using the bathroom, and I have to force her to go, and even then, she is reluctant.
Once she gets to the bathroom, she is in a hurry.
Sometimes she also drinks very little water and does not proactively drink on her own.
At night, when she feels the urge to urinate, she tosses and turns for over ten minutes, trying to hold it in.
Sometimes she leaks a little before rushing to the bathroom.
I wonder if this is related to her daytime behavior.
Should I encourage her to get up and use the bathroom when she is restless? Could this create a habit? She also experiences constipation but takes medication regularly, so her bowel movements are relatively smooth.
I'm unsure if this is related.
Should we see a urologist or a nephrologist? Is there anything we should record before seeing a doctor? Thank you for your response.

Even, 40~49 year old female. Ask Date: 2017/10/05

Dr. Xiao Kaiwen reply Pediatrics

Behavioral training can be initiated, such as implementing appropriate punishment.
If there is any leakage, assistance should be provided to clean the underwear, or privileges related to their favorite activities may be revoked.
Positive reinforcement should be given for proactive and correct urination.
A referral to a pediatric nephrology department at a major hospital can be made for urine tests or simple urodynamic studies to rule out conditions such as urinary tract infections, diabetes, proteinuria, or anatomical abnormalities.
Only severe constipation would significantly affect urination.

Reply Date: 2017/10/05

More Info

Understanding urinary retention issues in children can be quite challenging for parents, especially when it involves behaviors like holding urine for extended periods. Your daughter's situation, where she frequently delays going to the bathroom despite showing signs of urgency, raises several important considerations regarding her urinary health and overall well-being.

Firstly, it's essential to recognize that children may sometimes have difficulty recognizing their body's signals for urination. This can be due to various factors, including developmental stages, anxiety, or even behavioral patterns that have formed over time. In your daughter's case, her reluctance to go to the bathroom and the long intervals between urination could indicate a learned behavior where she has conditioned herself to ignore her body's signals. This can lead to urinary retention, which is not only uncomfortable but can also increase the risk of urinary tract infections (UTIs) and other complications.

The fact that she sometimes experiences urgency after holding it for a long time suggests that her bladder may be filling beyond its comfortable capacity. The bladder is a muscular organ that can stretch to accommodate urine, but consistently holding urine for extended periods can lead to overstretching and potential dysfunction. Additionally, if she is not drinking enough fluids, this can exacerbate the situation, as concentrated urine can irritate the bladder and lead to discomfort.

Regarding her nighttime behavior, if she is tossing and turning and struggling to get up to use the bathroom, it may be beneficial to encourage her to go to the bathroom before bed. If she wakes up during the night and seems restless, gently prompting her to use the bathroom may help prevent accidents and reinforce the habit of responding to her body's signals. However, it's crucial to approach this without creating anxiety around urination, as stress can further complicate the issue.

The connection between her urinary habits and her constipation is also worth noting. Constipation can lead to a full rectum, which can put pressure on the bladder and make it more difficult for a child to recognize the need to urinate. Since you mentioned that she is on medication for constipation and has regular bowel movements, it would be beneficial to monitor her diet and fluid intake to ensure she is getting enough fiber and hydration, which can help alleviate both constipation and urinary issues.

As for seeking medical advice, it would be prudent to consult with a pediatric urologist or nephrologist. These specialists can provide a comprehensive evaluation of her urinary habits and determine if there are any underlying medical issues contributing to her symptoms. Before the appointment, keeping a detailed record of her fluid intake, urination patterns, any instances of urgency, and bowel habits can provide valuable information for the healthcare provider.

In summary, your daughter's urinary retention issues may stem from a combination of behavioral patterns, hydration habits, and possibly her bowel health. Encouraging regular bathroom breaks, ensuring adequate fluid intake, and consulting with a specialist can help address these concerns effectively. It's essential to approach this situation with understanding and support, helping her develop a healthy relationship with her body's signals.

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