The diagnosis of enuresis is made by adults and children over 5 years, if they face more than twice a month with 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 classmates, so they recommend treating urine incontinence from 6-7 years.
That is enuresis
ENURESIS are 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 involved in doctors since the time of the former Persian scientist Avicena, and for the first time the term "enuresis" was introduced into medical practice at the end of the 18th century. Since then, it was possible to find quite effective methods to treat the disease, but the mechanism of its occurrence has not yet been completely studied.
Most of the time, children suffer from an enuree, and for adolescence, in most cases, the disease passes alone.
In boys, enuresis is more common than girls
Experts recommend not ignoring this delicate problem even at an early age, due to urine incontinence, the child can develop diseases of the genitourinary system and psychological problems arise.
Studies have shown that in children with enuresis in 70% of cases, the level of anxiety has increased, they have difficulty communicating with their classmates and finding conflicts in the family due to their problem, which they cannot control. The Judicial Psychiatrist of New Zealand, John Makdonald, even included enuresis, along with zoosadism (brutal animal management) and Piruinia (passion for the cause caused), in the "behavioral triad", indicating a predisposition to cruel crimes. Personality formation is not influenced by the episodes of pride, but a trauma associated with mockery and punishments of parents, friends, brothers and sisters.
At 5 years, enuresis occurs in 15-20%of children, at 7 years, at 12%and 10, in 5%. The disease is also detected in 1-2% of adolescents and 0, 5 to 1% of adults.
In adults, enuresis usually develops after 45 years, women suffer three times more often than men. At this age, enuresis episodes are usually symptoms of diseases of the nervous and genitourinary system, and spontaneous cure, as in children, does not happen.
Causes of prosecution
Normally, the urine process occurs as follows. Urine through the ureters moves from the kidneys to the bladder, but does not come out: it is sustained by the muscular ring (sphincter), located at the place of the urethra complex with the bladder. Gradually accumulating, press the walls of the bubble and annoy the receptors that transmit a signal on the need to urinate the brain centers of the brain. The brain sends a signal that the sphincter of the urethra can relax. Normally, with persistent urine calls during sleep, a person wakes up and can deliberately endure for some time.
In children under 4 years of age, control centers on the urine in the brain are finally not formed, so they cannot always control this process. "Wet nights" of up to 4 to 5 years are not considered a deviation from the norm. But after 5 years, enuresis indicates a malfunction in any of the urine stages.
Causes of enuresis in children:
- The slow development of urine centers in the brain and other disorders of the central nervous system (central nervous system). Most of the time, this is an individual characteristic of the body and, as the central nervous system develops, the problem of prior becomes alone. The risk of developing the disease for this reason is greater in children who experienced oxygen hunger (even insignificant) during pregnancy and falling to the mother of toxicosis, entering the umbilical cord, an inappropriate presentation, etc. ;
- Polyuria 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, excessive activity of the parathyroid glands (hyperparathyroidism), the reduced production of a vasopressin hormone, which helps regulate the tone of the muscles of the internal organs and control the volume of urine. At night, it is usually more actively synthesized, so urine is less;
- Genitourinary system diseases. The inflammation of the urethra and the bladder, the neoplasms, the narrowing of the urethral channel, for example, due to the growth of the connective tissue, can also lead to the enuresis;
- stress. The loss of a relative, moving, going to the garden of infants often causes a night incontinence of urine;
- A strong dream, for which children do not wake up with urination.
Due to prior, the child often becomes the object of ridicule. This greatly reduces self -esteem and leads to psychological problems
Causes of enuresis in adolescents and adults:
- Hormonal disorders: Diabetes, Hyperparathyroidism, Vasopressin Reduction;
- Inflammatory diseases of the genitourinary system: pyelonephritis, urethritis, cystitis, prostatitis, orchitis (inflammation of the egg);
- regular alcohol abuse;
- column trauma, spinal cord;
- Congenital anatomical abnormalities (for example, a bladder too small) or weakening of the pelvic floor muscles;
- stress.
