The diagnosis of enuresis is made by adults and children over 5 years old, if they are more frequent than twice a month with voluntary urinary problems. The disease in children often occurs independently and does not affect their health. But enuresis seriously affects their children and their relationships with their parents and peers, so they recommend treating urine incontinence for 6-7 years.
What is an enuresis
Enuresis is a recurrent episode of urinary incontinence, which occurs at least twice a month for 3 months or more. Often, voluntary urine occurs at night. Studies on this problem have been involved in doctors since the time of ancient Persian scientists Avicenna, and for the first time the term "enuresis" was introduced into medical practice in the late 18th century. Since then, it is possible to find a very effective method for treating the disease, but the mechanism of occurrence has not been fully studied.
Often, children suffer from enuree, and by adolescents, in most cases, the disease passes on its own.
In boys, enuresis is more common than girls
Experts recommend not neglecting this delicate problem even at a young age, due to urine incontinence, children can develop genitourinary system diseases and psychological problems.
Studies have shown that in children with enuresis in 70% of cases, the level of anxiety has increased, they have difficulty communicating with their peers and facing family conflicts due to their problems, which they cannot control. New Zealand Judicial Psychiatry, John Makdonald, even includes enuresis, together with zoosadism (brutal animal handling) and pyruinia (spirit of burning), in "behavioral triads", which show a tendency to commit cruel crime. The formation of personality is not influenced by the episode of Enoreez, but the trauma associated with the ridicule and punishment of parents, friends, brothers and sisters.
At the age of 5, enuresis occurs at 15-20%of children, at 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, enuresis usually develops after 45 years, women suffer from them three times more often than men. At this age, episodes of enuresis are usually symptoms of nervous system disease and genitourinary - and spontaneous antidote, as in children, do not occur.
The cause of enoreez
Usually, the urinary process takes place as follows. Urine through the ureter moves from the kidneys to the bladder, but does not come out: it is held by a muscle ring (sfinkter), located at the place of the urethra compound with the bladder. Gradually accumulated, it presses on the bubble wall and interferes with receptors that send signals about the need to urinate into the brain center. The brain sends back the signal that you can relieve urethra sfinkter. Usually, with continuous calls for urination during sleep, one wakes up and intentionally lasts for some time.
In children under the age of 4, the control center of urine in the brain is not formed, so they cannot control this process. "Wet Night" up to 4-5 years is not considered a deviation from the norm. But after 5 years, the enuresis shows damage to the urinary stage.
Causes of enuresis in children:
- Slow development of the urinary center in the brain and other disorders of the central nervous system (central nervous system). Often, this is an individual characteristic of the body and as the central nervous system develops, the problem of enoreez walks on its own. The risk of developing the disease is because it is higher in children with oxygen starvation (though not important) during pregnancy and gives birth to maternal toxicity, enters the central rope, improper presentation, and so on;
- Polyuria is an excessive secretion of urine. This may be due to the fact that the child drinks plenty of fluids at night or due to hormone disorders. These include diabetes mellitus, excess paratiroid gland activity (hyperparathyroidism), reducing vasopressin hormone production, which helps control the muscle tone of the internal organs and regulates the amount of urine. At night, it is usually synthesized more active, so the urine form is low;
- Disease of genitourinary system. Inflammation of the urethra and bladder, neoplasms, narrowing of the uretral tract, for example, due to the growth of connective tissue, can also cause enuresis;
- Pressure. Losing relatives, moving, going to kindergarten often causes urine night incontinence;
- A strong dream, because the children do not wake up with the urine.
Because of Enoreez, children are often the object of ridicule. This greatly reduces oneself and leads to psychological problems
Causes of enuresis in adolescents and adults:
- Hormone disorders: diabetes, hyperparatiroidism, vasopressin reduction;
- Inflammation of the genitourinary system: pyelonephritis, urethritis, cystitis, prostatitis, orchitis (egg inflammation);
- regular alcohol abuse;
- spinal trauma, spinal cord;
- Congenital anatomical abnormalities (for example, too small bladder) or weakening the pelvic floor muscles;
- Pressure.
