When does it become a medical issue?

[mablemaybe]

Three year old constantly wets himself. 6 or 7 times a day. He can be dry for a few hours, then suddenly 4 or 5 accidents in quick succession even with toilet trips (where he does a wee) in between.

Looked into usual causes - no UTI, no constipation.

Nursery are at a loss as to causes.

The thing is, he WAS dry, for several months when first potty trained.

I've read on here that some people got their kids referred to continence teams at the hospital for medication for overactive bladder. At what point should we go down that route?

It's been 4 months of accidents.

He’s only 3. Lots of kids his age aren’t fully potty trained. Boys especially can take longer. Go back to pull ups for a while and try again in a couple of months.

You know as a parent when something's wrong. Waiting time is long but no harm in asking for a referral. It is a bit chore-some with completing diaries etc but at least you know you're doing all you can.

It is generally a nursing service but with deep knowledge of common continence issues, and healthy behaviours to work on. They cannot prescribe all the medications under the sun but the main ones, enough to deal with most issues that could be explained by something like constipation or overactive bladder.

They generally will asses how much he's drinking a day, how much he drinks in one go, whether he's a guzzler or a sipper, and his bowel movements (type, regularity, smell, colour). They won't begin to look at wetting until they're certain there isn't constipation involved. We found they won't offer overactive bladder medication unless DC can fully void (shown on a bladder ultrasound scan before and after wee) and until age 5.

Right now, I would encourage him to practice fully/double void, ask him to do a wee, and then ask him to do another little one when you can, to see if that makes a difference.

I'd also check for certain on the constipation by giving him a bowl of sweetcorn and see how long it takes to go through him (1-2 days = normal traction, more than that indicates constipation)...at least then you could be armed with this knowledge before an appointment.