The diagnosis of enuresis is adults and children over 5 years, if they are more often than twice a month 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-employment and his relationship with his parents and peers, so they recommend that urine are not recommended for 6-7 years.
What is enuresis
Enuresis are repeated episodes of urinary incontinence, which occur at least twice a month 3 months or more. Most often involuntary urination occurs at night. The study of this problem was dealt with doctors from the time of the ancient Persian scientist Avicenna, and for the first time, the term "Enuresis" was introduced into medical practice at the end of the 18th century. Since then, it has been possible to find quite effective methods of treatment of disease, but the mechanism of its phenomenon has not yet been fully studied.
The most common children suffer from Enure, and the adolescence in most cases the disease passes alone.
In boys, enuresis is more common than girls
Experts recommend that they do not ignore this sensitive problem even in your youth, because due to incontinent urine, the child can develop a genitourinary system diseases and psychological problems arise.
Studies have shown that in children with enuresis in 70% of cases an increased level of anxiety, they have difficulties in communication with peers and meet the conflicts in the family because of their problems, which cannot control. The New Zealand Judicial Psychiatrist, John Macdonald, even included Enuresis, with zoosadism (brutal animal handling) and piruinia (a passion for fire), in the "behavior of Triad", which indicates a predisposition to commute crimes. The formation of personality does not affect the episodes of the enorez, but traumas associated with the derision and penalties of parents, friends, brothers and sisters.
In 5 years, Enuresis appears in 15-20% of children, in 7 years - in 12%, and in 10 - 5%. The disease is also revealed 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. In this age, enuresis episodes are usually symptoms of diseases of nervous and genitine system - and spontaneous healing, as in children, do not appear.
Causes of enore
Usually the urination process appears as follows. Urine over the ureter moves from the kidney to the bladder, but does not exit: Holds the muscle ring (sphincter), located in the area of urethra with bladder. Gradually accumulating, presses to bubble walls and annoy receptors who transmit a signal on the need to urinate brain brain centers. The brain sends a signal that you can relax the sphincter urethra. Normally, with permanent calling calls during sleep, the person wakes up and can deliberately endure for a while.
In children under 4 years, control centers in brain urination are not finally formed, so they cannot always control this process. The "wet of the night" to 4-5 years is not considered deviation from the norm. But after 5 years, Enuresis indicates a malfunction at any of the urination phases.
Causes of enuresis in children:
- Slow development centers for the brain urination and other central nervous system disorders (central nervous system). Most often, this is a single characteristic of the body and as a central nervous system develops, the enore's problem goes alone. The risk of developing the disease for this reason is higher in children who have experienced oxygen (even insignificant) during pregnancy and childbirth - due to mother toxicosis, entering umbilical cable, irregular presentation, etc. ;
- The polyuria is an excessive excretry urine. It can appear due to the fact that a child drinks a lot of fluid at night or because of hormonal disorders. These include diabetes mellitus, excessive activity of paratyroid glands (hyperparariaTiroidism), reduced production of vasopriation hormone, which helps regulate the tons of the muscles of the internal bodies and control the amount of urine. It is usually more active in the night, so that the urine is formed less;
- Genitourinary system diseases. Inflammation of urethra and bladder, neoplasm, narrowing of the urethral channel, for example, due to the growth of connective tissue, can also lead to enuresis;
- Stress. Loss of relatives, moves, goes to kindergarten often causes night incontinence of urine;
- A strong dream, which is why children do not wake up with urination.
Due to enore, the child often becomes the subject of ridicule. This greatly reduces self-esteem and leads to psychological problems
Causes of enuresis in adolescents and adults:
- Hormonal disorders: diabetes, hyperparathryoidism, reduction of vasopreses;
- Inflammatory diseases of the genitourin system: chickenphritis, urethritis, cystitis, prostatitis, orchitis (inflammation of eggs);
- Regular alcohol abuse;
- Trauma spine, spinal cord;
- Congenital anatomical abnormalities (for example, too small bladder) or weakening the pelvic muscles;
- Stress.
