The diagnosis of enuresis is made up of adults and children over the age of 5, if more often twice a month they face the problem of involuntary urination. This disease in children often occurs independently and does not affect their health. But Enuresis seriously affects the child's self-esteem and his relationship with parents and peers, therefore they recommend treating incontinence from the urine for 6-7 years.
What is enuresis
The enuresis is the repeated episodes of urinary incontinence, which occur at least twice a month for 3 months or more. Very often, involuntary urination occurs at night. The study of this problem has been engaged in doctors since the times of the ancient Persian scientist Avicenna and for the first time the term "enuresis" was introduced in medical practice at the end of the 18th century. Since then, it has been possible to find fairly effective methods for the treatment of the disease, but the mechanism of its occurrence has not yet been completely studied.
Very often, children suffer from an enure and for adolescence, in most cases, the disease passes by itself.
In boys, enuresis is more common than girls
Experts recommend not to ignore this delicate problem even at a young age, because due to the counterinance of the urine, the child can develop diseases of the parental parent system and psychological problems.
Studies have shown that in children with an enacement in 70% of cases, the level of anxiety has been increased, they have difficulty communicating with peers and meeting family conflicts due to their problem, which they cannot control. The New Zealand judicial psychiatrist, John Makdonald, even included Enuresis, together with zoosadism (brutal animal management) and Piruinia (passion for the malicious fire), in the "behavioral triad", which indicates a predisposition to the commission of cruel crimes. The formation of the personality is not influenced by the episodes of Enorez, but a trauma associated with the mockery and punishment of parents, friends, brothers and sisters.
At 5 years old, Enuresi occurs in 15-20%of children, at 7 years old - in 12%and 10 - in 5%. The disease is also detected in 1-2% of teenagers and 0, 5-1% of adults.
In adults, enuresis usually develops after 45 years, women suffer from three times more often than men. At this age, the episodes of enuresis are generally symptoms of diseases of the nervous and parent -shared system - and spontaneous care, as in children, does not occur.
Causes of Enorez
Normally, the urination process occurs as follows. Urine through the ureters moves from the kidneys to the bladder, but does not come out: it is retained by the muscle ring (sphincter), located at the place of the compound of urethra with the bladder. By gradually accumulating, presses on the walls of the bubble and annoys the receptors that transmit a signal on the need to urinate to the brain centers of the brain. The brain remains a signal that you can relax the sphincter of the urethra. Normally, with persistent calls to urination during sleep, a person wakes up and can deliberately last for some time.
In children under the age of 4, the control centers on urination in the brain are finally formed, so they cannot always control this process. "Wet nights" up to 4-5 years are not considered a deviation from the norm. But after 5 years, Enuresi indicates a malfunction in one of the stages of urination.
Causes of enuresis in children:
- The slow development of urination centers in the brain and other central nervous system disorders (central nervous system). Very often, this is an individual characteristic of the body and as the central nervous system develops, Enorez's problem goes by itself. The risk of developing the disease for this reason is higher in children who have had oxygen hunger (even insignificant) during pregnancy and childbirth of the mother of toxicosis, entering the umbilical cord, improper presentation, etc. ;
- Polyhia is an excessive urine secretion. It can occur due to the fact that the child drinks many liquids at night or due to hormonal disorders. These include diabetes mellitus, the excessive activity of the paratyroid glands (hyperparathyroidism), the reduced production of a vasopressin hormone, which helps to regulate the tone of the muscles of the internal organs and controls the volume of the urine. At night, it is usually more actively synthesized, so the urine forms less;
- Diseases of the parental parent system. The inflammation of the urethra and bladder, neoplasms, narrowing of the urethral canal, for example, due to the growth of the connective tissue, can also lead to enuresis;
- stress. The loss of a relative, who moves to kindergarten often cause a night incontinence of urine;
- A strong dream, due to which children do not wake up with urination.
Because of Enorez, the child often becomes the object of the ridiculous. This significantly reduces the car -and leads to psychological problems
Causes of enuresis in teenagers and adults:
- Hormonal disorders: diabetes, hyperparathyroidism, reduction of vasopressine;
- Inflammatory diseases of the parent system -common: pieelonefrite, urethritis, cystitis, prostatitis, orcite (inflammation of eggs);
- regular alcohol abuse;
- Spinal trauma trauma, spinal cord;
- congenital anatomical anomalies (for example, too small bladder) or weakening of the pelvic floor muscles;
- stress.
