Enuresis in children: causes, symptoms and treatment of enuresis
Enuresis is an involuntary act of urination, occurring primarily during sleep without any apparent physical causes.
In almost all cases, the disease occurs in children over 5 years of age( before this age, nighttime urination is considered nome), in adolescents, enuresis is much less common.
The older the child, the lower the incidence rate. According to statistics, boys are usually carriers of the disease. Among adults, only one person in a hundred suffers from enuresis. The disease was mentioned in the writings of Avicenna, who at one time described his symptoms and possible causes. Enuresis causes a number of psychological problems in the child, as well as contributes to conflict situations in the family.
Some parents consider enuresis as a serious illness, referring to a specialist, and some prefer to punish the child, regarding nighttime urination, as unwillingness to wake up at night.
The main cause of enuresis is associated with autonomic disorders. Contribute to the disease neurotic disorders that cause disruption of the cerebral cortex. Sometimes dysfunction is not pronounced, it is manifested by alternating manifestations of the disease with "dry" nights.
Some experts argue that the cause of the disease is closely knit with a hereditary predisposition, which is manifested by an anomaly in the development of innervation of the urinary tract. Partly promotes enuresis dysfunction of the secretion of certain substances( histamine, vasapressin, serotonin, etc.) that affect the bladder.
There are several other factors of the disease, they include:
In temporary form, adults can be:
Classification distinguishes between primary( congenital) and secondary( acquired) enuresis.
This is a case of a primary diuretic in the case when a child older than 5 years continues to perform an act of urination in bed during a night's sleep in the absence of diseases from the nervous, genitourinary, endocrine systems.
Secondary enuresis is diagnosed if the symptoms of enuresis return after an imaginary recovery, which lasted no less than 6 months. Very often, the cause of secondary enuresis is stress, for example, moving, fright, etc. There are following forms of the disease: psychogenic, functional, organic and mixed. The disease can occur at different times of the day.
In this regard, distinguish: nocturnal diuresis, day and night diuresis, as well as diuresis daily( it is very rare).
Urinary secretion occurs in the kidneys. From there, along the ureters( two tubes), it constantly enters the bladder, whose capacity is approximately equal to 1.5 liter.
The walls of the bladder are smooth muscles, so they are easy to stretch, because of this, the pressure in it is practically unchanged. Overlap the exit from the bladder to the urethra of the sphincters( there are only two of them - external and internal).
At the heart of the disease is a disruption in the work of these sphincters, as well as diseases affecting the nervous system, innervated urethra and bladder.
The most important sign of enuresis is urination in a dream, which is the reason for contacting a specialist. Some children during urination do not bother.
Other children are worried: they can wake up immediately after they become wet underwear. In a state of wakefulness, as well as during catarrhal diseases, pain and frequent urination( pollakiuria) may occur.
See also how to treat urinary incontinence in men.
For the diagnosis, a detailed study of the anamnesis. It specifies the beginning, course, appearance time, volume of urine, frequency of acts of urination, determined by diuresis.
The clinical picture is assisted by examinations conducted by a neurologist, otolaryngologist, endocrinologist, psychiatrist, etc. The patient's personality is carefully studied. For example, with oligophrenia, epilepsy enuresis, including daytime, as a symptom of the underlying disease is common.
Of the instrumental methods of research, electroencephalography, which is performed during wakefulness and during sleep, is of particular value. The results after this study in patients with enuresis indicate the presence of hyperexcitability of some parts of the cerebral cortex.
In addition, patients are recommended to:
Treatment of enuresis is a complex approach, focused on the development and consolidation of the lost reflex, which consists in awakening the desire for the act of urination. The orientation of therapy is aimed at stimulating the nervous system, metabolism and accelerating the regulatory processes that are associated with urination.
Treatment of the disease in childhood are involved: pediatrician, nephrologist, neurologist, psychologist. In adults, enuresis is treated by the following specialists: therapist, surgeon, urologist, psychiatrist, psychologist, endocrinologist.
General rules for the treatment of enuresis in children:
As an integral part of the therapy, effective folk medicine can be used, for example, ground dill seed, dried cowberry leaves, plantain seeds, etc. It is not recommended to engage in self-medication, ignore therapy prescribed by a doctor.
It should be remembered that only with the help of an integrated approach to the treatment of enuresis, which includes a way of life, psychological mood and medications, can cure ailment.
In almost all cases, the disease occurs in children over 5 years of age( before this age, nighttime urination is considered nome), in adolescents, enuresis is much less common.
The older the child, the lower the incidence rate. According to statistics, boys are usually carriers of the disease. Among adults, only one person in a hundred suffers from enuresis. The disease was mentioned in the writings of Avicenna, who at one time described his symptoms and possible causes. Enuresis causes a number of psychological problems in the child, as well as contributes to conflict situations in the family.
Some parents consider enuresis as a serious illness, referring to a specialist, and some prefer to punish the child, regarding nighttime urination, as unwillingness to wake up at night.
