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Voiding pattern and acquisition of bladder control from birth to age 6 years--a longitudinal study
U-B Jansson1, M Hanson, U Sillén
1Department of Surgery, Queen Silvia Children's Hospital and Sahlgrenska Academy, Göteborg, Sweden. ullabritt.jansson@vgregion.se
Insights
Healthy children achieve daytime dryness around 3.5 years and nighttime dryness by 4 years. Bladder sensation awareness emerges early, suggesting toilet training can begin sooner for better bladder control acquisition.
Area of Science:
- Pediatrics
- Urology
- Child Development
Background:
- Understanding typical bladder control development is crucial for identifying potential issues.
- Previous studies have varied in methodology and age ranges, necessitating further research.
Purpose of the Study:
- To describe the voiding patterns and bladder control acquisition in healthy children up to age 6.
- To establish normative data for daytime and nighttime dryness, voiding volumes, and post-void residual volumes.
Main Methods:
- Longitudinal study of 59 healthy children (36 female, 23 male) from infancy to age 6.
- Utilized 4-hour voiding observation, uroflowmetry, and ultrasound every 3-6 months.
- Assessed age of dryness, voiding patterns, bladder capacity, and post-void residual volume.
Main Results:
- Median age for daytime dryness was 3.5 years; nighttime dryness was 4 years, with no significant sex differences.
- Daytime dryness was achieved approximately 10 months before nighttime dryness.
- Bladder sensation reported by 31% at 2 years, 79% at 3 years, and 100% at 4 years; median bladder capacity increased significantly with age.
Conclusions:
- Bladder control acquisition is occurring later than expected, despite earlier bladder function awareness.
- Early awareness of bladder sensation from 1.5 years suggests potential for earlier toilet training.
- Infants with specific early indicators (e.g., small post-void residual volume, large bladder capacity) may achieve daytime dryness sooner.
Purpose:
We describe the voiding pattern and acquisition of bladder control in healthy children up to age 6 years.
Materials And Methods:
We determined age for daytime and nighttime dryness, voiding patterns, voiding volumes and post-void residual volume per 4 hours individually and noninvasively every 3 months up to age 3 years and every 6 months up to age 6 years in 36 female and 23 male patients using 4-hour voiding observation and uroflowmetry/ultrasound.
Results:
Median age for attaining daytime and nighttime dryness was 3.5 and 4 years, respectively. No significant difference was found between girls and boys. All but 1 child attained daytime dryness an average of 10 months before attaining nighttime dryness. Bladder sensation was reported in 31%, 79% and 100% of patients at ages 2, 3 and 4 years, respectively. Median bladder capacity was 67 ml, 123 ml and 140 ml at years 1, 3 and 6, respectively. Median post-void residual volume was 5.5 ml, 0 ml and 2 ml at ages 1, 3 and 6 years, respectively.
Conclusions:
Today bladder control is acquired at a later stage despite earlier awareness of bladder function. The occurrence of bladder sensation from age 1.5 years motivates an earlier start with toilet training. Infants with small post-void residual volume at age 6 months or large bladder capacity will probably attain daytime dryness earlier than those with large post-void residual volume at age 6 months or small bladder capacity.
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