One of the most embarassing and stressful condition for a child is represented by the presence of urinary incontinence during the day and/or at night. The physiologic urinary sphincteric control (which follows the fecal control) usually occur around the age of 2 years, initially during the day and subsequently also at night.
The persistence of incontinence of urine, exclusively during the night, in a child at least 5 years old is defined as primary mono-symptomatic nocturnal enuresis. It represents a very frequent and common situation in children, with a nearly 10-15% incidence at 6 years but with a spontaneous annual resolution rate around 15% and a reduced final rate of only 1% in the adolescent/adult population.
It is very important to exclude any associated problem during the day which may lead to a sudden and involuntary urine loss (ie wet underpants) because of urgency symptoms. This specific condition is not secondary to a UTI but it is linked to a bladder dysfunction related to an immature behaviour which generates involuntary bladder contractions (hyperactive bladder) and micturating urgency.
The Pediatric Urologist task is to be able to judge and correctly analyze all elements (familiarity, anatomical and/or functional aspects) which determine the urinary incontinence and to identify the best and most appropriate therapeutic solution to make the child eventually dry!