Frequent Urination in Young Children

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