Most of the time, enuresis develops under the influence of several factors at the same time, and in some cases it is not possible to accurately distinguish the main cause of incontinence.
Enterior classification
ENURESIS is divided into primary school, when the problem was first identified and complete control periods on urine, and secondary, which was preceded by a "dry" period 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, sometimes it is divided into night, day and mixed. Complicated and uncomplicated enuresis is also distinguished: 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 pronor
The main sign of enuresis is the inability to control urination during night sleep. Less frequently, during the day. The unusual emptying of the bladder cannot happen every night, but regularly. The diagnosis of enuresis is done if this occurs two or more times a month for 3 months.
With an enuree, a person can urinate more frequently during the day, face an involuntary urinary leak, experience a false urination or, on the contrary, feel that after visiting the toilet, the bladder is not completely exhausted.
Children and adolescents with enuresis can be more closed and irritable, to sleep worse at night, reduce school performance.
What doctor treats enuresis?
Enuresis causes a variety of reasons, therefore, a large number of specialists are dedicated to their diagnosis and treatment. Adult patients are recommended to communicate with the therapist and the urologist. If the child's enuresis, it is necessary to come to the pediatrician reception who will carry out an inspection and recommend narrow specialists. This can be urologist, gynecologist, nephrologist, neurologist, psychotherapist, endocrinologist. General professionals and close specialists collect family history, listen to the patient's complaints and examine. The diagnosis of enuresis is usually carried out on the basis of a clinical image, and instrumental tests and studies are prescribed to clarify the causes.
Enoraz Laboratory Diagnosis
Nechiporenko helps evaluate the general condition of the body and identify the inflammation of the genitourinary system.
In some cases, an analysis is prescribed to determine the level of vasopressin (antidiuretic hormone). It controls the level of water in the body and affects the intensity of urination.
Instrumental diagnosis of enuresis
With an enuree, the doctor can prescribe an bladder ultrasound. This study can be replaced by magnetic resonance or computed tomography of the bladder and other organs of the urinary system.
Ultrasound helps evaluate the bladder work and discover how much urine remains in it after the urine
If the ultrasound results are not enough to determine the cause of enuresis and prescribe the treatment, the patient is directed to a cystographic exam. For this procedure, a catheter is introduced into the bladder and fills the organ with a contrasting drug or oxygen, after which they take photos of the bladder full and emptied.
Evaluate the speed and volume of urine flow during the urine allows the uroflowetry method. During the study, the urine patient in the funnel-receptor of the Urofloumeter apparatus. With this study, you can obtain information on the urine flow rate and fluid volume, selected indicators (markers) of deviations from the standard. These data are entered into the sensor -related operating system, processed, and the results are shown in the computer monitor graphically. The doctor decipher the results.
If the patient in the past had injuries or the doctor suspects anomalies of the structure of the lumbosacro department, which can also cause enuresis, can prescribe an radiography of this spine.
In children and adolescents, enuresis develops more frequently due to injuries or infections, but for the late development of the central nervous system and stress. In this case, a neurologist and psychotherapist recommends them to examine.
WWTING TREATMENT
In adults and adolescents, enuresis is usually a symptom of infection, endocrine disease or injury. Therefore, in the first place, it is necessary to identify this pathology as soon as possible and begin its treatment.
Inures in children is about the correction of behavior (motivational therapy), medicines, physiotherapy, psychotherapy or combinations of these methods.
Drug treatment
If the main cause of enuresis is the violations of the nervous system, the drugs that help normalize their work can prescribe the child. These are group B vitamins, nootropic drugs, glutamic acid, glycine. Antidiuretic medications are also prescribed and, in some cases, tricyclic antidepressants. But the latter are used less frequently, since they have a more pronounced side effect.
Separately or as part of complex therapy, drugs are prescribed that normalize the work of the muscle cover of the bladder - detrues. If enuresis is associated with an infectious disease, they can prescribe an antibiotic course.
