Daytime Wetting (Diurnal Enuresis)

Diurnal enuresis (daytime wetting) is when a child who should be toilet trained has wetting accidents during the day. Children are usually toilet trained between the ages of 2 and 4 years old.

A child can have daytime accidents for several months or even years after being toilet trained. About 3 percent to 4 percent of children between the ages of 4 and 12 years wet during the day. Daytime wetting is twice as common among girls as boys.

There are many possible causes of daytime wetting in children. Some of the common causes of daytime wetting include:

  • Constipation
  • Bladder spasms
  • Infrequent urination
  • Urinary tract infection

Children generally do not wet out of laziness, emotional problems or toilet training methods. Children with medical conditions such as cerebral palsy, Down syndrome and ADHD may be older before they are toilet trained.

  • Urinating often
  • Urgency
  • Weak urinary stream
  • Squatting / grabbing genitals
  • Pain with urination
  • Bed wetting

Talk to your pediatrician or family doctor first if your child is having daytime wetting. Your doctor may suggest that a specialist see your child. Specialists who care for children with diurnal enuresis are pediatric urologists, nephrologists and trained nurse practitioners.

  • A complete medical history and physical exam of your child will be done at the first visit.
  • A urine test will be done to check for a bladder infection.
  • More testing may be needed.    

Behavior Changes

  • Create a schedule for your child to urinate.
  • Change your child’s diet and have him or her drink more fluids.
  • Be positive and give support to your child.
  • Punishment is not effective in treating wetting (enuresis).

Medication

  • Medications that relax the bladder and decrease bladder spasms may be given.
  • Relaxing the bladder can help the bladder hold more urine.
  • Medicines that are commonly prescribed are Ditropan™, Detrol™, and Enablex™.
  • Your child may need to take these medications for several months to years.

Bowel Program

  • It is important for your child to have daily soft bowel movements.
  • Your child should eat a diet with lots of fruit and vegetables. (Drinking more fluids helps keep bowel movements soft.)
  • Your child should try to go to the bathroom around the same time every day.
  • He or she should not be in a hurry when using the bathroom. (Your child should be relaxed while on the toilet.)
  • Sometimes children will need to take stool softeners or laxatives for constipation.

Pelvic Floor Exercises  

  • Pelvic floor exercises are special training sessions for a child who has daytime wetting. 
  • Using a computer, a child is taught to relax the muscles in the pelvic area.
  • Motivation is very important for biofeedback to be successful.
  • A child is expected to do exercises at home, complete diaries and follow a voiding schedule.
  • Daytime wetting and is older than 4 years of age
  • Daytime wetting and was previously dry for six to nine months
  • Complaints of frequent urination, urgency, pain with urination or fever

Last Updated 06/2013