Pollakiuria , also called extraordinary daytime urinary frequency, is a benign condition defined as frequent small voids in a previously toilet trained child with no polyuria or evidence of infection.  The condition is self-limited with an average duration of 7-12 months.

See also: diurnal enuresis and nocturnal enuresis

Signs and Symptoms:

  • Distinct change in normal voiding pattern to one with increased frequency. Main complaint of parents is frequent urination that interrupts school or daily activities
  • Average frequency is every 15-20 minutes, but can occur as often as every five minutes.
  • Peak age is 5-6yo with a range of 3-14yo
  • Small amount of urine with each void
  • Urine color, stream, and odor are normal
  • Nocturia may be present (25% of patients) but urination is not as frequent as daytime symptoms
  • No incontinence, although a small percentage may develop secondary nocturnal enuresis
  • No changes in bowel habits
  • No dysuria, abdominal, or flank plain
  • Usually associated with a psychological stressor

Differential Diagnosis:

  • Neurogenic bladder
  • May present with weak and dribbling stream, loss of bladder control
  • Often associated with spinal cord injury
  • Enterobius vermicularis infestation
  • May cause urinary frequency
  • Present with anal puririts, especially at night
  • Positive scotch tape test
  • Polyuric conditions (Diabetes mellitus/insipidus)
  • Abnormal urinalysis
  • Urinary tract infection
  • Dysuria
  • Abnormal urinalysis
  • Drugs (antihistamines, diuretics, theophylline, cisapride, psychotropic drugs.)

Evaluation and Diagnosis:

Parents are usually concerned that their child has diabetes mellitus or a urinary tract infection

Careful history and physical

  • Evidence of change in normal voiding pattern
  • Any history of UTIs
  • Small voids
  • Absence of polydypsia
  • No abdominal or flank pain
  • No dysuria
  • Normal neurological exam, especially of lower extremities


  • Normal urine specific gravity (low in DI)
  • Negative urine glucose
  • No hematuria, proteinuria or WBCs
  • Spot urine calcium to creatinine ratio to evaluate to hypercalciuria (>0.2 is abnormal)
  • 24 hr urine calcium (normal <4mg/kg/day)

Ultrasonography and voiding cystourethrography have not show any abnormalities in patients with solitary symptom of urinary frequency and is thus not indicated.


No definitive cause of pollakiuria but some triggers include:

  • Non bacterial cystitis
  • Chemical urethritis
  • Abnormal urine composition
  • Hypercalciuria has been indentified in children with pollakiuria
  • Heightened bladder sensitivity in cold weather months
  • Significant social or emotional stressors
  • Frequency may occur only in the stressful environment and improvement in symptoms following counseling or resolution of the stressful situation has been reported.
  • Most frequently described psychogenic triggers are school problems, academic difficulties or bullying, perceived threat to self or a loved one. Parental divorce. Death of a family member, relocated to a new school, birth of a sibling


  • Reassure the parents, it will likely resolve over days or weeks
  • Anticholinergics (oxybutynin and propantheline) are useful for treating incontinence but are not very effective for urinary frequency
  • Identification of an emotional trigger and allow child to talk to parent about what worries them may relieve symptoms


  1. Farber,JM.  A Strategy to Treat Pollakiurua.  Contemporary Pediatrics March 2013
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  7. Index of Suspicion. Pediatrics in Review.  2003 June;24(6)207-212.