Often, enuresis develops under the influence of several factors at once, and in some cases, it is not possible to distinguish the leading cause of incontinence.
Enoreez's classification
Enuresis is divided into primers, when the problem is identified for the first time and the full control period of urine, and secondary, preceded by a "dry" period controlled for six months or more.
In the clinical proposal of our Ministry of Health, the disease is defined as urine night incontinence occurring during sleep. But in medical practice, sometimes it is divided into night, day and mixed. Complicated and uncomplicated enuresis are also distinguished: in the first case, this syndrome is not associated with other diseases, in the second it is associated with central nervous system pathology, infections and other problems with the urinary system.
Symptoms of Enoreez
The main sign of enuresis is the inability to control the urine during the night's sleep. Less often - during the day. Extraordinary bladder emptying cannot occur every night, but frequently. The diagnosis of enuresis is made if this occurs two or more times a month for 3 months.
With Enuree, one can urinate more frequently during the day, face a voluntary urination leak, experience false urine or, rather, feel that after visiting the toilet, the bladder is not completely exhausted.
Children and adolescents with enuresis can be more closed and angry, sleeping worse at night, they reduce school performance.
Which doctor treats enuresis
As a result, enuresis causes a variety of reasons, therefore, a large number of experts are involved in their diagnosis and treatment. Adult patients are recommended to contact therapists and urologists. In the event of a children's enuresis, it is necessary to come to the receipt of a pediatric specialist who will conduct an examination and recommend a narrow specialist. These can be urologists, gynecologists, nephrologists, neurologists, psychotherapists, endocrinologists. General practitioners and narrow experts collect family history, hear patients' complaints, and examine. The diagnosis of enuresis is usually based on clinical picture, and testing and instrumental studies are set to explain the causes.
Enoreez's lab diagnostics
To evaluate the general condition of the body and to identify inflammation of the genitourinary system assisted by general urine analysis and urine analysis by nechiporenko.
In some cases, the analysis is prescribed to determine the level of vasopressin (antidiuretic hormone). It controls the water level in the body and affects the intensity of the urine.
The diagnosis of enuresis instrumental
With Enuree, doctors can prescribe bladder ultrasound. This study can be replaced by magnetic resonance or tomography calculated on the bladder and other urinary system.
Ultrasound helps evaluate the work of the bladder and know how much urine is left in it after urine
If the ultrasound decision is insufficient to determine the cause of the enuresis and prescribe treatment, the patient is directed to the cystographic examination. For this procedure, the catheter is introduced into the bladder and filling the organs with different drugs or oxygen, after which they take a picture of the bladder that is filled and emptied.
Evaluating the speed and amount of urine flow during urine allows uroflowetry method. During the study, the patient dumped into the urofloumeter's funnel. With this study, you can find information on urine flow rate and the amount of fluid, select the indication (marker) of the deviation from the norm. These data are included in the operating system related to the sensor, processed, and the result is displayed on a computer monitor in graphic form. The doctor declared the results.
If the patient in the past is injured or the doctor suspects the anomaly of the lumbosacral department structure, which can also trigger an enuresis, may prescribe this X-ray.
In children and adolescents, enuresis is most often developed not due to injury or infection, but due to the development of the central nervous system and stress. In this case, they are recommended by examinations by neurologists and psychotherapists.
Enoreez treatment
In adults and adolescents, enuresis is most common symptoms of infection, endocrine disease or injury. Therefore, first of all, it is necessary to identify this pathology as early as possible and begin its treatment.
Children's strength is treated with behavioral correction (motivational therapy), medicine, physiotherapy, psychotherapy or a combination of this method.
Drug
If the main cause of enuresis is a violation of the nervous system, medicines that help normalize their work can be prescribed to children. These are vitamin B vitamins, nootropic drugs, glutilic acid, glycine. Antidiuretic drugs are also prescribed and in some cases of tricyclic antidepressants. But the latter is used less often, as they have clearer side effects.
