Overactive Bladder in Children: Causes, Diagnosis, and Treatment
Overactive Bladder: An Overview
Overactive bladder (OAB) is an uncomfortable and oftentimes embarrassing chronic condition that causes sudden urges to urinate. Symptoms of OAB are similar in adults and children, but for kids it can be even more shameful and disruptive. Daytime accidents can negatively impact a child’s social and emotional well-being.
If your child is experiencing symptoms of overactive bladder, including the frequent urge to urinate, leaking, and both daytime and nighttime accidents, learn more about OAB and make an appointment with your pediatrician.
OAB in Children
It may seem like frequent urination and accidents are normal parts of being a kid, but past a certain age they’re not. Approximately ten percent of children in the U.S. have symptoms that are severe enough to warrant a diagnosis of OAB. Most common is the regular, or near constant, urge to urinate. This is enough for an OAB diagnosis, but your child may also have accidents, small leaks, or the need to go throughout the night.
Symptoms of OAB
The most common symptom of OAB in children is the urge to go to the bathroom more often than is normal. If your child has OAB, their bladder contracts even when it isn’t full. This gives the sensation of needing to urinate. Your child may not tell you directly that they have the urge, but look for signs like dancing around or jumping from one foot to the other.
Less commonly, your child may experience leakage, especially when active or when sneezing. Your child may also wet the bed at night or have accidents during the day.
What Causes OAB in Children?
There are several possible causes of OAB. In some kids it may be a delay in maturation, and something that will eventually be outgrown. Because bladder contractions are controlled by nerves, OAB may be caused by a neurological disorder.
Diagnosis of OAB
If your child has any signs of OAB you should make an appointment with your pediatrician for a check-up. The doctor will want to give your child a physical exam and hear a history of symptoms. Your doctor may also want to check for constipation and take a sample of urine to analyze for infection or other abnormalities.
Your child may also need to participate in voiding tests. These tests may include measuring the volume of urine, and anything left in the bladder after voiding, or a measure of the flow rate. Your child may also need to have an ultrasound to take an image of the bladder.
Treating OAB with Lifestyle Changes
Unless the problem is especially severe, your pediatrician will likely suggest non-medical strategies for treatment as a first effort. You may be asked to try bladder training with your child, which means sticking to a urination schedule and resisting the urge to go in between.
You may also try limiting certain foods and drinks that can make OAB worse. A moisture alarm used in the bed may help your child learn to wake up in the night when they have to go and to avoid accidents.
Treatment with Medications
If the non-medical strategies fail to help your child, your pediatrician will probably suggest medications. If your child is constipated, a laxative may be prescribed. If your child has an infection, a course of antibiotics will take care of it.
If neither constipation, nor an infection is causing the OAB, your pediatrician may prescribe a drug called oxybutynin. This is a drug that relaxes the bladder and reduces the contractions that lead to the urge to urinate.
When other treatment strategies fail to help relieve your child’s symptoms of OAB, your doctor may want to try nerve stimulation. Because nerves control the bladder’s contractions, stimulating them in a regular manner can reduce the out-of-control spasms that cause urges.
A device can be implanted under the skin near your child’s tailbone. With a small battery, the device delivers electrical impulses that control the bladder’s contractions. More often used in adults, this treatment is only used in children as a last resort. In the few instances in which it has been placed in children, it has been found to be safe and effective.
Chen, Y., Yang, S. S., Chang, S. Overactive Bladder
During Childhood: When and How it Should be Treated. Incont. Pelvic
Floor Dysfunct. 2010; 4(1):13-17. Retrieved November 19, from http://www.tcs.org.tw/issue/Folder/4_1/13_17.pdf
● Device Helps Ease Child’s Overactive Bladder Burden. (2013, February 14). Vanderbilt University Medical Center. Retrieved November 19, 2013, from http://news.vanderbilt.edu/2013/02/device-helps-ease-child-overactive-bladder-burden/
● Overactive Bladder. (2010, May 6). University of Washington School of Medicine and Public Health. Retrieved November 19, 2013, from http://www.uwhealth.org/healthfacts/B_EXTRANET_HEALTH_INFORMATION-FlexMember-Show_Public_HFFY_1105110075319.html
● Urinary Incontinence in Children (2012, June 12). National Kidney and Urologic Diseases Information Clearinghouse. Retrieved November 19, 2013, from http://kidney.niddk.nih.gov/kudiseases/pubs/uichildren/