Urinary Issues in Children: When to Seek Medical Advice

Children sometimes experience urgency to urinate and at other times do not urinate?

Hello doctor, my son is 8 years old.
Since he started elementary school, he often doesn't drink water or urinate while at school, sometimes going 4-6 hours without urinating.
When he gets home, he sometimes has difficulty urinating, but if I encourage him to drink water, he will need to go shortly after.
His urine is somewhat yellow and has a slight odor, but there are no bubbles.
At home, we make sure he drinks water regularly, but within half an hour, he often runs to the bathroom.
Sometimes, when he's playing, he doesn't fully empty his bladder and will need to go again after about 5 minutes.
However, when he's playing in the park, even though he drinks water, he doesn't mention needing to urinate.
Should I take him to see a doctor? He says he doesn't feel unwell, but I'm very worried.
Thank you for your help.

Danxin Xiaohai de Mama, 30~39 year old female. Ask Date: 2021/11/23

Dr. Chen Jiansheng reply Urology

Please seek medical examination.

Reply Date: 2021/11/23

More Info

When it comes to urinary issues in children, it is essential for parents to be vigilant and proactive in seeking medical advice, especially when there are noticeable changes in their child's urination patterns. In your case, your 8-year-old son exhibits several concerning behaviors regarding his urinary habits, which warrant further evaluation.

Firstly, the fact that your son often goes without urinating for 4-6 hours while at school and then has difficulty urinating upon returning home raises some red flags. While it is not uncommon for children to become engrossed in activities and neglect their need to urinate, the combination of infrequent urination and the need to drink water before he can urinate could indicate an underlying issue. The yellow color and odor of his urine, while not necessarily alarming, can suggest dehydration, especially if he is not drinking enough fluids throughout the day.

It's important to consider the following factors:
1. Fluid Intake: Children should be encouraged to drink water regularly throughout the day, especially during school hours and while engaging in physical activities. If your son is not drinking enough, it could lead to concentrated urine, which may explain the yellow color and odor.

2. Urinary Frequency: The need to urinate frequently at home, especially after drinking water, could indicate a possible overactive bladder or a lower bladder capacity. This is often seen in children who may feel anxious or pressured in certain environments, such as school.

3. Behavioral Factors: Children may sometimes hold their urine due to distractions or discomfort in using public restrooms. If your son is reluctant to use the restroom while at school or in public places, it may be beneficial to discuss this with him to understand any fears or anxieties he may have.

4. Physical Examination: Since your son does not express any discomfort, it is still advisable to have a pediatrician conduct a physical examination. They may check for any signs of urinary tract infections (UTIs) or other underlying conditions that could be affecting his urinary habits.

5. Urinalysis: A simple urinalysis can provide valuable information about your son's urinary health. It can help rule out infections, assess hydration status, and check for any abnormalities in the urine.

6. Consultation with a Specialist: If the pediatrician finds any abnormalities or if your son's symptoms persist despite increased fluid intake and encouragement to urinate regularly, a referral to a pediatric urologist may be necessary. They can conduct further evaluations, such as bladder function tests, to determine if there are any underlying issues that need to be addressed.

In summary, while your son may not currently show signs of discomfort, the changes in his urinary habits and the potential for dehydration are reasons to seek medical advice. It is always better to err on the side of caution when it comes to children's health. Regular check-ups and open communication with your child about their bodily needs can help ensure that any issues are identified and managed early on. Encouraging a healthy fluid intake and regular bathroom breaks, especially during school hours, can also contribute to better urinary health.

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