DS won’t stop wetting pants

[CloverPyramid]

DS is currently 3 years 10 months and we potty trained him at 2 years 9 months. It was remarkably easy and he went 7 months without any issues and very rare accidents. Then he started wetting himself every day. Not full on puddles on the floor, but pants are very wet and it can be seen on trousers. It’s been ongoing for 6 months now.

He still takes himself to the toilet with no prompting at least once an hour. He fully understands the feeling of needing a wee. Yet he’s still managing to wet himself in between visits. It’s not that he’s too engaged in fun activities, it happens during boring routine activities as well.

We’ve been to the doctor who ruled out any medical issues (UTI, diabetes etc). He poos normally (no accidents there either) so we know it’s not constipation causing it. We’ve stopped blackcurrant (and all) squash entirely since the issue began as we heard that could cause bladder issues. We don’t let him drink excessive amounts of water. The wettings don’t align with any particular time of day (eg being tired, after a drink etc).

We’ve tried various reward incentives. Sticker charts with toy rewards. Special pants that he picked out and doesn’t want to wet. Tons of praise and treats when he has a dry day. We’ve talked about it repeatedly (over six months, we’re not lecturing him daily or anything). None have worked.

I hoped if the rewards and positivity didn’t work, he’d just grow out of it by himself but it’s been 6 months now. If he was a month older, he’d be starting school still having daily accidents.

What else can we do? I’m open to anything.

Could he be impacted? Is his poo always very soft? Try reading the Eric continence website

Gosh that's frustrating. How does he react when wet? Rush to change himself? Upset? Or keeps playing?
Any big changes like new sibling?

If you want your boy to be able to hold their wee longer, the advice we were given was to fill the bladder up.

So actually encouraging our child to drink more water so the bladder stretches and learns to hold more (rather than giving less water when my child was having accidents).

If he goes to the toilet to wee every hour it's really odd he's still wetting his pants too. I'd take him to his GP and ask for a bladder scan. Most DC this age only go to wee once every 2 hours.

My DS is 10 and is finally starting to grow out of these small accidents. He potty trained really easily soon after he was 2 and he was immediately dry at night. He has never once wee'd in his sleep. But until recently he regularly (a few times a week) failed to go to the toilet when he needed to and ended up with wet shorts. In his case he just always left it too late/forgot/refused to go unless he was bursting. Finally he has realised that this is no way to live and has decided he doesn't want to piss himself when he goes to secondary school next year and has started to pay attention to his bladder.

Some of the reading I have done around this over the years has suggested that he should be drinking more not less in the day time. This helps the bladder appropriately trigger the feeling of needing to go and ensures the kidneys etc are working as they should. I don't know the science behind it but I would think restricting fluids probably not a good idea.

See if you can get a referral to your local bladder and bowel team.

But it sounds as others have said as though he is just not letting his bladder fill fully - if you're restricting drinks and he's going every hour, then he's only ever letting a trickle out. Our bladder nurse advised having a proper drink, not sips from a water bottle throughout the day - a whole drink of water with breakfast, go to the loo at break or what would be break time. A whole drink of water at break, loo before lunch. Whole drink of water with lunch, loo mid afternoon. You get the picture. The water bottle culture where they just sip throughout the day stops them from understanding the sensation of having a big drink, getting a properly full bladder, and then releasing a full bladder.

Going to the toilet every hour doesn’t sound right. My son is the exact same age and he can go 2-5 hours between having a pee. Is every hour normal? I would think that’s maybe linked to the problem.

Needing to wee every hour and still having wet pants is not right. I'd go back to the doctor and ask for further investigations.

In the meantime, he should be drinking more, not less, to stretch his bladder. Never deny/limit his water intake to stop him wetting his pants.

If there is no physical cause then I think something like anxiety/nervous bladder will be to blame. How does he feel/respond when he has an accident? Can you pinpoint anything that happened around the time he started wetting himself?

Who looks after him apart from you? Do you use childcare/grandparents/family friend etc?

Thanks for advice everyone!

No big life changes or anything that happened around the time the issue started. He isn’t upset about being wet, just annoyed at having to change pants. I can’t tell if he is unaware he’s done it or aware and just doesn’t care. We’ve tried various reactions to the wetting (never angry or unkind- just different approaches like no reaction, talking about it at the time, talking about it later, pointing out that we have to stop activities to change) but he just isn’t fussed. He goes to nursery and has the same issue there, but because he takes himself to the toilet regularly and it’s only one accident a day and contained in his trousers they don’t necessarily notice it’s happened.

Sorry to have misrepresented, but we’re not restricting his water intake and he isn’t going to the toilet every hour religiously. I was trying to head off the two most common questions that always come up when I ask about this: “does he drink too much?” and “does he go to the toilet often enough?” and have badly phrased it, it seems. Apologies.

We don’t restrict his water at all and he drinks the same as any similar aged child as far as I can tell. I just mean we don’t let him down huge amounts or sip a water bottle constantly. For the toilet, he takes himself anywhere between 1-3 hours and often does hold it much longer (without accidents). I was just showing that he’s not avoiding the toilet or not knowing the sensation of needing to go.

I’ll try increasing his water intake in case that does solve the issue. And then it sounds like back to the GP is the only other option. Thank you all.