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What does it mean if your child wants to pass urine frequently, but the urine test shows no evidence of infection?

Multiple reasons, but it is usually seen when children have a holding behaviour. That is, when they are engrossed in an activity (playing, screen time) they tend to ignore body signals to pass urine or stools until they are no longer able to hold. Then they rush to the washroom but they do not empty their bladder or bowel completely.

When this happens repeatedly, the natural response to a full bladder or bowel sensation is lost. The bladder then contracts frequently even if there is no urine in the bladder. This is interpreted as urine sensation and the child visits the washroom often. Sometimes this may lead to leaking of urine In their underwear. Occasionally parents notice that their toilet trained child is wetting their pants or is preferring to use diapers again. These children are screened for urine infections and structural abnormalities. If all the tests are normal then the child is put on a bladder management schedule. That is the child is consciously taught good bladder and bowel habits. It starts with regular sleep time, drinking adequate fluids, cutting down on screen time. The child is encouraged to visit the washroom every 2-3 hrs. And the child is taught to empty the bladder to completion (they are asked to attempt to void one more time before leaving the washroom). Improvement is gradual. Some children may need medications to reduce the frequent bladder contractions or laxatives to improve bowel movement. Further tests are done if there is no improvement of symptoms.
Bed wetting usually resolves by the age of 5-7 years. Persistent bedwetting beyond 7 years or new onset bedwetting or bed wetting with associated wetting during the daytime need evaluation and management under supervision of a pediatric urologist.

Dr. Lavanya Kannaiyan

Pediatric Surgeon & Pediatric Urologist

Rainbow Children’s Hospital, Banjara Hills