Patient's question:
My baby (boy) is now 15 months old. Since birth, he has been urinating more frequently than other children. About an hour after drinking water, he starts well, urinating every 30 minutes. After urinating twice like this, he can continue for over an hour, needing to urinate every seven or eight minutes. The amount is not much, and I don't know if it's normal. I hope the experts can help me.Doctor's answer:
Hello: Regarding the issue of frequent urination in children, parents should first consider whether the child has a urinary tract infection. They should also consider whether there are issues such as phimosis, balanitis, overactive bladder, vesicoureteral reflux, or stones. If all tests show no abnormalities, it is indeed possible that the child exhibits psychogenic urinary frequency.a. Causes
Children's psychological development is not yet mature, making them easily influenced by external environments, suggestive language, and other factors. Their control, stress resistance, and expressive abilities are still relatively weak. Therefore, even mild stimuli, such as residual urine stimulating the foreskin and genital area, discomfort from clothing friction, the sound of flowing water, or whistling, can trigger the urge to urinate. Additionally, parental habits and personality traits can also affect the child. For example, if adults suffer from urinary frequency, parents overly emphasize "not holding urine," frequently anxiously remind the child "do you need to urinate," or the child faces stress from schoolwork, family, and interpersonal relationships, or if the child has an impatient or anxious personality, these can all contribute to psychogenic urinary frequency in children.
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b. Treatment Methods
The treatment for psychogenic urinary frequency in children should first and foremost be psychological therapy. Therefore, the first step is to understand the underlying cause, followed by behavioral therapy, also known as "urinary retention training."
Parents may be puzzled: isn't holding urine unhealthy? Why would we teach children "urinary retention training"? In fact, "holding urine" and "urinary frequency" depend on urine volume. Only when the bladder is fully stretched (400 milliliters or more) is it considered holding urine. For 200-300 milliliters, it is merely the normal storage process of the bladder and is also necessary for effective bladder contraction. Because the bladder must swell to a certain extent (200 milliliters or more) for urination to be forceful; otherwise, if the urine volume is too low (the bladder is not sufficiently stretched), it can lead to weak, feeble urination, a feeling of residual urine, and trigger the next urinary frequency, creating a vicious cycle. Therefore, "urinary retention training" aims to control the urge to urinate by increasing the bladder's storage capacity, but it should not exceed the bladder's capacity of 400 milliliters. Of course, "400 milliliters" cannot be measured directly, so parents should observe the amount of urine each time the child urinates and the speed of urine flow to determine how much the child should hold back.
If a child suffers from "psychogenic urinary frequency," parents must fully understand and cooperate with the doctor's treatment methods to achieve success. Otherwise, it is highly possible that some actions by parents could make the condition incurable. For example, some parents are even more anxious about their child urinating than the child themselves, while others are overly indulgent, allowing the child to go whenever they say "I need to urinate" and even letting them sit on the toilet indefinitely. Therefore, with psychological adjustment and "urinary retention training," let the child overcome the distress of urinary frequency as soon as possible!