Overactive Bladder In Children: Causes And Treatment

An abnormal urge to urinate and a frequency of urination greater than 8 times a day may indicate that the child has an overactive bladder. In this article we tell you what are its causes, its diagnosis and its treatment.
Overactive Bladder in Children: Causes and Treatment

Overactive bladder in children is a syndrome that causes an urgent need to urinate. In these cases, the need is so great that it can even be difficult to control, causing involuntary loss of pee.

Although this problem can occur in both adults and children, in this article we explain what is an overactive bladder in children, what are its causes, how it is diagnosed and what is the treatment.

Overactive Bladder in Children

Overactive bladder (OB) is a syndrome that presents itself as an urge to urinate, that is, an urgent need to urinate. It is usually also accompanied by an increase in frequency. In fact, it is the second most frequent cause of bladder dysfunction in children after enuresis.

The intensity of urgency is so great that in many cases it is impossible to control. Thus, the child may leak urine. This can cause serious problems in the child’s life as it can have a negative impact on their social or emotional life.

Thus, when there is leakage of urine due to the impossibility of controlling the urge to urinate, the child may start to avoid or reject the participation in various activities for fear of suffering losses in front of other people. For this reason, it is important to be aware of the symptoms and consult a specialist as soon as possible.


Overactive bladder nocturnal enuresis in children

First, we should not confuse overactive bladder with other conditions such as enuresis (out of urine only at night). BH can present itself at any time of the day.

In general terms, this problem manifests the following signs or symptoms:

  • Urination frequency of more than 8 times a day.
  • Difficulty controlling the need to urinate.
  • Possible urine leakage.
  • Retention maneuvers such as sitting cross-legged or adopting other positions to try to avoid losses.
  • In extreme cases, it can cause urinary incontinence.
  • The symptoms cause anguish and affect the child’s normal life.

Causes of Overactive Bladder

Current theory indicates that BH could be related to a late maturation of the central nervous system. Thus, when the bladder fills, the inhibitory reflex of urination is not efficiently activated.

This problem could be related to the child’s physical conditions, such as urinary tract abnormalities, bladder or kidney infections and lack of maturation of the central nervous system, as indicated above. However, it could also be related to other conditions such as constipation.

In some cases, it is because the child has not learned how to correctly control urination (a process that usually starts between 3 and 5 years of age). This means that the child has not learned correctly to control the sphincters.

On the other hand, conditions such as mental, behavioral, learning or anxiety disorders, among others, may have the overactive bladder problem as one of their symptoms.


Child learning to control the pee

In order to establish a diagnosis of BH, the doctor will carry out the following tests and exams:

  • Complete medical record. Both parents and child (if you can) should detail their urination habits. The doctor will even ask for a control through a “voiding diary” in which the frequency and intensity of urine are specified. In addition, the professional will consult the medical record for possible triggering problems.
  • Physical Probing. This research will be carried out both in the area of ​​the urinary system and through tests to prove the functioning of the nervous system.
  • Urine Testing. With this procedure it will be possible to establish whether there are infections.
  • Based on evidence from previous tests, your doctor may also advise you to perform an ultrasound or other urodynamic studies to rule out more serious problems.


The treatment of overactive bladder in children will always depend on its causes. So, for example, if it was caused by constipation (in this case, the stool presses on the bladder), the treatment will be aimed at solving this intestinal problem.

In either case, the most common forms of treatment are:

  • Bladder training. It may include scheduling urination (every X hours), urinating twice when going to the bathroom, or relaxing your pelvic floor muscles, among others.
  • In some cases, your doctor may recommend a pharmacological treatment (usually oxybutynin). In this way, symptoms will be relieved until the child learns to effectively control their sphincters. In addition, it would also be possible to prevent urinary tract infections.
  • Parental support. In no case should parents reprimand the child, as it is not voluntary. On the contrary, the child must have your understanding and support. In this sense, a motivational therapy could even be established, stimulating the child with rewards if he/she successfully follows the program.


Parental support in cases of overactive bladder in children

It is important to be aware of the symptoms of an overactive bladder. In fact, as has been proven, it can have a really negative impact on the child’s social, school or emotional health, deteriorating their self-esteem.

Therefore, it is important to consult the doctor if we notice symptoms or signs related to this syndrome. That way, we can first rule out the physical problems and then start a treatment to solve them.

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