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, he can continue for over an hour, needing to urinate every seven or eight minutes. The amount is not much, and I’m not sure 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 and the child indeed exhibits psychological features of frequent urination, then the following should be considered: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 ill-fitting clothing, 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 frequent urination, parents excessively emphasize "not holding urine," or parents frequently anxiously remind the child "do you need to urinate?"—along with the child experiencing stress from schoolwork, family, and interpersonal relationships, or having an impatient or anxious personality—these can all contribute to psychological frequent urination in children.
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b. Treatment Methods
The treatment for psychological frequent urination in children should first prioritize psychological therapy. Therefore, the first step is to identify 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 "frequent urination" depend on urine volume. Only when the bladder is fully expanded (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. 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 expanded), it can lead to weak, feeble urination, a feeling of residual urine, and trigger the next episode of frequent urination, 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 urination to determine how much the child should hold back.
If a child suffers from "psychological frequent urination," parents must fully understand and cooperate with the doctor's treatment methods to achieve success. Otherwise, the condition may be difficult to cure due to some actions taken by parents. For example, some parents are even more anxious about their child urinating than the child is, while others are overly indulgent. If the child says "I need to urinate," they let the child go without restraint, even leaving them on the toilet for extended periods. Therefore, with psychological adjustment and "urinary retention training," children can soon overcome the distress of frequent urination!