Urgency, Incontinence and Dysuria

We commonly hear and read about these terms urgency, incontinence and dysuria. But what are these terms all about?

At about 2 years of age, children have developed bladder control (continence). They can briefly hold their urine and can signal their desire to void. 

At 3 years of age, children achieve daytime control and can hold their urine more effectively. At age 4&1/2 years, children are already continent both day and night. This process of initiation and completion of urination requires an intact and coordinated neuromuscular interaction and is developed between 3&1/2 and 6 years of age.

When a child cannot hold his urine when expected of his age, then it is called incontinence. The most common form of incontinence is nocturnal enuresis. 

Some cases can be asymptomatic and can be tolerated however, some need further investigation and evaluation.

Urgency incontinence is usually related to an acute Urinary Tract Infection. It can be a problem especially if associated with dysuria, fever, chills and lower abdominal discomfort.

On the other hand, dysuria refers to pain on urination. If there is terminal dysuria, there could be a problem to the distal urethra. If there is total dysuria, there could be cystourethritis.

These symptoms warrant comprehensive clinical history, physical examination and laboratory work up to identify the problem and to be able to manage the disease entity causing one to have urgency, incontinence and dysuria.