Very often, Enuresis develops under the influence of several factors simultaneously and in some cases it is not possible to precisely distinguish the main cause of incontinence.
ENOREZ classification
The enuresis is divided in primary, when the problem has been identified for the first time and the complete control periods on urination and secondary, which has been preceded by a "dry" period controlled for a long time for six months or more.
In the clinical recommendations of the Ministry of Health of our country, the disease is defined as a night incontinence of urine that occurs during sleep. But in medical practice, it is sometimes divided into night, day and mixed. The complicated and simple enuresis stands out: in the first case, the syndrome is not associated with other diseases, in the second it is associated with pathologies of the central nervous system, infections and other problems with the urinary system.
Symptoms of enorez
The main sign of enuresis is the inability to control urination during night sleep. Less often - during the day. The unusual emptying of the bladder cannot occur every night, but regularly. The diagnosis of enuresis is done if this happens two or more times a month for 3 months.
With an enure, a person can urinate more often during the day, involuntary urinary losses, experimenting false urination or, on the contrary, feel that after visiting the bathroom, the bladder is not completely exhausted.
Children and teenagers with enacesi can become more closed and irritable, to sleep worse at night, reduce performance to school.
Which doctor deals with enuresis
The Enuresis causes a series of reasons, therefore, a large number of specialists is engaged in its diagnosis and treatment. Adult patients are recommended to contact the therapist and the urologist. If the child's enuresis, it is necessary to come to the pediatrician reception that will lead an inspection and recommend restricted specialists. This can be a urologist, gynecologist, nephrologist, neurologist, psychotherapist, endocrinologist. General medical doctors and restricted specialists collect a family history, listen to the patient's complaints and examine. The diagnosis of enuresis is generally made on the basis of a clinical picture and tests and instrumental studies are prescribed to clarify the causes.
Enorez's laboratory diagnostics
Evaluate the general conditions of the body and identify the inflammation of the parent system -common is helped by a general urine analysis and by the analysis of the urine by NeciCorenko.
In some cases, an analysis is prescribed to determine the level of vasopressin (antidiuretic hormone). It controls the water level in the body and affects the intensity of urination.
Instrumental diagnosis of enuresis
With an enuree, the doctor may prescribe a bladder ultrasound. This study can be replaced with magnetic resonance imaging or computerized tomography of the bladder and other organs of the urinary system.
Ultrasound helps to evaluate the work of the bladder and find out how much urine remains after urination
If the results of the ultrasounds are not sufficient to determine the cause of the ensence and prescribe the treatment, the patient is aimed at a cystographic examination. For this procedure, a catheter is introduced into the bladder and fills the organ with a drug or contrasting drug or oxygen, after which it takes photos of full and emptied bladder.
Evaluate the speed and volume of the urine flow during urination allows the Uroflowetry method. During the study, the patient urine in the use of the Uroflumetro apparatus. With this study, it is possible to obtain information on the speed of the flow of urine and on the volume of the fluid, select the indicators (markers) of the deviations from the standard. These data are entered in the operating system relating to the sensor, processed and the results are displayed on the computer monitor in graphic form. The doctor deciphery the results.
If the patient in the past has had injuries or the doctor suspects the anomalies of the structure of the lumbosacral department, which can also cause enuresis, it can prescribe an X -ray of this spine.
In children and adolescents, Enuresis develops more often not because of injuries or infections, but due to the late development of the central nervous system and stress. In this case, they are recommended by the examination by a neurologist and psychotherapist.
Enorez treatment
In adults and adolescents, enuresis is often a symptom of infection, endocrine disease or injuries. Therefore, first of all, it is necessary to identify this pathology as soon as possible and start treatment.
Enures in children is treated by correction of behavior (motivational therapy), drugs, physiotherapy, psychotherapy or combinations of these methods.
Pharmacological treatment
If the main cause of enaceresis is the violations of the nervous system, the drugs that help normalize its work can be prescribed to the child. These are group B vitamins, nootropic drugs, glutamic acid, glycine. Antidiuretic drugs and in some cases tricyclic antidepressants are also prescribed. But the latter are used less often, since they have a more pronounced side effect.
