Enurse diagnosis is made by adults and children over 5 years old if they face the problem of involuntary urination more than twice a month. 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 they recommend treating urine non-resentment from the age of 6-7.
What is enuresis
Enuresis are repeated episodes of urinary incontinence, which 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 engaged in doctors since the time of the ancient Persian scientist Avicenna, and for the first time the term "enuresis" was introduced into medical practice in the late 18th century. Since then, it was possible to find very effective methods of treating the disease, but the mechanism of its occurrence has not yet been fully studied.
Most often, children suffer from an enuree, and adolescence, in most cases, the disease passes itself.
In boys, enuresis is more common than girls
Experts recommend not ignoring this delicate problem even at a young age, because due to the non -urine, the child may develop diseases of the genitourinary system and occur psychological problems.
Studies have shown that in children with an enuresis in 70% of cases, the level of anxiety has increased, they have difficulty communicating with their peers and encountering family conflicts because of their problem, which they cannot control. New Zealand Psychiatrist John Makdonald even included enuresis, along with zoosadism (brutal animal treatment) and Piruinia (passion for arson), in the "behavior triad", indicating a predisposition to commit cruel crimes. Personality formation is not influenced by Enorez's episodes, but a trauma associated with ridicule and punishment by parents, friends, brothers and sisters.
At the age of 5, enuresis occurs in 15-20%of children, at the age of 7 - at 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, enuresis episodes are usually symptoms of diseases of the nervous and genitourinary system - and spontaneous cure, as in children, does not occur.
The causes of Enorez
Normally, the urination process occurs as follows. Urine through the urethra moves from the kidneys to the bladder, but does not come out: it is maintained by the muscle ring (sphincter), located at the site of the urethra complex with the bladder. Gradually accumulating, it crushes on the bubble wall and disturbs the receptors that transmit a signal about the need to urinate on the brain's brain centers. The brain again sends a signal that you can relax the urethra sphincter. Normally, with constant calls for urination during sleep, a person wakes up and can deliberately endure for some time.
In children under the age of 4, the control centers on 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 the norm. But after 5 years, the enuresis shows a malfunction in any of the stages of urination.
Causes of Enuresis in Children:
Due to Enorese, 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:
Most often, the enuresis develops under the influence of several factors immediately, and in some cases it is not possible to distinguish the main cause of incontinence at all.
ENOREZ
The enuresis is divided into elementary, when the problem was first identified and periods of full control over urination, and secondary, which was preceded by a "dry" controlled 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 nightly urinary incontinence that occurs during sleep. But in medical practice, it is sometimes 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 is associated with central nervous system pathology, infections and other problems with the urinary system.
Symptoms of Enorez
The main sign of the enuresis is the inability to control urination during night sleep. Less often - during the day. The unusual bladder gap can not happen every night, but regularly. Enurse diagnosis is made if this occurs two or more times a month for 3 months.
With an enuree, a person can urinate more often during the day, face involuntary urine leakage, experience false urination or, conversely, feel that after visiting the toilet, the bladder is not completely tired.
Children and teens with enuresis can become more closed and frustrated, to sleep worse at night, they reduce school performance.
Which doctor treats the enuresis
Enuresis cause a number of reasons, so a large number of specialists are engaged in its diagnosis and treatment. Adult patients are recommended to contact therapist and urologist. If the child's enuresis, it is necessary to wait for the pediatrician who will perform an inspection and recommend close specialists. This can be a urologist, gynecologist, nephrologist, neurologist, psychotherapist, endocrinologist. General practitioners and close specialists collect a family story, listen to the patient's complaints and examine. The diagnosis of enuresis is usually made on the basis of a clinical appearance, and instrumental tests and studies are prescribed to clarify the causes.
Laboratory diagnostics of Enorez
To evaluate the overall condition of the body and identify inflammation of the genitourinary system is aided by a general urine analysis and urine analysis by Nechiporenko.
In some cases, an analysis is described 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 an ultrasound of the bladder. This study can be replaced by magnetic resonance or calculated tomography of the bladder and other organs of the urinary system.
Ultrasound helps to evaluate bladder work and find out how much urine remains in it after urination
If the ultrasound results are not sufficient to determine the cause of the enuresis and to describe the treatment, the patient is directed to a cystographic examination. For this procedure, a catheter is inserted into the bladder and fills the organ with a reverse drug or oxygen, after which they take pictures of the stuffed and empty bladder.
Evaluate the speed and volume of urine flow during urination allows the uroflowetry method. During the study, the patient urinates in the receiver of the urofloumeter pipe pipe. With this study, you can get information about the degree of urine flow and fluid volume, select the indicators (markers) of deviations from the norm. These data are entered into the operating system related to the sensor, processed, and the results appear on the computer monitor in graphic form. The doctor deciphes the results.
