What is Overactive Bladder in Children

Overactive bladder is a group of urinary symptoms. With overactive bladder, your child may feel a sudden need to pass urine (urinate). After feeling this sudden urge, your child might also leak urine if he or she cannot get to a bathroom fast enough (urinary incontinence).

Leaking urine is not always unusual for children. Many young children leak urine during the day or at night. Children usually develop better bladder control by age 6–7. However, sometimes these symptoms may interfere with your child’s daily activities.

Overactive bladder is associated with poor nerve signals between your child’s bladder and brain. His or her bladder may get a signal to empty before it is full. Your child may also have very sensitive muscles that make your child’s bladder squeeze too soon.

What are the causes?

This condition may be associated with or caused by:

• A small bladder.
• A defect in the shape of the bladder or the tube that carries urine out of the body (urethra).
• Urinary tract infection. This affects girls more than boys.
• Constipation.
• Behavioral conditions, such as anxiety or attention deficit hyperactivity disorder (ADHD).
• Spasms in the muscles that control the release of urine.
• Neurological conditions, such as spina bifida.
• Stress and anxiety.
• Caffeine.
• Food allergies.
• Holding urine for too long. Children sometimes do this out of habit.
• Obstructive sleep apnea. With this condition, a child’s breathing stops and restarts in quick episodes. It can happen many times each hour. This interrupts the child’s sleep and can lead to bed-wetting.
• Nighttime urine production. The body usually makes less urine at night. If it makes more, the child will need to urinate.

What increases the risk?

Your child is more likely to have an overactive bladder if he or she has:

• A family history of the condition.
• ADHD.
• Obstructive sleep apnea.
• Slow growth or development.

What are the signs or symptoms?

Symptoms of this condition include:

• Sudden, strong urges to urinate.
• Urinating at least 8 times during the day.
• Not being able to get to the bathroom in time.
• Bed-wetting.
• Frequent nighttime urination.
• Pain when passing urine.
• Attempting to hold urine.
• Dribbling after passing urine or feeling the need to urinate right away.

How is this diagnosed?

Your child’s health care provider may suspect overactive bladder based on your child’s symptoms. The health care provider will:

• Do a physical exam and take your child’s medical history.
• Order a blood or urine test to check for possible causes, such as infection.

Your child may also need to see a health care provider who specializes in the urinary tract (urologist). If obstructive sleep apnea might be the cause of the condition, your child may need to see a sleep specialist.

How is this treated?

An overactive bladder often goes away on its own as the child gets older. For overactive bladder that does not go away over time, treatment will depend on the cause of the condition and whether it is mild or severe. Options include:

• Bladder training.
  • The child learns to control the urge to urinate by following a schedule that directs him or her to urinate at regular intervals (timed voiding). This keeps the bladder empty.
  • Bladder training also involves strengthening the bladder muscles. These muscles are used to start and stop urination. Your child will need to learn how to control these muscles.
• Diet changes, such as:
  • Not eating foods or drinking liquids that contain caffeine.
  • Drinking less fluids. If bed-wetting is a problem, your child may need to cut back on fluids in the evening.
  • Eating a healthy and balanced diet to prevent constipation.
• Medicines, such as:
  • Antibiotics to treat a urinary tract infection.
  • Antispasmodics to calm the bladder muscles.
• Preventive measures:
  • Having your child empty his or her bladder right before going to bed, and waking up your child at night to urinate. This may be helpful if bed-wetting is a problem.
  • Using moisture alarms. These are small pads that you put inside your child’s pajamas. They contain a sensor and an alarm. When your child wets the bed, the alarm makes a noise to wake up the child. Another person might need to sleep in the same room to help.

Follow these instructions at home:

• Give over-the-counter and prescription medicines only as told by your child’s health care provider.
• If your child was prescribed an antibiotic medicine, give it as told by your child’s health care provider. Do not stop giving the antibiotic even if your child starts to feel better.
• Help your child make any diet or lifestyle changes that are recommended by your child’s health care provider.
• Keep all follow-up visits as told by your child’s health care provider. This is important.

Contact a health care provider if:

• Your child has a fever.
• Your child’s pain or discomfort gets worse.

Get help right away if:

• Your child is in extreme pain.
• Your child’s bladder control is not suitable for his or her age.

Summary

• Overactive bladder refers to a condition in which your child has a sudden need to pass urine.
• Many conditions may lead to an overactive bladder in children.
• An overactive bladder often goes away on its own as the child gets older.
• If treatment is needed, it may include bladder training, diet changes, and medicines.
• Follow instructions about changing your child’s diet, giving medicines, and when to get medical help.