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Question :
My 8-yr old son frequently urinates in his pants. This happens at least 2 or 3 times per week at different times, almost always during the day. I have punished him but it seems to make no difference. When I ask him about it, he says he just can't hold it, even on a 5 minute drive from day care to home. He is not excessively thirsty, nor is he losing weight, and otherwise he seems healthy. Could this be a medical problem, or is it behavioral?    
Answer
This problem needs evaluation for the cause before labelling it as behavioural. Is he having any soiling due to passage of stools? If, yes a neurological problem should be ruled out. Other problems such as bladder dyssynergia, urinary tract infections, diabetes, VUR etc also have to be ruled out. Consult a pediatric Nephrologist for same.
 
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