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During normal development, children become more aware of their bladders. This maturation process allows the ability to control their bladder and prevent wetting. Children learn to override the normal tendency of the sphincter to relax by contracting their sphincters, thus staying dry. This is a normal reaction of a child to prevent wetting and allows a child time to get to a bathroom. However, an unhealthy situation occurs when a child continues to maintain a contracted sphincter against a full or straining bladder (holds for long periods of time). This, in essence, sets up two muscles working against each other. Over time, the muscle will become to large, with the bladder wall reaching two to three times its normal thickness because of muscle fiber enlargement. In severe cases, damage to the kidneys can occur.
The exact cause is unknown, but there is a behavioral component to the change in the bladder caused by excessive holding and increased bladder irritation.
It is very important to remember that the behaviors that have created bladder instability often begin long before any symptoms are identified. Therefore, it will likely take time to reverse the habits and changes which have occurred. It takes dedication and commitment to ensure that treatment is followed closely.
Urology - Pediatric