Enuresis

Enuresis is a pathology in which one person cannot control the bladder emptying. In most cases (more than 95%), we speak of a children's closure if control over urination has not yet been fully formed. However, the disease can also be found in adults (especially older people) if the ability to control the emptying of the bladder has already been lost.

The problem of involuntary urination is mostly shown at night when a person sleeps (up to 80% of all cases). This happens much less often during vigilance.

There is no precise information about the prevalence of this disease, since the parents turn far away to the doctor. According to reports, enuresis in children aged 5 years appear in 5-10% of cases; under 10 year old 3-5%; Under 15 year olds and older (enuresis of adults and adolescents) -1%.

Types of disease

Enuresis is classified according to various parameters. Depending on the basic cause of the disease, differ:

• Primary enuresis. According to statistics, it makes up more than 90% of cases in children under 5 years. A characteristic of primary enuresis is the lack of neurological or urological pathologies against which a person could develop urinary incontinence. With this form of the disease, the child has no long periods of time (from 3 to 6 months) if it wakes up dry. With increasing age, the proportion of primary exercise in the incidence structure is reduced. For example, children make 12 years old and older in children that about 50%make it out.
• Secondary enuresis. This type of pathology is also referred to as recurring ones because it appears again after a long remission period. In this case, there is a connection with some urological, endocrine or neurological diseases that can contribute to involuntary urination. It should be noted that this variety of the problem can occur first after the child has reached control over urination (but not earlier than 6 months after).

Depending on the time of the manifestation, the disease can be the following types:

• Night Enuresis. This is the most common version of the disease that manifests itself at night. It is believed that a night continent from urine can be associated with the late maturation of the bladder in a child or a small volume. Hormonal causes are also possible - for example a low vasopressin level. This is a hormone that holds moisture in the body. The disease can also be associated with a very strong sleep in a child and difficulties in awakening.
• Daily enuresis. This form of the disease is much less common. It is characterized by the fact that patients have problems with control over urination during the day.

Depending on the associated diseases and complications of enuresis, it comes about:

• Uncomplicated. In this case, the patient has no pathological changes that were provoked by urinary incontinence.
• Complicated. This form of the disease is discussed if it takes place against the background of other diseases. These are, for example, infections or anomalies in the development of the urinary system, the nervous system and other pathologies.

Enorez prevention

Parents can recommend some preventive measures to help prevent the beginning of the disease. Such events include:

1. Timely treatment of urinary tract infections;
2. Control over the volume of the liquid that the child used during the day, but in this case it is worth taking into account the season and the air temperature.
3. Sanitary and hygiene training of the baby. It implies the teaching of hygiene for the genitals;
4. Promptly rejection of diapers. Often diapers no longer hear when the child reaches the age of two years.
5. If the episodes of urinary incontinence are stopped by the child at night in order to be six years old, measures must be taken for a comprehensive examination of the baby, which means that the cause of the disease and their treatment is determined.

The reasons for the development of the disease

The reason for the development of enuresis is unknown. In this regard, experts present various theories, each of which has a number of indirect evidence and is usually taken into account in the treatment. Consider these theories in more detail:

• Violation of maturation. It is believed that the involuntary urination in night or day is associated with a delay in the development of the human nervous system. In addition, these violations can have both organic and psychogenic nature. In the first case, we talk about a direct lesion of some structures of the brain, spinal cord or the peripheral nerves (e. g. due to an infection). Psychogenic factors can be emotional shocks, traumatic experience and others.
• Inheritance. After a few observations, the likelihood of developing the disease is higher, even if the child's parents also suffered from this disease at the same time. Due to the delicacy of this problem, it is quite difficult to identify such a pattern.
• Hormonal theory. A possible cause of night consumption is a violation of the secretion of Vasopressin. This hormone holds water in the body and its production increases at night. For this reason, a healthy person is rarely concerned about urination in sleep. When the child has reduced hormone production at night, this contributes to the development of enuresis. It must be said that such a hormonal imbalance is observed with some pathologies, for example not -aichar -diabetes.
• Stress. It is still not clear where the chicken is and where the egg is. According to observations, many children with urinary incontinence have stressful and other mental factors. For example, inexplicable fears, low self -esteem and others. At the same time, the patient's mental state often improves when the problem of enuresis is solved. It is therefore possible to serve incontinent and as a factor for unstable mental condition of a person.

