(Apologies in advance that this is pretty detailed!). My nearly 5-year old son has been potty trained since he was about 2 and 10 months and never has proper accidents during the day (ie wet trousers from a completely emptied bladder). However, whilst he has always very reliably informed us before he needs a poo, I have never, ever seen him show any signs of needing a wee (eg hopping up and down, touching his willy, etc) and he only ever spontaneously asks to go to the loo when he has a small damp patch in his pants. Whilst I can guarantee that if he has asked to go to do a wee that the damp patch will be there when we get to the toilet, he does not have to run to the toilet to make it on time when he does ask - he can take time for us to find a toilet, so I don't think this is simply because he is just holding on too long and no longer able to hold the urine in, as once he's leaked a really tiny amount, he can consciously hold on for some time. And if asked to go to the loo before we go out, he has no problems doing this - there is nothing wrong with his urine flow or voluntary control, just something a bit off with his "subconscious" control. In addition, whilst he was mostly dry at night for about a year (ie would have one or two accidents about every two months, usually when run down), he is now (since April) wet every single night and has had to go back into nappies at bedtime. He has never, ever, woken up to do a wee - it's just that his bladder used to be able to hold on all night and now it can't.
How normal is this damp-pants syndrome in a 5-year old? Is this apparent lack of sensitivity to a gradually filling bladder something I should worry about? He had 3 lumbar punctures as a baby, so I am always paranoid that somehow some kind of nerve damage was done (particularly since 2 of the LPs were not done well and resulted in blood contamination in the spinal fluid, making the procedure a waste of time...), so would be grateful for some reassurance. (And yes, I know the chances of permanent damage having been done are extremely low).
Also (if there are any drs. reading this), he recently had a urine infection, following a bout of balanitis, and an ultrasound was done of his bladder. Apparently, he does not fully void his bladder when peeing, but the amount left behind is not sufficient for this to be thought a cause of his urine infection (which was most likely the severe balanitis), it's just "not ideal". Why would he have this problem??? Is this the cause of his damp pants? And/or is it a result of the fact that he has mild hypotonia (and EDS hypermobility type)? Will it get better over time? Or worse??? Should I be asking more questions of doctors about my son's minor incontinence, or just assuming that it will get better on its own as he matures? He does not suffer from constipation, by the way - or not so far as I can tell, since he empties his bowels every day and has never had faecal incontinence.