Enuresis - is incontinence, uncontrolled urination in the night and in the daytime.
Usually, the term "enuresis" refers mainly nocturnal enuresis in children and any episodes of urinary incontinence in adults.
general information
The disease is due to its sensitivity, causing great psychological complexity of the plan violates the mind and provokes neuroses, which further worsens the condition and exacerbates the disease, because the original nature of enuresis in the majority neurological.
Furthermore, enuresis often accompanies diseases of the urogenital tract, what complicates diagnosis and treatment of the underlying condition.
Children of enuresis can speak not before 4-5 years, it is at this age finally ripen the brain structures responsible for awakening for going to the toilet. Earlier this age nocturnal urinary control can not be scheduled and children are wetting the bed, without waking up.
In children under five years of enuresis occurs in 20% of cases, at the age of 6 years - about 12% under the age of 12 years, about 3%, and up to 18 years of age, affecting approximately 1% of adolescents.
Boys are affected three times more often girls, but the girls episodes of enuresis can turn into adulthood episodes of urinary incontinence or enuresis development in adulthood.
Causes of enuresis in children
In the development of enuresis in children identified a number of the leading causes. First of all, this is the delay of forming centers of the brain responsible for the control of urination.
Enuresis can result from disorders release of antidiuretic hormone, which level should rise progressively to the night time. Due to its action reduces the amount of urine at night, it becomes more concentrated. If the hormone is not enough urine is released in higher amounts, there is an overflow of the bladder and formed enuresis.
Predispose to the development of enuresis urinary tract infections - pyelonephritis and cystitisAnd genital inflammation - for girls vulvovaginitises, Boys - balanoposthitis. In children, enuresis predispose worm infestation.
High role of genetic susceptibility to enuresis, if the parents in childhood were marked episodes - a child's risk is increased threefold.
Pronounced influence stress, psychological trauma and emotional upsets. Often children start wetting the bed when the parents divorce, school problems, family conflicts.
Bedwetting may occur as a result of sleep disorders, if the child's sleep is very strong, and it just does not feel the urge to urinate and not wake up.
Typically enuresis occurs not by the impact of a single cause, and due to the action of multiple factors simultaneously.
Causes of enuresis in adults
In adults, the main causes of enuresis are diseases or degenerative changes in the urogenital system, malformations of the bladder or urethra, stone formation. For women, hormonal imbalance is becoming urgent in the period menopause degenerative changes in the muscles of the urethra.
In old age, in the first place are the degenerative changes in the brain areas that control break between the spinal cord and head.
Separately, in recent years it began to allocate neurotic and neurosis-like form of urinary incontinence.
diagnosis of enuresis
diagnostic base - enuresis episodes that occur after five years, continuing regularly at least 3 months. Adult enuresis is considered virtually any fact of urinary incontinence in the daytime or at night.
In order to clarify the diagnosis carried out a detailed survey and examination of the patient, his overtures stomach and examine the sex organs for congenital or acquired defects. It is mandatory held ultrasound abdominal organs and pelvis with a full bladder, and after his discharge. Further illustrated:
- Study volume and rate of urination during the day and at night,
- IVP,
- cystography and tsitoskopiya,
- tsrofluometriya,
- consultation of the neurologist, ENT physician in order to avoid chronic disease that provokes enuresis.
enuresis treatment
In the treatment of enuresis in children play an important role parents and their attitude to the problem - the mainstay of treatment - is not medicines and treatments, and psychological support, psychotherapy, voiding mode and control over quantity drunk. It is necessary to reduce the amount of fluid taken at bedtime, review the power not to consume diuretic foods at night.
When antidiuretic hormone deficiency carried correction synthetic analogs (Minirin).
When the tone of the bladder can be appointed driptan or its analogs to reduce spasms and increasing the volume of the bubble.
With the weakening of bladder tone mode use forced urination and preparations, tonics bladder wall (Minirin, prazerin).
In the case of the neurological nature of enuresis treatment is indicated neurosis, therapy and auditory training, parents are advised to forcibly raise the child on the potty.
The range of treatments include physical therapy - ultrasound, micro-currents or thermal treatments on the area of the bladder, physiotherapy, massages.
A promising method of treatment of enuresis today is acupuncture and osteopathy. They gently and gradually restore the interaction between cortical and spinal structures of the nervous system, restoring control over the urination process.
Kegel exercises when enuresis
When stressful enuresis in adults first step to a cure are usually Kegel exercises, which help strengthen the pelvic floor muscles.
The first exercise can be done in any position, it is important only to the muscles of the abdomen, buttocks and legs have been relaxed. It is several times to produce compressive movement of the muscles around the anus, as if preventing bowel. It is performed several times a day at every opportunity.
Exercise during urination. It is time to hold the stream, and then re-start. Thus strengthening the front group of the pelvic floor muscles.
Exercise, combining the first and second exercises. It is necessary to start with relaxation and then slowly squeeze the pelvic muscles of the day, starting from the back of the group, and then engaging the front. One exercise cycle is on four counts. Should repeat for two minutes at least three times a day.
Forecast
Enuresis Treatment is long and requires patience and painstaking, but the prognosis of it favorable. Virtually all patients are cured of enuresis completely.
