PEDIATRIC UROLOGY

doi: 10.1590/S1677-55382010000400029

Later toilet training is associated with urge incontinence in children
Barone JG, Jasutkar N, Schneider D
Division of Urology, Section of Pediatric Urology, Robert Wood Johnson Medical School, New Brunswick, NJ, USA
J Pediatr Urol. 2009; 5: 458-61

• Objective: The objective of this study was to determine if later toilet training is associated with urge incontinence in children.
  Methods: We used a case-control study design to yield level 2 evidence.
  Results: Initiation of toilet training after 32 months of age was associated with urge incontinence (P=0.02).
  Conclusion: For children who display signs of toilet-training readiness, training should be initiated prior to 32 months of age to reduce the risk for urge incontinence.

• Editorial Comment
  This was a case controlled study matching 58 patients who presented to a pediatric urology office with urge incontinence and 157 controls from a general pediatric practice. The patient ages range between 4 and 12 years. Parents were given a questionnaire that included demographics, socioeconomic status, urinary symptoms, and age at the initiation of toilet training. Parents also indicated whether they used a child or parent-oriented approach. The investigators found that the only statistically significant difference between cases and controls was the mean age at toilet training. Patients with urge incontinence were trained at a mean age of almost 32 months whereas the control group was trained at just under 29 months. There was no difference in the type of toilet training method utilized.
  Parents are often interested in getting advice on when and how to potty train their children. The study shows an association between urge incontinence and potty training at a later age. The authors point out that there is data to suggest that potty training at an age less than 27 months might not be helpful either. Certainly, each child and family must be looked at individually; however, we now have more evidence to suggest that there may be an “ideal time” to initiate potty training.

M. Chad Wallis
Division of Pediatric Urology
University of Utah
Salt Lake City, Utah, USA
E-mail: chad.wallis@hsc.utah.edu