The most commonly enuresis is developing under the influence of several factors at once, and in some cases it is not possible to distinguish the main cause of incontinence at all.
Enorez Classification
Enuresis is divided into primary, when the problem was first identified and the period of complete control over urination, and the secondary, which preceded the controlled "dry" for a long time for six months or more.
In the clinical recommendations of the Health Ministry 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. In different and uncomplicated enuresis is also different: in the first case, the syndrome is not connected to other diseases, in the second it is connected to the pathologies of the central nervous system, infection and other problems with the urinary system.
Symptoms of Enoreza
The main sign of Enureza is the inability to control urination during a night sleep. Less often - during the day. Unusual bladder emptying cannot appear every night, but regularly. The diagnosis enuresis is done if this happens two or more times a month for 3 months.
With Enuree, a person can more often have to face an involuntary urinary leak, experience false urine or, vice versa, to feel that after visiting the toilet, the bladder that bladder is not completely exhausted.
Children and adolescents with enuresis can become more detained and irritable to sleep at night, they reduce the performance at school.
Which doctor treats enuresis
Enuresis cause various reasons, so a large number of experts deal with its diagnosis and treatment. Adult patients are recommended to contact the therapist and urologist. If the child is enuresis, it is necessary to come to the pediatrician reception that will implement inspection and recommend narrow experts. It can be urologist, gynecologist, nephrologist, neurologist, psychotherapist, endocrinologist. General practitioners and narrow experts collect family history, listen to the patient's complaints and examine. The diagnosis enuresis is usually done on the basis of a clinical picture, and tests and instrumental studies are prescribed for clarification of the cause.
Laboratory diagnostics of enore
To assess the general condition of the body and identify inflammation of the genitourin system helps the general urine analysis and the analysis of Urina Nechiporenko.
In some cases, an analysis is prescribed in order to determine the level of vasopres (antidiaour hormones). This controls the water level in the body and affects the urination intensity.
Instrumental diagnosis of ENUREZA
With Enerura, the doctor can prescribe the ultrasound of the bladder. This study can be replaced with a magnetic resonance or calculated tomography of the bladder and other urgency bodies.
Ultrasound helps to assess the work of the bladder and find out how much urine remains in it after urinating
If ultrasound results are not enough to determine the cause of ENURESS and the prescribed treatment, the patient is focused on a chistographic review. For this procedure, the catheter is introduced into a bubble and fill the organ with contrasting medicine or oxygen, followed by filled and empty bladder.
Assess the speed and amount of urine flow during urination allows uroflowetry method. During the study, the patient urs into a drug-receiver of the Urofloumeter apparatus. With this study, you can get information on the flow rate and fluid circulation rate, select Indicators (markers) from the standards. These data are entered in the sensor related to the sensor, processed and the results are displayed on the computer monitor in graphics form. The doctor decipher the results.
If the patient in the past had an injury or doctor suspects the anomalies of the structure of the LumbusCral Department, which can also cause Enuresis, can prescribe the X-ray of this spine.
In children and adolescents, enuresis is most often developed due to injuries or infections, but due to the late development of the central nervous system and stress. In this case, it recommends them by examining neurologists and psychotherapists.
Enorez treatment
In adults and adolescents, enuresis is the most common symptom of infection, endocrine disease or injury. Therefore, it is primarily necessary to identify this pathology as soon as possible and start their treatment.
It is preserved in children treated with the correction of behavior (motivational therapy), medications, physiotherapy, psychotherapy or combinations of these methods.
Medicine treatment
If the main cause of enurging a violation of the nervous system, medications that help the normalization of its work can be prescribed to the child. These are vitamins of a group B, noootropic drugs, gliconic acid, glycine. Antidiautic drugs are also prescribed and in some cases tricyclic antidepressants. But the latter is used less often because they have more pronounced side effects.
