Urinary Issues in Three-Year-Olds: Causes and Concerns

Q: Urinary Issues in Three-Year-Olds: Causes and Concerns

Hello： <br>1. <br>There are many reasons for children to experience sudden urinary incontinence or bedwetting, such as drinking too much water before bedtime, being too cold which reduces the frequency of bathroom visits until they urgently need to urinate, being overly tired dur

Urination patterns in three-year-old children?

Hello Doctor: Our little one is three years and two months old.
Over the past two months, we have noticed some issues related to urination.
Thank you for your patience in reading this.

1.
For the past two months, she has been urinating a little in her pants before going to the toilet.
Sometimes she wets herself three to four times a day, while other times she can go three to five days without wetting.
Is it possible that she has an infection? Does she need to be examined? (She did not have this issue from age two to three.)
2.
Previously, she had no history of bedwetting, but a few days ago, I noticed that her back and pants were slightly wet when she woke up, and the bedsheet was also a little damp.
When she used the potty, she urinated an unprecedented amount (about 220cc).
However, I am confused; does bedwetting usually involve a little bit or a lot? It seems like it should be a full bladder release, right? Why does it seem like she only leaked a little? Can a three-year-old's bladder hold that much?
3.
Last month during a health check, it was found that she has a mild unilateral hydronephrosis (3mm).
What could be the possible causes of this? Are her symptoms related to the hydronephrosis?
4.
What precautions should be taken for pediatric hydronephrosis? Are there specific dietary considerations? Thank you, Doctor.
I appreciate your help! A concerned mother.

Ren Ma, 30~39 year old female. Ask Date: 2005/12/09

Dr. Zhang Peixin reply Pediatrics

Hello:
1.
There are many reasons for children to experience sudden urinary incontinence or bedwetting, such as drinking too much water before bedtime, being too cold which reduces the frequency of bathroom visits until they urgently need to urinate, being overly tired during the day leading to deep sleep at night, or infections.
It is recommended to take the child to the hospital for a urine culture to initially rule out any infections.
2.
The bladder is quite elastic, but frequently holding in urine can lead to infections.
Additionally, if the bladder becomes distended, its elasticity may decrease, leading to residual urine and an increased risk of bedwetting, which is an undesirable habit.
3.
A 3mm dilation is not classified as hydronephrosis, so there is no need for concern, and mild hydronephrosis typically does not present any symptoms.
4.
If hydronephrosis is indeed present, it is important to follow the physician's instructions for regular monitoring.
Dietary recommendations include maintaining a balanced diet, avoiding excessive salt and high protein intake.
Sincerely, Dr.
Zhang Pei-Hsin, Pediatrics.

Reply Date: 2005/12/09

More Info

Understanding urinary issues in young children, particularly in a three-year-old, can be quite concerning for parents. The symptoms you describe, such as frequent urination, occasional bedwetting, and the presence of residual urine, can stem from various causes. Let’s break down your concerns and provide some insights based on medical knowledge.

1. Frequent Urination and Accidents: It is not uncommon for young children to experience episodes of frequent urination, especially if they are transitioning from diapers to using the toilet independently. The fact that your daughter is having accidents, such as wetting her pants before reaching the toilet, could indicate a few possibilities. One potential cause is a urinary tract infection (UTI), which can lead to increased urgency and frequency of urination. Given that this is a new behavior for her, it would be prudent to consult a pediatrician for a urinalysis and possibly a urine culture to rule out infection.

2. Bedwetting and Urine Volume: Bedwetting (nocturnal enuresis) can occur in children for various reasons, including deep sleep, developmental factors, or even stress. The amount of urine she produced (220cc) is significant, and while it may seem unusual for a child to wet the bed with a large volume, it is not unheard of. Children can sometimes leak small amounts of urine due to a full bladder, especially if they are in a deep sleep and do not wake up to the sensation of a full bladder. The bladder's capacity can vary among children, and it is possible for a three-year-old to hold a considerable amount of urine, but it is also essential to ensure that she is not holding it for too long during the day, which could lead to bladder issues.

3. Mild Hydronephrosis: The finding of mild hydronephrosis (3mm) on a recent check-up is another aspect to consider. Hydronephrosis refers to the swelling of a kidney due to a build-up of urine. In young children, this can be caused by various factors, including anatomical abnormalities, urinary reflux, or even external compression. Mild hydronephrosis often does not present symptoms and may not be a cause for concern, especially if it is not progressive. However, it is essential to follow up with your pediatrician or a pediatric urologist to monitor this condition and determine if any further evaluation or intervention is necessary.

4. Diet and Management: In terms of dietary considerations, maintaining a balanced diet with adequate hydration is crucial. Encourage your daughter to drink water throughout the day, but try to limit excessive fluid intake before bedtime to reduce the likelihood of bedwetting. Additionally, establishing a regular bathroom routine can help her develop better bladder control.
In summary, while the symptoms you describe can be concerning, they are not uncommon in young children. It is essential to consult with a pediatrician to conduct appropriate tests and evaluations to rule out any underlying conditions, such as infections or anatomical issues. With proper guidance and management, most children outgrow these issues as they develop better bladder control and habits. Remember, open communication with your healthcare provider is key to addressing your concerns and ensuring your child's health and well-being.

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