In this section
Bowel and bladder dysfunction
Urinary Tract Infection
Urinary incontinence is defined as day wetting in a child over 5 years of age that occurs more than once per month for ≥ 3 months.
Functional causes of incontinence in children include:
Red flags feature in Red
Previously ever been dry during the day? If there has never been a period of dryness noted, or child has continuous incontinence/dribbling (not intermittent) strongly consider anatomical abnormalities.
Symptoms: voiding frequency, incontinence, urgency, nocturia, polyuria, holding manoeuvres (eg standing on tiptoes, crossing of the legs, or squatting with the heel pressed into the perineum), straining, weak stream, intermittency, dysuria.
Completed Bladder Diary
Look for comorbidities and treat as appropriate (see Initial Management):
A focused physical examination will assist in identifying underlying conditions/causes of incontinence.
Renal tract ultrasound (with pre and post void residual).
Pharmacological management is second line treatment. It should be commenced by local paediatric team or continence service. Behavioural modification should continue throughout treatment.
Oral. First-line option.
DitropanTM 5mg Tablets*
Transdermal route (OxytrolTM patch- off label
< 12 yo) can be used if patient can’t swallow or can’t tolerate oral oxybutynin. Do not cut or divide patches as drug release characteristics may be affected.
AMH Children’s Dosing Companion (online). Adelaide: Australian Medicines Handbook Pty Ltd; 2017 July. Available in
If red flags for other disorders are present, refer as appropriate.
For emergency advice and paediatric or neonatal ICU transfers, call the Paediatric Infant Perinatal Emergency Retrieval (PIPER) Service: 1300 137 650.
Day time wetting and Bladder retraining
Urinary Incontinence (Raising Children Network)
Day wetting (Continence Foundation of Australia)
Last revised July 2018