Separately or as part of complex therapy, medications are prescribed to normalize the operation of the muscular shell of the bladder - Detrozor. If enuresis is associated with infectious diseases, they can prescribe the course of antibiotics.
Physiotherapy
Procedures are prescribed as an independent type of treatment or in combination with medicines. Paraffin applications on the lower abdomen and on the back in the field of lurbosacral department, the exercise of physiotherapy, electrophoresis, magnetotherapy provide good effect.
For a comprehensive treatment of enuresis, gymnastics and physiotherapy are used
Psychotherapy
In cases where Enuresis has developed as a result of stress or neurotic disorders, the psychotherapist prescribes treatment. If a child suffers with Enureo, good performance give family psychotherapeutic sessions and sedatives that are suitable for a small patient according to age. But it is even more important to create a favorable atmosphere for him at home, to show that adults will help him befriend this problem. In no case you should not beat up and shame a child: that is the least wrong for his disease. 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 use of diapers with Enureo, which hide unpleasant sensations and levels of problems - it is better to protect the bed with adhesive or disposable diaper. There are special devices - enuremated allegors attached to pajamas or underwear and respond to the first excreted urine drops with an audible signal. It gradually gets used to the person to answer the urge towards the body and wake up in time to go to the toilet.
Strictly compliance with the day and regular visits to the toilet plays an equally important role. Before going to bed, it is better to go to the toilet twice: to evening hygienic procedures (washing, brushing, shower) and after them. During the day you have to drink enough water, but an hour or two before bed, it is worth limiting the use of fluids, as well as products that irritate the bladder - this is primarily citrus fruit and juices. Teen and adults must leave alcohol, tea, coffee, energy and other drinks that contain caffeins.
Forecast and prevention
Summer treatment, compliance with doctor's recommendations, daily routine and, most importantly, adequate and well-meaningful reactions to parents and other relatives give good results and allow you to fully resolve involuntary night urination.
It is impossible to prevent themselves, but the risk of its development has been reduced if it is healthy during pregnancy: refuses bad habits, leads a healthy lifestyle and follow medical recommendations to avoid complications during pregnancy and childbirth.
If the child is already encountering a problem of enorres, a favorable environment in the family and a children's team will help prevent his repetition. It is worth standing in every effort to avoid stressful situations that can cause relapse diseases. Adults are recommended to carefully monitor their health and in time to identify and treat the genitourinary system infection, as well as use condoms during sex to avoid infections sexually.
Frequently asked questions
What is enuresis?
Enuresis is an involuntary adult urination and children over the age of 5, which occur more often twice a month, usually during sleep. This disease in children often occurs independently and does not affect their health. But seriously affects the child's self-esteem and his relationship with his parents and peers, so many experts recommend the treatment of the incontinence of urine from 6-7 years.
Why did an adult described at night in a dream?
Night urinary incontinence can cause genitourinary system infections, hormonal failures, spine trauma and spinal cord, pelvis muscles and even strong experience. This can also occur if a person is in a state of alcohol or narcotic intoxication. If accidental urination into the night regularly appears, you must contact a doctor who can determine the cause of this sensitive problem and prescribing treatment.
How to get rid of the enore?
The cause of enuresis 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. The treatment is prescribed depending on what exactly caused the night incontinence of urine. They usually combine medications (synthetic hormones, sedatives, tricyclic antidepressants) and physics, electrophoresis, gymnastics, magnetic and laser therapy. If enuresis is connected to a neurotic disorder or chronic stress, it is recommended to seek the help of the therapist.
Which doctor treats enuresis?
Enuresis cause various reasons, so a large number of experts deal with its diagnosis and treatment. Adult patients are recommended to contact the therapist and urologist. If the child is enuresis, it is necessary to come to the pediatrician reception that will implement inspection and recommend narrow experts. It can be urologist, gynecologist, nephrologist, neurologist, psychotherapist, endocrinologist.