Causes of enuresis in children
The main cause of enuresis is associated with autonomic disorders. Contribute to the disease neurotic disorders that cause disruption of the cerebral cortex. Sometimes dysfunction is not pronounced, it is manifested by alternating manifestations of the disease with "dry" nights.
Some experts argue that the cause of the disease is closely knit with a hereditary predisposition, which is manifested by an anomaly in the development of innervation of the urinary tract. Partly promotes enuresis dysfunction of the secretion of certain substances( histamine, vasapressin, serotonin, etc.) that affect the bladder.
There are several other factors of the disease, they include:
- delay in the physical development of the child;
- cases of sleep apnea;
- is an overdue ability to control the act of urination.
In temporary form, adults can be:
- 1) Temporary enuresis, the causes of which are stones in the bladder and kidneys, chronic constipation, the use of certain medications, etc.;
- 2) Permanent enuresis, the main causes of which are the formation of fistulas that connect the bladder cavity( urethra) and the vagina, diseases( tumors, stroke, sclerosis, etc.) of the central nervous system.
Classification of enuresis
Classification distinguishes between primary( congenital) and secondary( acquired) enuresis.
This is a case of a primary diuretic in the case when a child older than 5 years continues to perform an act of urination in bed during a night's sleep in the absence of diseases from the nervous, genitourinary, endocrine systems.
Secondary enuresis is diagnosed if the symptoms of enuresis return after an imaginary recovery, which lasted no less than 6 months. Very often, the cause of secondary enuresis is stress, for example, moving, fright, etc. There are following forms of the disease: psychogenic, functional, organic and mixed. The disease can occur at different times of the day.
In this regard, distinguish: nocturnal diuresis, day and night diuresis, as well as diuresis daily( it is very rare).
Bladder function and pathogenesis
Urinary secretion occurs in the kidneys. From there, along the ureters( two tubes), it constantly enters the bladder, whose capacity is approximately equal to 1.5 liter.
The walls of the bladder are smooth muscles, so they are easy to stretch, because of this, the pressure in it is practically unchanged. Overlap the exit from the bladder to the urethra of the sphincters( there are only two of them - external and internal).
At the heart of the disease is a disruption in the work of these sphincters, as well as diseases affecting the nervous system, innervated urethra and bladder.
Symptoms of
The most important sign of enuresis is urination in a dream, which is the reason for contacting a specialist. Some children during urination do not bother.
Other children are worried: they can wake up immediately after they become wet underwear. In a state of wakefulness, as well as during catarrhal diseases, pain and frequent urination( pollakiuria) may occur.
See also how to treat urinary incontinence in men.
Diagnosis of enuresis
For the diagnosis, a detailed study of the anamnesis. It specifies the beginning, course, appearance time, volume of urine, frequency of acts of urination, determined by diuresis.
The clinical picture is assisted by examinations conducted by a neurologist, otolaryngologist, endocrinologist, psychiatrist, etc. The patient's personality is carefully studied. For example, with oligophrenia, epilepsy enuresis, including daytime, as a symptom of the underlying disease is common.
Of the instrumental methods of research, electroencephalography, which is performed during wakefulness and during sleep, is of particular value. The results after this study in patients with enuresis indicate the presence of hyperexcitability of some parts of the cerebral cortex.
In addition, patients are recommended to:
- cystoscopy;
- cystography;
- determination of bladder capacity.
Treatment of enuresis in children
Treatment of enuresis is a complex approach, focused on the development and consolidation of the lost reflex, which consists in awakening the desire for the act of urination. The orientation of therapy is aimed at stimulating the nervous system, metabolism and accelerating the regulatory processes that are associated with urination.
Treatment of the disease in childhood are involved: pediatrician, nephrologist, neurologist, psychologist. In adults, enuresis is treated by the following specialists: therapist, surgeon, urologist, psychiatrist, psychologist, endocrinologist.
General rules for the treatment of enuresis in children:
- 1) Before putting the baby to bed, it is necessary to take him to the toilet, and before going to bed himself - to wake the child and offer to go to the toilet again;
- 2) From psychological techniques you can use the "Star Map" method: the child should receive from the parents a reward in the form of a painted star in the album for a "dry" night. The method is not suitable for children whose attempts to remain dry are unsuccessful;
- 3) Strictly adhere to the regime of the day: on time there, go to bed and wake up at one time. On the eve of sleep is not recommended to play noisy games, watch TV.Promotes recovery evening walk, reading a good book. The child should sleep on the bed with a slightly raised mattress at the foot end;
- 4) Some children are helped to defeat the ailment of the alarm device. They can be an alarm clock, which should be started in advance to the alleged act of urination. Immediately after the baby's signal, it is necessary to awaken and offer to go to the toilet. Over time, the baby will wake up earlier than the signal and the number of cases of involuntary urination and excreted urine will noticeably decrease.
Traditional medicine against enuresis
As an integral part of the therapy, effective folk medicine can be used, for example, ground dill seed, dried cowberry leaves, plantain seeds, etc. It is not recommended to engage in self-medication, ignore therapy prescribed by a doctor.
It should be remembered that only with the help of an integrated approach to the treatment of enuresis, which includes a way of life, psychological mood and medications, can cure ailment.