Question
My soon to be 7yo son is still experiencing daily wetting. Night time wetting has never been mastered even after cutting down liquids before bedtime, but he did at one point master the day time and now (by now I mean it's been a little over 6 months) he is constantly (daily, and sometimes more than once) wetting his pants unless we remind him to go to the bathroom. This happens in school, at home, pretty much everywhere. We did a blood test and have been doing some more digging to make sure there is no physical reason for this but it appears that it is not physical.
There really have not been any changes lately that could give us a clear answer to what could be causing this and he seems to not notice until his pants are already wet and then he runs to the bathroom. We have been trying not to shame him but at this point he realizes he is not "supposed" to be doing this so he will say that it is water or try to hide it from us. Sometimes we ask him to use the bathroom and he says he does not want to and 5 min later his pants are wet.
Answer
If you have not seen a pediatric urologist, I recommend you have them give him a full check up. Do this first if you haven't done so yet.
If the medical gets completely ruled out it can also be a sensory processing issue, this would be evaluated by an occupational therapist and they would be looking at his interoception sense. This sense helps us understand our body's internal sensations. This is the sense that helps us know if we're hungry, thirsty, hot, cold, or any other feeling that begins within our bodies.
In the meantime, as a way to do something while you wait for tests and doctors, let your son know that the bathroom breaks will be part of the routine. Then have him go to the bathroom every 2 hours, whether he feels like going or not. Every two hours it's a bathroom break, he goes in, he tries and goes on to the next thing.
This will keep you from the power struggle, the fear or his embarrassment.
In between those 2 hours don't ask him about the bathroom, only if you are about to go on a long car ride. In that situation make sure to have him go potty before he gets in the car.
It's not a "do you want to go..." it's a "time to go and try..."