Pediatric stress incontinence

    
      Re: Pediatric stress incontinence
    


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Posted by HFHS M.D.-MS on February 23, 1998 at 18:29:44:

In Reply to: Pediatric stress incontinence posted by Steve on February 17, 1998 at 23:49:20:

: My almost 8-year-old son has had a severe case of urinary stress incontinence for years now.  He never was completely toilet-trained.  He is almost always dry at night, and fairly dry when quiet during the day, but immediately starts leaking with any movement, even with a fairly empty bladder.  He never lets a full load go, just leaking.  He wears training pants to school, but can even soak through that by the afternoon, even after going to the bathroom 3 times at school.
  We are presently trying a beeper on him.  If he's active, though, he can go through 4 underpants in an hour with this.  It seems like a long road this way.  A couple of years ago, a pediatric urologist performed a urinary function test (fill the bladder with a catheter, watch it empty).  It seemed normal, except for a somewhat undersized bladder.
  What could be causing this?  Infection?  The urine doesn't show it, but the end of his foreskin is often red from irritation and occasionally swollen.  Neurological?  He says he doesn't feel anything when he's leaking and isn't aware of it.  Structural?  Would Kegals help him?  What would a cystoscopic examination reveal?  That's a possible next step.
  Any enlightenment you could provide would be much appreciated.
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Dear Steve
Thanks for your questions.
There are multiple reasons your son could be leaking and a carefully planned work-up will help determine what is best for him.
With urinary leakage in small amounts all the time, two causes come to mind:overflow urinary incontinence and stress urinary incontinence.  Overflow incontinence occurs is when the bladder is so full it