Enuresis

Enuresis is a pathological syndrome affecting the psychological and physiological side of a person. Such a disease as enuresis is interpreted as pathological incontinence of the act of urination. Incontinence occurs mainly in a state of sleep, when a person is least in control of himself. Suffer from a similar disease mainly children of early school age.

Such a problem can cause irreparable harm not only physiologically, but also mentally. Children who are constantly faced with embarrassment experience the strongest psychological stress, which only aggravates the pathology.

The causes of enuresis are in violation of the functioning of the urinary system and require a comprehensive diagnosis.

Urologists claim that enuresis develops in 20% at an early age (5-6 years) and in 11-12% of children older than 6-7 years. A very small percentage (1%) of children suffer from enuresis at an older age – 12 years or more.

In fact, there is still no adequate border that would separate the physiological urination of children from pathological enuresis. It is generally believed that at the age of five a child can already fully control his physiological functions and in case of loss of control over urination, people around the child, parents and doctors should pay attention.

The problem of enuresis is dealt with by neurologists, psychologists, urologists, nephrologists and other specialists.

CAUSES OF ENURESIS
There are several major serious causes that can cause urinary incontinence in children who have reached the age of 5-6 years:

Genetic predisposition. In some cases, if one of the parents had cases of enuresis in childhood, then the child has some predisposition to the development of such a disease.
Diseases of the urinary system and infections. Diseases that cause chronic urinary retention in the child’s body, thereby causing mixed urinary incontinence.
Delayed development, in particular of the brain centers responsible for urination. When the interaction of these cerebral centers with the organs of excretion is disrupted, primary urinary incontinence develops.
Endocrine disorders. In case of violation of the secretion of a special hormone – vasopressin, responsible for the synthesis of urine and its density, enuresis can also develop. Deficiency of this hormone at night provokes the formation of more urine, and consequently, overflow of the bladder and incontinence.
CLASSIFICATION OF ENURESIS
The first group of enuresis is distinguished on the basis of previous cases of incontinence:

Primary enuresis – there were no cases of urinary incontinence earlier (after reaching 5 years).
Secondary recurrent enuresis – there were cases of urinary incontinence after reaching the age of five. As a rule, with recurrent enuresis, the “dry” period lasts up to several months, after which repeated cases of urinary incontinence occur.
The second group is allocated on a temporary basis:

Mixed enuresis – 10% of cases.
Daytime enuresis – 5% of cases.
Nocturnal enuresis – more than 85% of cases.
Enuresis, the cause of which lies in infection, is called complex enuresis.

DIAGNOSIS OF ENURESIS
The diagnosis of enuresis is made when episodes of urinary incontinence appear for a few months – at least 3x. the child must undergo examinations – an ultrasound examination of the abdominal organs, in particular the bladder, a study of blood glucose levels (if diabetes is suspected). Urography, uroflowmetry, and cystoscopy are also performed.

TREATMENT OF ENURESIS
Treatment of enuresis is a time–consuming process that requires an attentive and comprehensive approach. First of all, the child is assigned a special drinking regime. Fluid intake is excluded a few hours before bedtime, but it is necessary to make up for this deficiency during the day so that the child receives the optimal amount of fluid.

In case of hormonal disorders, the patient is prescribed replacement therapy with desmopressin, which is selected individually under the supervision of a specialist.

With the neurotic etiology of enuresis, a psychiatrist, a psychologist and parents should work with the child to identify the specific cause of incontinence. In addition, medications that improve the functioning of the nervous system can be prescribed – sedatives, vitamin therapy.

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