My 13 year old son stains his underwear

[Jane]

I have a bright, funny 13 year old son.  He does well in school, yet was diagnosed with ADD 2 years ago.  He was never put on medication as the trial that the doctor did proved inconclusive. While he is in school he does not very often have this problem of stained underwear, but when home on vacation, out of his normal routine, seems to develop this problem.  He has been treated for constipation before, because he was holding it, causing himself to get backed up.  This doesn't seem to be the problem now though.  He didn't train easily as a toddler and we had him to a couple of different urologists.  One said "busy boy syndrome" and the other said he'd grow out of it.  He had trouble getting there in time for urination and bowel movements.
  I'm concerned that this is a psychological problem. He doesn't like to talk about it and is obviously embarrassed when I ask him about it. He plays video games incessantly and is very engrossed in them.  Could it be that he is concentrating so much on the games that he doesn't notice the sensation of having to go?  This isn't good for a child of his age.  Please offer some advice.
Frustrated and worried Mom

[jus]

Your son probably isnt wiping that well after he goes to the bathroom.  Little stains in the underwear certainly isnt a problem at all, however, if they are very large ones, talk to him, and ask him what could be the problem.  Overall though, I wouldnt get to upset anout this situation.

[Kevin Kennedy, Ph.D.]

Dear Jane,

The information you conveyed does not indicate the presence of an emotional disorder, but rather some carelessness around personal cleanliness and hygiene. My inclination would be to treat this as such, and request that your son's pediatrician or other health care providers have a brief private talk with him. It is likely as he continues to develop that he will take more interest in this issue and display a more mature approach.