Physiotherapy
The procedures are prescribed as a type of independent treatment or in combination with medications. Paraffin applications in the lower abdomen and on the back in the area of the lumbosacro department, physiotherapy exercises, electrophoresis, magnetotherapy give a good effect.
For comprehensive enuresis treatment, gymnastics and physiotherapy are used.
Psychotherapy
In cases where enuresis developed as a result of stress or neurotic disorder, a psychotherapist prescribes treatment. If a child suffers from an enuree, family and sedative psychotherapy sessions have a good effect that are suitable for a small patient by age. But it is even more important to create a favorable atmosphere for him at home, demonstrate that adults on his side will help him cope with this problem. In no case should he scold and embarrass the child: it is less to blame 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 can recommend individual therapy.
Experts do not advise using diapers with an enuree, who hide unpleasant sensations and level the problem: it is better to protect the bed with an adhesive or disposable diaper. There are special devices: Enuremados alarmrs that are connected to pajamas or underwear and respond to the first drops excreted urine with a sound signal. This gradually gets used to a person to respond to impulse to the body and wake up in time to go to the bathroom.
Strictly compliance with the regime of the day and regular visits to the bathroom plays an equally important role. Before bed, it is better to go to the bathroom twice: even the afternoon hygiene procedures (wash, brush, shower) and after them. During the day, it must drink enough water, but one or two hours before bedtime, it is worth limiting the use of fluids, as well as products that irritate the bladder, this is mainly fruits and citrus juices. Teenagers and adults also need to abandon alcohol, tea, coffee, energy and other drinks that contain caffeines.
Forecast and prevention
Summer treatment, compliance with the doctor's recommendations, daily routine and, most importantly, the adequate and benevolent reaction of parents and other relatives give good results and allows them to completely get rid of the problem of involuntary night urine.
It is impossible to prevent enuresis, but the risk of its development is reduced if the future mother carefully monitors her health during pregnancy: she rejects bad habits, leads a healthy lifestyle, observes the daily routine and follows the doctor's recommendations to avoid complications during pregnancy and child childbirth.
If the child has already found the problem of prior, the favorable environment in the family and the children's team will help avoid their repetition. It is worth doing everything possible to avoid stressful situations that can cause a relapse of the disease. Adults are recommended to carefully control their health and, on time, to identify and treat infections of the genitourinary system, as well as use condoms during sex to avoid sexually transmitted infections.
Frequent questions
What is enuresis?
Enuresis is involuntary urinating in adults and children over 5 years, which happens more frequently 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 their relationship with parents and colleagues, so many experts recommend treating urine incontinence from 6 to 7 years.
Why was an adult described at night in a dream?
Night urinary incontinence can cause infections of the genitourinary system, hormonal failures, trauma of the spine and spinal cord, weakening of the pelvic floor muscles and even serious experiences. This can also happen if a person is in a state of alcohol or narcotic intoxication. If involuntary urination at night occurs regularly, you should consult a doctor who can determine the cause of this delicate problem and prescribe treatment.
How to get rid of priorness?
The cause of enuresis can be infectious diseases, stress, hormonal malfunction. In children, the urine night incontinence is often associated with the characteristics of the development of the central nervous system. The treatment is prescribed depending on what exactly caused a night incontinence of urine. Most of the time they combine medications (synthetic hormones, sedatives, tricyclic antidepressants) and physiotherapy methods: electrophoresis, gymnastics, magnetic therapy and laser. If the enuresis is associated with a neurotic disorder or chronic stress, it is recommended to seek help from a therapist.
What doctor is inurersis?
Enuresis causes a variety of reasons, therefore, a large number of specialists are dedicated to their diagnosis and treatment. Adult patients are recommended to communicate with the therapist and the urologist. If the child's enuresis, it is necessary to come to the pediatrician reception who will carry out an inspection and recommend narrow specialists. This can be urologist, gynecologist, nephrologist, neurologist, psychotherapist, endocrinologist.