The above theories mainly affect children. As for adult enuresis, the following violations and circumstances have negative factors here:

• Pathology of the nervous system, for example stroke, damage to the spinal cord, the neurogenic bladder and others;
• Diseases of the urinary system, including kidney failure, pathology of the prostate gland, a decrease in the tone of the muscles of the pelvic floor, frequent urinary tract infections and other diseases;
• Pregnancy because in this state the strong pressure from the uterus (especially with a large size of the fetus and/or its active movement) lies on the bladder.

This problem can also be provoked by taking medication, for example contraceptives.

Symptoms of the disease

The main symptom for Enorez is an involuntary urination. Most of the time this happens at night, but also during the day (during vigilance). Against the background of urinary incontinence, the following symptoms are also possible:

• Shyness;
• Closure;
• Cruck complexity;
• emotional instability;
• Aggressive behavior (in rare cases).

Adult enuresis can be accompanied by frequent urination (often against the background of some diseases). Due to the weakness of the muscles of the pelvic floor (which develops with age), an urine leak is possible in the event of sudden movements, cough and even in peace.

Complications

There are two main groups of complications with an enuresis:

• Complications from the psyche and the nervous system. Most of the time this applies to children. The child feels inferior and closed. For example, some aspects of children's life are inaccessible, for example excursions in warehouse. Adult enuresis can also cause such problems. All of this is a serious factor for the development of anxiety and depression.
• Complications from the urinary system organs. The risk of infectious and inflammatory diseases of the urinary tract increases. These are cystitis, urethritis, prostatitis and other pathologies, which manifest themselves from the urethra through painful urination, atypical discharge as well as pain in the step and lumbar area.

Diagnosis

With an enuresis, it is first recommended to contact a pediatrician (when we talk about a child) or contact a therapist. After the first examination and survey, the doctor can instruct the patient to close specialists - urologist, nephrologist, psychiatrist or neurologist.

The diagnosis usually contains the following events:

• Survey and neurological examination;
• Ultrasound of the kidneys and blisters;
• General urine analysis and analysis of Nechiporenko;
• X -Ray of the lumbar region.

In rare cases, the patient is aimed at other studies, for example CT or MRI.

Enorez treatment

The Enorez treatment is comprehensive. Consider the main components of such therapy:

• Drug treatment. Medicines that reduce the urine volume generated are prescribed. These are analogues of the hormone vasopress. The dosage and reception mode is selected so that the moisture mainly pauses at night (when we talk about night exercise).
• The type of liquid and nutrition. The doctor gives recommendations for the use of liquid and power supply system. In this case, it is necessary to take into account the diet of a child or adult, the level of his physical activity, the presence of simultaneous diseases and a number of other factors. In particular, it is recommended to give up the use of kebein -containing drinks, as they improve the diuresis and take additional liquids. If the patient drives sport (which means that he is actively sweating), we accept the absorption of the increased volume of the liquid.
• Aweck of the enuraval. At the beginning of the last century, a special alarm clock was developed for the treatment of Enorez. The first such alarms worked according to the principle of closing the electrical circuit when the first urine waste occurred. At the same time, the patient was annoyed by a small electrical discharge, which is why a person was awakened. Modern, expanded alarm clocks are acoustic and equipped with a sensitive moisture sensor. The most common option is a clip connected to underwear. As soon as the first drop of urine enters the sensor, the alarm clock works. The task of this treatment is the formation of the reflex "The urge to urinate - awakening". There are also special leaves with sensors, in contrast to an alarm clip. In this case, the signal will be triggered later when the urine current already reaches the sheet. The effectiveness of the treatment of night monosymptomatic enuresis using an enurears alarm clock is around 70-80%.

Depending on the accompanying disorders, the treatment of enuresis can also be assumed by correcting mental or neurotic disorders. The complex treatment of this problem also provides for meetings with a psychologist. At the same time, it would not hurt to consult the child's specialists and parents. The psychologist tells them how they can motivate children to properly motivate you to meet all the instructions of the doctor to get control of urinating. The punishment of the child or the formation of an unfavorable emotional environment in the family (due to urinary incontinence) is unacceptable and is only worsened.

rehabilitation

As a rule, this pathology takes place in children after treatment or independently of one another, which cannot say about adult enuresis (since it occurs against the background of certain chronic diseases). Therefore, no rehabilitation is required after treatment. In some cases, the child needs classes with a psychologist or psychotherapist to help him make contacts if the patient had had certain difficulties in psychological nature.

prevention

There are no specific measures to prevent enuresis. It is important that the parents connect to the problem in the early stages without waiting for the disease to continue. In adults, it can be preventive measures in this case:

• timely treatment of diseases of the bladder and other urological pathologies;
• Active lifestyle;
• Preventive examinations in the doctor, especially after 45 years.