The diagnosis of enuresis is made by adults and children over 5 years of age, if they are more than twice a month to face the problem of involuntary urination. This disease in children is often found independently and does not affect their health. But Enuresis seriously affects the child's self -esteem and his / her relationship with parents and peers, so they recommend being treated with urine incontinence for 6-7 years.
Enureis is the multiple urinary incontinence episodes that occur at least twice a month for 3 months or more. Most often, involuntary urination occurs at night. The study of this problem has been concerned with doctors from the time of ancient Persian scientist Avicenna and for the first time the term "Enrese" was introduced in medical practice in the late 18th century. Since then, it was possible to find quite effective methods of treating the disease, but the mechanism of its occurrence has not yet been fully studied.
Most often, children suffer from Enuree and adolescence, in most cases the disease passes independently.
In boys Enuresis is more common than girls
Experts recommend that you do not ignore this delicate problem even at a young age, because due to urinary incontinence, the child can develop diseases of the genotor system and psychological problems arise.
Studies show that in children with enuresis in 70% of cases, the level of anxiety has been increased, they have difficulty communicating with peers and encounter conflicts in the family because of their problem they cannot control. The forensic psychiatrist in New Zealand, John McDonald, even included enuresis, along with zoosadism (brutal animal handling) and pirouncia (a passion for arson), in the "behavioral triad", which shows a predisposition to committing cruel crimes. The formation of the person is not influenced by the episodes of parish, but a trauma related to mockery and punishment by parents, friends, brothers and sisters.
At the age of 5, the enuresis occurs in 15-20%of children in the age of 7 - in 12%and in 10 - in 5%. The disease is also detected in 1-2% of adolescents and 0, 5-1% of adults.In adults, Enrese usually develops after 45 years, women suffer from them three times more than men. At this age, the episodes of enuresis are usually symptoms of diseases of the nervous and genital system - and spontaneous treatment, as in children, does not occur.
Reasons for a parcel Usually, the urination process proceeds as follows. Urine through the urethra moves from the kidneys to the bladder, but does not come out: it is held by the muscle ring (sphincter) located at the site of the urethral joint with the bladder. It gradually accumulates, it presses on the walls of the balloon and irritates the receptors that transmit a signal for the need for urination in the centers of the brain of the brain. The brain sends back a signal that you can relax the sphincter to the urethra. Usually, with constant urination calls during sleep, one wakes up and can deliberately last for a while.
In children under 4 years of age, the centers for control of the urination in the brain are not finally formed, so they cannot always control this process. "Wet nights" up to 4-5 years are not considered a deviation from normal. But after 5 years, Enureis shows a malfunction of any of the urination stages.
Causes of Enuresis in Children:
The slow development of the urinary urination centers and other disorders of the central nervous system (central nervous system). Most often it is an individual characteristic of the body and with the development of the central nervous system, the problem with Enorez goes on its own. The risk of developing the disease is therefore higher in children who have experienced oxygen starvation (even insignificant) during pregnancy and the birth of the mother's birth, entering the umbilical cord, improper performance and more. ; Polyuria is an excessive urine secretion. This may occur due to the fact that the child drinks a lot of fluids at night or due to hormonal disorders. These include diabetes mellitus, excessive activity of the parathyroid glands (hyperparathyroidism), a decrease in the production of 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 synthesized more actively so that the urine is formed less; Diseases of the genius system. Inflammation of the urethra and bladder, neoplasms, narrowing of the urethral canal, for example due to the growth of connective tissue, can also lead to enuresis; Stress. The loss of relative, moving, walking in kindergarten often causes night incontinence of the urine; A strong dream because children do not wake up with urination. Due to the parish, the child often becomes the subject of ridicule. This significantly reduces yourself and leads to psychological problems
Causes of enuresis in adolescents and adults:
Hormonal disorders: diabetes, hyperparathyroidism, decrease in vasopressine; Inflammatory diseases of the genius system: pyelonephritis, urethritis, cystitis, prostatitis, orchitis (inflammation of eggs); regular alcohol abuse; spinal cord trauma, spinal cord; Congenital anatomical abnormalities (such as too small bladder) or weakening of the pelvic floor muscles; Stress. Most often, Enuresis develops under the influence of several factors at once, and in some cases it is not possible to accurately distinguish the main cause of incontinence.
