Continence problems not tackled in childhood are more likely to continue into adolescence with a potentially “devastating” impact on teenagers’ lives, according to a major new study.
It is, therefore, vital that clinicians are able to identify those at risk of ongoing bladder and bowel issues and ensure they get the right help, said the study authors.
“There’s lots of professional help available and it’s important to access it in good time”
Researchers from the University of Bristol looked at data on urinary incontinence for more than 8,700 participants in the long-term Children of the 90s study.
Reports were made by parents on several different occasions when their children were aged between four and nine.
The research team compared this data with information that two thirds of the group – nearly 6,000 young people – provided about themselves when they were aged 14.
They found that between the ages of four and nine, almost one in six children – 15.6% – experienced bedwetting.
One in 20 – 5.8% – wet themselves during the day, while 7% were wet both during the day and at night.
Strikingly the study found those who wet themselves during the day and night in childhood were significantly more likely to still be wetting the bed aged 14, with a 23-fold increased risk of the problems continuing.
It compares to a three-fold increased risk of bedwetting for those who only had continence problems at night when younger.
“We hope this research will raise awareness of the issue and encourage more people to seek help and support”
Children who wet themselves during the day – but not at night – had a 10-fold increase risk of still have the same problem in adolescence compared to children with normal bladder control. They were also more likely to report delaying going to the toilet and having hard stools.
Almost two thirds of children could control their bladder by the age of four or five but 8.6% could not do this until they were older.
Those who were older when they achieved bladder control were more likely to be wetting the bed aged 14.
By the age of 14 the study found 2.9% of participants were wetting themselves during the day and 2.5% were bedwetting.
The findings show 4.8% had a sudden need to urinate, 2.7% had to go to the toilet frequently, while 9.2% said they had woken during the night and gone to the toilet “quite often” or “a lot” it the past two weeks.
A significant proportion – 13.7 % – of 14-year-olds who took part said they had avoided going to the toilet until the last minute.
The study authors said it was important for clinicians to understand the risks of incontinence problems continuing into adolescence and later life.
“The awareness of long-term outcomes of childhood incontinence is important in clinical practice, as this implies that some children need to be assessed regularly and prioritised for treatment,” said the paper in the journal BMJ Open.
“Owing to the well-documented economic and social impacts of incontinence, there is a need to identify patterns of childhood incontinence that are less likely to resolve with age,” it stated.
Lead researcher, Carol Joinson, said a “wait and see” approach was not always appropriate and health professionals should support families to get the help they needed.
Untreated childhood urinary problems may persist into teens
“Incontinence gets harder to treat as children grow older. It also becomes more socially unacceptable, which can significantly impact on a person’s quality of life, mental health and ability to hold down a job,” she said.
“There’s lots of professional help available and it’s important to access it in good time,” she added.
Juliette Randall, chief executive of children’s bowel and bladder charity ERIC hoped the research – believed to be one of the largest studies of incontinence – would help raise awareness.
“The impact of struggling with continence issues can be devastating for children, teenagers and their families and we hope this research will raise awareness of the issue and encourage more people to seek help and support,” she said.
Young people involved with the charity have worked with the University of Bristol researchers to develop teen-friendly material for its website.
ERIC also runs a confidential helpline for parents and young people as well as providing resources and training for professionals.