Separately or as part of complex therapy, drugs that normalize the work of the muscle shell of the bladder - Detruzor are prescribed. If Enuresi is associated with an infectious disease, it can prescribe an antibiotic course.
Physiotherapy
The procedures are prescribed as a type of independent treatment or in combination with drugs. Paraffin applications on the lower abdomen and on the back in the area of the lumbosacral department, physiotherapy exercises, electrophoresis, magnetotherapy give a good effect.
For complete enaceive treatment, gymnastics and physiotherapy are used
Psychotherapy
In cases where enuresis developed following stress or neurotic disorder, a psychotherapist prescribes the treatment. If a child suffers from an enure, a good effect from family psychotherapy and sedative sessions suitable for a small patient by age is given. But it is even more important to create a favorable atmosphere for him at home, to demonstrate that adults on his side will help him cope with this problem. In no case should you reproach and assert the child: he is less responsible for his illness. The pressure and aggression will lead to the fact that the symptoms will not disappear, but will increase. In adolescents and adults, enuresis can also be caused by psychological causes and in this case they may recommend individual therapy.
Experts do not recommend using diapers with an enuree, which hide the unpleasant sensations and level the problem: it is better to protect the bed with adhesive or disposable diaper. There are special devices: enuremate alarm clocks that are connected to pajamas or underwear and respond to the first drops of urine excrees with a sound signal. This gradually gets a person to respond to the impulse to the body and wake up in time to go to the bathroom.
Conformity strictly with the day of the day and regular visits to the bathroom plays an equally important role. Before going to bed, it is better to go to the bathroom twice: until the evening hygiene procedures (washing, brushing, shower) and after them. During the day, you have to drink enough water, but an hour or two before bedtime, it is worth limiting the use of liquids, as well as products that irritate the bladder: this is mainly citrus fruits and fruit juices. Teenagers and adults must also abandon alcohol, tea, coffee, energy and other drinks containing caffeine.
Forecast and prevention
Summer treatment, respect for the doctor's recommendations, daily routine and, above all, the adequate and benevolent reaction of parents and other relatives gives good results and allow you to completely get rid of the problem of involuntary night urination.
It is impossible to prevent enuresis, but the risk of her development is reduced if the mother waiting carefully monitors her health during pregnancy: she refuses bad habits, leads a healthy lifestyle, observes the daily routine and follows the doctor's recommendations to avoid complications during pregnancy and childbirth.
If the child has already encountered Enorez's problem, the favorable environment in the family and children's team will help prevent his repetition. It is worth making every effort to avoid stressful situations that can cause an impact of the disease. Adults are recommended to carefully monitor their health and in time to identify and treat infections of the parental system, as well as to use condoms during sex to avoid sexually transmitted infections.
Frequent questions
What is Enuresis?
Enuresis is an involuntary urination in adults and children over the age of 5, which occurs more often twice a month, usually during sleep. This disease in children often occurs independently and does not affect their health. But Enuresis seriously affects the child's self-esteem and his relationship with parents and peers, so many experts recommend treating incontinence from the urine for 6-7 years.
Why was an adult described at night in a dream?
Night urinary incontinence can cause infections of the parental parent system, hormonal failures, trauma of the spinal spine and spinal cord, weakening of the muscles of the pelvic floor and even serious experiences. This can happen even if a person is in a state of alcohol or narcotic intoxication. If the involuntary urination at night occurs regularly, it is necessary to consult a doctor who can determine the cause of this delicate problem and prescribe treatment.
How to get rid of enorez?
The cause of the enacely can be infectious diseases, stress, hormonal malfunctions. In children, the night incontinence of urine is often associated with the characteristics of the development of the central nervous system. Treatment is prescribed according to what has caused exactly a night incontinence of urine. Very often they combine medicines (synthetic, sedative hormones, tricyclic antidepressants) and physiotherapy methods - electrophoresis, gymnastics, magnetic therapy and laser. If Enuresi is associated with a neurotic disorder or chronic stress, we recommend asking for help from a therapist.
Which doctor deals with enuresis?
The Enuresis causes a series of reasons, therefore, a large number of specialists is engaged in its diagnosis and treatment. Adult patients are recommended to contact the therapist and the urologist. If the child's enuresis, it is necessary to come to the pediatrician reception that will lead an inspection and recommend restricted specialists. This can be a urologist, gynecologist, nephrologist, neurologist, psychotherapist, endocrinologist.