If the patient in the past had injuries or the doctor suspects abnormalities of the structure of the lumbosacral department, which can also provoke the enuure, may prescribe an X radius of this back.
In children and adolescents, the enuresis most commonly develops not due to damage or infections, but due to the delayed development of the central nervous system and stress. In this case, they are recommended by examination by a neurologist and psychotherapist.
Treatment of Enorez
In adults and adolescents, enuresis is most often a symptom of infection, endocrine disease or damage. Therefore, first of all, it is necessary to identify this pathology as soon as possible and begin its treatment.
Enules in children are treated by behavioral correction (motivational therapy), medicines, physiotherapy, psychotherapy or combinations of these methods.
Treatment
If the main cause of the enuresis is violation of the nervous system, drugs that help normalize his work can be prescribed to the child. These are group B in group, nootropic drugs, glutamic acid, glycin. Antidiuretic drugs are also prescribed and in some cases tricyclic antidepressants. But the latter are used less frequently, as they have a more pronounced side effect.
Separately or as part of the complex therapy, the medicines are prescribed that normalize the work of the bladder muscle shell - detrouns. If the enuresis is associated with an infectious disease, they can prescribe a course of antibiotics.
Physiotherapy
Procedures are described as a type of independent treatment or in combination with medicines. Applications for paraffin to the lower abdomen and the back of the lumbosacral department area, physiotherapy exercises, electrophoresis, magnetotherapy give a good effect.
For comprehensive enussion, gymnastics and physiotherapy treatment are used
Psychotherapy
In cases where the enuresis developed as a result of stress or neurotic disorder, a psychotherapist prescribes treatment. If a child suffers with an enuree, a 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 adults on his side will help him cope with this problem. In no case should you reproach and shame the child: it is less to blame for his 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 using diapers with an enuree, which hide unpleasant sensations and level the problem - it is best to protect the bed with adhesive or available diaper. There are special devices - anticipated alarm hours that are attached to pajamas or internal and respond to the first excreted urine points with a sound signal. This gradually teaches a person to respond to the request in the body and wake up in time in order to go to the toilet.
Strictly compliance with the day's regime and regular bathroom visits play an equally important role. Before going to bed, it is best to go to the toilet twice: up to evening hygiene procedures (washing, washing, shower) and after them. During the day, you need to drink enough water, but one hour or two before bedtime, it is worth limiting the use of fluid, as well as the products that irritate the bladder-this is mainly citrus and fluid. Adolescents and adults should also abandon alcohol, tea, coffee, energy and other drinks containing caffeine.
Forecasting and prevention
Summer treatment, compliance with doctor's recommendations, daily routine and, most importantly, adequate and well -loved parents and other relatives give good results and allow you to get rid of the problem of involuntary night urination.
It is impossible to prevent the enuresis, but the risk of its development is reduced if the expected mother carefully monitors her health during pregnancy: rejects bad habits, directs a healthy lifestyle, observes daily routine and follows the doctor's recommendations in order to avoid complications during pregnancy and childbirth.
If the child has already encountered Enorez's problem, the favorable environment in the family and the children's team will help prevent its recurrence. It is worth making any effort to avoid stressful situations that can provoke a relapse of the disease. Adults are recommended to carefully monitor their health and in time to identify and treat infections of the genitourinary system, as well as to use condoms during sex to avoid sexually transmitted infections.
Frequently
What is enuresis?
Enuresis is involuntary urination in adults and children over 5 years old, which occurs most 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 urine disallows from 6-7 years.
Why was an adult at night described in a dream?
Urinary nightmares can cause infections of the genitourinary system, hormonal failures, spinal trauma and spinal cord, weakening of the pelvic floor muscles and even severe 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 Enorez?
The cause of the enuresis can be infectious disease, stress, hormonal malfunction. In children, urinary night retaining is often associated with the features of the development of the central nervous system. The treatment is prescribed depending on what exactly caused a nightly urinary incontinence. Most commonly combine medicines (synthetic hormones, sedatives, tricyclic antidepressants) and methods of physiotherapy - 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.
Which doctor treats the Enura?
Enuresis cause a number of reasons, so a large number of specialists are engaged in its diagnosis and treatment. Adult patients are recommended to contact therapist and urologist. If the child's enuresis, it is necessary to wait for the pediatrician who will perform an inspection and recommend close specialists. This can be a urologist, gynecologist, nephrologist, neurologist, psychotherapist, endocrinologist.