Classification of Enorez Enuresis is divided into primary when the problem is first identified for the first time and periods of complete control over urination and secondary, which is preceded by a controlled "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 the night incontinence of the urine that occurs during sleep. But in medical practice, it is sometimes divided into night, day and mixed. The complex and uncomplicated enuresis also differs: 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 urine system.
Symptoms of Enor The main sign of enuresis is the inability to control urination during night sleep. More rarely - during the day. Unusual bladder emptying cannot appear every night, but regularly. The diagnosis of enuresis is made if this occurs two or more times a month for 3 months.
With Enuree, a person can urinate more frequently during the day, stand up against an involuntary leakage of urine, experience false urination, or, conversely, feel that after visiting the toilet, the bladder is not completely exhausted.
Children and adolescents with Enuresis can become more closed and irritable, sleep worse at night, they reduce performance at school.
Which doctor treats enuresis Enuresis causes various causes, therefore a large number of specialists are engaged in its diagnosis and treatment. Adult patients are recommended to contact the therapist and the urologist. If the child of the child is necessary to get to the admission of the pediatrician, who will check and recommend narrow specialists. This can be a urologist, gynecologist, nephrologist, neurologist, psychotherapist, endocrinologist. General doctors and close specialists collect a family history, listen to the patient's complaints and examine. The diagnosis of enuresis is usually made on the basis of a clinical picture and tests and instrumental studies are prescribed to clarify the causes.
Laboratory Diagnosis of Enorez In order to evaluate the general condition of the body and to identify inflammation of the genological system, it is assisted by a general analysis of urine and analysis of urine by Nechiporenko.
In some cases, an analysis is prescribed to determine the level of vasopressin (anti -diuretic hormone). It controls the level of water in the body and affects the intensity of urination.
Instrumental diagnosis of enuresis With Enuree, the doctor may prescribe ultrasound of the bladder. This study can be replaced by magnetic resonance imaging or computed tomography of the bladder organs and other urinary systems.
Ultrasound helps to evaluate the work of the bladder and understand how much urine is left in it after urination
If ultrasound results are not sufficient to determine the cause of the enuresis and prescribe treatment, the patient is referred to a cystographic examination. For this procedure, a catheter is introduced into the bladder and fills the organ with contrast medicine or oxygen, after which they take pictures of a filled and emptied bladder.
Assess the speed and volume of urine flow during urination allows the method of urofline. During the study, the patient urinates in the funnel of the uroflometrial apparatus. With this study, you can get information about the speed of the urine flow and the volume of the fluid, select indicators (markers) of deviations from the norm. These data are entered into the operating system connected to the sensor, the processed and the results are displayed on a computer monitor in graphic form. The doctor decipher the results.
If the patient in the past has had injuries or the doctor suspects abnormalities of the structure of the lumbosacral department, which can also provoke enuresis, may prescribe an X -ray of this spine.
In children and adolescents, enyreshea most often develops not due to injuries or infections, but due to the delayed development of the central nervous system and stress. In this case, they are recommended by study by a neurologist and psychotherapist.
Parcel In adults and adolescents, enyresa is the most often symptom of infection, endocrine disease or injury. Therefore, first of all, it is necessary to identify this pathology as early as possible and to begin its treatment.
Enures in children is treated by behavior correction (motivational therapy), medicines, physiotherapy, psychotherapy or combinations of these methods.
Medication If the main cause of the enuresis is the disorders of the nervous system, the child may be prescribed medicines that help to normalize his or her work. These are B vitamins, nootropic drugs, glutamic acid, glycine. Anti -diuretic drugs are also prescribed, and in some cases tricyclic antidepressants. But the latter are less used as they have a more expressed side effect.