Separately or as part of complex therapy, prescribed drugs that normalize the work of the bladder muscle - Detruzor. If enuresis is associated with infectious diseases, they may prescribe antibiotic courses.
Physiotherapy
The procedure is prescribed as a type of free treatment or combined with medication. The paraffin application at the bottom of the stomach and back in the lumbosacral department area, physiotherapy training, electrophoresis, magnetotherapy has a good effect.
For comprehensive enuresis, gymnastics and physiotherapy treatment used
Psychotherapy
In cases where enuresis develops due to stress or neurotic disorders, psychotherapy prescribes treatment. If children suffer from Enuree, a good effect is given by family psychotherapy and sedative sessions that are appropriate for small patients. But it is more important to create a good atmosphere for her at home, to show that adults by her will help her solve this problem. In the case of no, you have to scold and embarrass the children: not to be blamed for his illness. Stress and aggression will lead to the fact that 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 using diapers with enuree, which hides unpleasant sensations and measuring problems - it is best to protect the bed with adhesive diapers or disposable. There is a special device - an alarm clock that is attached to the piyama or underwear and responds to the first drop of urine with a sound signal. This gradually used to respond to the desire for the body and get up in time to go to the toilet.
Strictly compliance with day regime and permanent visits to the toilet play a role as important. Before going to bed, it is best to go to the toilet twice: until the night's hygiene procedure (washing, brushing, bathing) and after them. During the day, you need to drink enough water, but one or two hours before bed, it is worth limiting the use of fluid, as well as the product that stimulates the bladder-especially fruits and citrus juices. Adolescents and adults also need to leave alcohol, tea, coffee, energy and other caffeine.
Forecast and prevention
Summer treatments, compliance with doctor's recommendations, daily routines and, most importantly, adequate and good relative reactions to good results and allow you to get rid of voluntary night urination.
It is not possible to prevent enuresis, but the risk of development is reduced if a pregnant mother carefully monitors her health during pregnancy: rejecting bad habits, leading a healthy lifestyle, observing daily routines and following the doctor's recommendations to prevent complications during pregnancy and childbirth.
If the child has found Enoreez's problems, an encouraging environment in the family and children will help prevent repetition. It is necessary to make every effort to avoid stressful situations that can cause relapse of the disease. Adults are recommended to monitor their health carefully and in time to identify and treat the genitourinary system infection, as well as use condoms during sex to prevent sexually transmitted infections.
Frequent questions
What is an enuresis?
Enuresis is a voluntary urine in adults and children over 5 years old, which occurs more often twice a month, usually during sleep. The disease in children often occurs independently and does not affect their health. But enuresis serious affects their children and their relationships with their parents and peers, so many experts recommend treating urine incontinence from 6-7 years.
Why are adults depicted at night in dreams?
Night urinary incontinence can cause genitourinary system infections, hormone failure, spinal trauma and spinal cord, weakening the pelvic floor muscles and even severe experience. This can also happen if a person is in a state of alcohol or narcotic intoxication. If the urine is voluntary at night, you must consult a doctor who can determine the cause of this fine problem and prescribe treatment.
How to get rid of Enoreez?
Causes of enuresis can be infectious diseases, stress, hormone damage. In children, urine night incontinence is often associated with the features of the central nervous system development. The treatment is prescribed depending on what actually causes urine incontinence. Often combining drugs (synthetic hormones, sedatives, tricyclic antidepressants) and physiotherapy methods - electrophoresis, gymnastics, magnets and laser therapy. If enuresis is associated with neurotic disorders or chronic stress, it is recommended to seek the help of a therapist.
Which doctor treats enuresis?
As a result, enuresis causes a variety of reasons, therefore, a large number of experts are involved in their diagnosis and treatment. Adult patients are recommended to contact therapists and urologists. In the event of a children's enuresis, it is necessary to come to the receipt of a pediatric specialist who will conduct an examination and recommend a narrow specialist. These can be urologists, gynecologists, nephrologists, neurologists, psychotherapists, endocrinologists.