What Evidence Do We Need to Improve the Attainment of Bladder and Bowel Control in Children and Prevent Negative

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Alexander von von Gontard1, Giovanni Mosiello2, Tufan Tarcan3

  • 1Department of Urology, Governor Kremers Centre, Maastricht University Medical Centre, Maastricht, The Netherlands.

Neurourology and Urodynamics
|February 3, 2026
PubMed

Insights

Childhood incontinence, including nocturnal enuresis and fecal incontinence, can persist into adulthood, posing medical and mental health risks. Identifying risk and protective factors early is crucial for prevention and improved clinical care.

Area of Science:

  • Pediatric Urology
  • Childhood Functional Disorders
  • Continence Management

Background:

  • Nocturnal enuresis (NE), daytime urinary incontinence (DUI), fecal incontinence (FI), and functional constipation (FC) are prevalent childhood functional disorders.
  • These conditions can persist into adolescence and adulthood, impacting long-term health and well-being.

Purpose of the Study:

  • To review evidence on risk factors hindering bladder/bowel control attainment and contributing to persistent incontinence.
  • To outline protective factors that minimize long-term negative sequelae of childhood incontinence.

Main Methods:

  • A multidisciplinary expert think tank group from the International Consultation on Incontinence Research Society (ICI-RS) reviewed existing evidence.
  • Both prospective and retrospective data were considered, with discussions on future research directions and clinical practice improvements.

Main Results:

  • Childhood incontinence can extend into adulthood, associated with increased medical and mental health risks.
  • Identified risk factors include genetics and environment (e.g., late toilet training, prolonged diaper use, digital media, lack of transitional care).
  • Research on prevention strategies and the interaction between risk and protective factors is lacking.

Conclusions:

  • Childhood incontinence often precedes adult incontinence, necessitating early preventive measures.
  • Future research should prioritize identifying both risk and protective factors.
  • Enhanced collaboration between pediatric services and adult urology is essential for improved patient outcomes.
Abstract

Keywords:
adolescent urinary incontinenceadult urinary incontinencefecal incontinencefunctional constipationgeneticsnocturnal enuresispreventionrisk factorstoilet trainingtransition

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