Pollakiuria, derived from
pollakis in greek meaning often, is also known as extraordinary daytime urinary
frequency. Pollakiruia is a benign condition defined as frequent small
voids in a previously toilet trained child without evidence of a urinary
tract infection. If your child is urinating frequently it is important to call the office so that we may help you distinguish between pollakiuria and other more serious causes. Urination with pollakiuria may occur every 5-10 minutes with
the child urinating as many as 10-30 times per day. An important distinguishing
factor between polyuria (going the bathroom at an increased frequency secondary
to a pathologic reason such as diabetes) and pollakiuria is that in pollakiuria
the amount of urine voided is very small whereas in polyuria the amount is
usually consistent with a normal voiding volume. The main concern from parents
in pollakiuria is that the frequent urination interrupts school or other daily
activities. The key to pollakiuria is that it occurs only during daytime
hours and most commonly in kindergarten or pre-school aged children. Peak
age is 5-6 years old with a range from 3-14 years old. Also, urine color,
stream and odor are normal in pollakiuria. There should be no change in bowel
habits, pain with urination, abdominal pain or fever. Pollakiruia is a self
limiting condition usually lasting 7-12 months.
Pollakiuria is often brought on by a
psychological stressor such as academic difficulties, bullying, death of a
loved one, relocation to new school, addition of a new sibling, or divorce.
Other triggers may include heightened bladder sensitivity in the colder months
or exposure of the urethra to a chemical irritant (bubble baths, hot tubs,
tight underwear). The diagnosis of pollakiuria is usually made based on
clinical history, physical exam and a negative urinalysis (study of the urine).
Imaging such as an ultrasound is rarely indicated. Treatment includes reassurance
as in most cases it will resolve over days to weeks (however it is not unusual
to take many months). Bladder spasm medications sometimes used in other
conditions have not been found to be of any benefit. The key is to identify the
emotional trigger and allow the child to talk with his/her parents about what
worries them. It may be noted that the urinary frequency only occurs in the
stressful environment and improvement of symptoms following counseling or
resolution of the stressful situation has been seen.
References:
1. Bass,
L. Pollakiuria, Extraordinary Daytime Urinary Frequency: Experience in
Pediatric Practice. Pediatrics. 1991 May;87(5):735-737
2. Hellerstein
S, Lineharger J. Voiding Dysfunction in Pediatric Patients. Clincial
Pediatrics. 2003 (42):43-49
