Why is my potty trained child’s underwear occassionally damp?

A mom of a six-year-old patient asked recently, “Why is my daughter’s underwear damp?”

—She’s been potty trained for 3 years.

—She is dry overnight.

—She urinates about 6 times in the daytime.

—She doesn’t complain of pain during urination.

Yet,  her underwear is occasionally slightly wet.

We don’t know if anyone has ever tracked the statistics, but this girl’s cause of damp underwear is common in little girls.  Called vaginal voiding,  vaginal voiding occurs when a girl urinates on the toilet with her legs tightly pushed together. She pulls her pants down minimally, to about mid-thighs so urine gets trapped in the vagina as it comes out the urethra. When she stands up and pulls up her pants, the drop of urine that was trapped in the vagina will drip out into her underwear.

The treatment of vaginal voiding is simple. Make sure your daughter pulls her pants all the way down to her ankles when sitting on the toilet. Encourage her to spread her knees apart while urinating. You could even have her sit on the toilet seat BACKWARDS, facing the back of the toilet. This position forces the knees apart  and prevents any urine from becoming trapped. In turn, her underwear will remain dry.

A reason both girls and boys occasionally have damp underwear is giggle incontinence or cough incontinence, which is exactly what it sounds like—a bit of urine gets leaked during laughing or coughing.

To help kids who leak during coughing or laughing, first make sure that they are not holding in their urine for too long. Have your child do a potty check, as in “go sit on the potty,” every 2-3 hours throughout the day. Try setting an alarm on her iPod or on your cell phone. Often, merely providing enough opportunities during the day to empty the bladder cures the problem of leaking during laughing or coughing.

After trying these simple measures, if your child’s underwear is still wet or your child tells you that she still leaks during coughing or laughing, discuss this problem with your child’s doctor. In addition, please know that while laughing daily is wonderful, daily coughing is not normal.   Your child may need further evaluation for the source of a daily cough.

Damp or wet underwear may not be the most glamorous pediatric topic, but it is important for the kids who suffer from it. Hopefully this post offered a quick fix for some of your kids. You and your laundry machine will be happier.

Julie Kardos, MD and Naline Lai,MD
©2014 Two Peds in a Pod®