Separately or as part of complex therapy, medicines are prescribed that normalize the functioning of the muscle sheath of the bladder - a depositor. If Enureis is associated with an infectious disease, they may prescribe a course of antibiotics.
Physiotherapy The procedures are prescribed as an independent type of treatment or in combination with medicines. Paraffin applications of the lower abdomen and back in the lumbosacral department, physiotherapy exercises, electrophoresis, magnetotherapy give good effect.
Gymnastics and physiotherapy are used for complete treatment of enuresis
Psychotherapy In cases where the enresee develops as a result of stress or neurotic disorder, the psychotherapist prescribes treatment. If a child suffers from Enuree, good effect is given by family psychotherapy sessions and sedatives that are suitable for a small patient by age. But it is even more important to create a favorable atmosphere for him at home to show that his adults on his side will help him deal with this problem. In no case should you quarrel and ashamed the child: it is less to blame for his or her illness. 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 advise the use of diapers with Enuree, which hide the unpleasant sensations and equalize the problem - it is better to protect the bed with glue or diaper diapers. There are special devices - alarm clocks that are attached to pajamas or underwear and respond to the first excreted drops of urine with a beep. This gradually gets used to responding to the desire for the body and wake up on time to go to the toilet.
Strictly complying with the day regime and regular visits to the toilet plays an equally important role. Before you go to bed, it is better to go to the toilet twice: to the evening hygiene of hygiene (washing, washing, shower) and after them. You should drink enough water during the day, 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 mostly citrus fruits and juices. Teens and adults should also abandon alcohol, tea, coffee, energy and other caffeine -containing beverages.
Prediction and prevention Summer treatment, adherence to the doctor's recommendations, everyday life and most importantly - the adequate and benevolent reaction of parents and other relatives give 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 its development is reduced if the expectant mother carefully monitors her health during pregnancy: refuses bad habits, leads a healthy lifestyle, monitors everyday life and follows the doctor's recommendations to avoid complications during pregnancy and childbirth.
If the child has already encountered the problem of Enorez, the favorable environment in the family and children's team will help prevent it from recuting. It is worth making every effort to avoid stressful situations that can provoke a relapse of the disease. Adults are advised to carefully monitor their health and in time to identify and treat infections of the genius system, as well as to use condoms during sex to avoid infections transmitted sexually.
Frequent questions What is Enuresis?
Enureis is an involuntary urination in adults and children over 5 years of age, which is more common twice a month, usually during sleep. This disease in children is often found independently and does not affect their health. But Enuresis seriously affects the child's self -esteem and his / her relationship with parents and peers, so many experts recommend treating urine incontinence for 6-7 years.
Why was an adult described at night of sleep?
Night urinary incontinence can cause infections of the genius system, hormonal damage, spinal and spinal cord trauma, weakening of the pelvic floor muscles and even severe experiences. This can also happen if a person is in a state of alcohol or drug 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 Enorez?
The cause of the Enresea may be infectious diseases, stress, hormonal malfunctions. In children, night incontinence of urine is often associated with the characteristics of the development of the central nervous system. Treatment is prescribed depending on what exactly caused night incontinence of the urine. Most often they combine medicines (synthetic hormones, sedatives, tricyclic antidepressants) and physiotherapy methods - electrophoresis, gymnastics, magnetic and laser therapy. If Enureis is associated with neurotic disorder or chronic stress, it is recommended to seek help from the therapist.
Which doctor treats Enuresis?
Enuresis causes various causes, therefore a large number of specialists are engaged in its diagnosis and treatment. Adult patients are recommended to contact the therapist and the urologist. If the child of the child is necessary to get to the admission of the pediatrician, who will check and recommend narrow specialists. This can be a urologist, gynecologist, nephrologist, neurologist, psychotherapist, endocrinologist.
