Enuresis is a pathology in which a person is unable to control bladder emptying. In the vast majority of cases (more than 95%), we are talking about a children's enure, when urination control is not yet fully formed. However, the disease is also found in adults (especially the elderly) when the ability to control bladder emptying is already lost.
The problem of involuntary urination manifests mainly at night, when a person sleeps (up to 80% of all cases). Much less often this occurs during awakening.
There is no accurate information about the dominance of this disease, as the parents always refer to the doctor for this. According to reports, among children aged 5, enuresis occurs in 5-10% of cases; Between 10-year-olds-3-5%; Between 15 -year -olds and older (enuresis of adults and adolescents) -1%.
Types of illness
Enuresis is classified according to different parameters. Depending on the root cause of the disease, distinguish:
Primary enuresis. According to statistics, it accounts for more than 90% of cases in children under the age of 5 years. One feature of the primary enurse is the lack of any neurological or urological pathology, against which a person can develop urinary incontinence. With this form of the disease, the child has no long periods (from 3 to 6 months), when he wakes up dry. With age, the part of the primary energy in the incidence structure is reduced. For example, in children 12 and older, about 50%constitutes it.
Secondary enurse. This type of pathology is also called repeated, as it occurs again after a long period of forgiveness. In this case, there is a link to some urological, endocrine or neurological diseases that may contribute to involuntary urination. It should be noted that this variety of the problem may appear first after the child reaches urination control (however, no earlier than 6 months after that).
Depending on the time of manifestation, the disease may be the following types:
Enuresis of the night. This is the most common version of the disease that manifests at night. It is assumed that a nightly urinary incontinence can be associated with the late roasting of the bladder in a child or a small volume. Hormonal causes are also possible - for example, a low level of vasopressin. 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 difficulty with awakening.
Daily enuresis. This form of the disease is much less common. It is characterized by the fact that patients have problems with urination control during the day.
Depending on the concomitant diseases and complications of the enuresis, this happens:
Uncomplicated. In this case, the patient has no pathological changes provoked by urinary incontinence.
Complicated. This form of the disease is discussed when it continues against the backdrop of other disorders. For example, these are infections or abnormalities in the development of the urinary system, irritable and other pathologies.
Prevention of Enorez
Parents may recommend some preventive measures that help prevent the onset of the disease. Such events include:
Timely treatment of urinary tract infections;
Control over the volume of the juice consumed by the child during the day, but in this case it is worth considering the season and air temperature;
Sanitary and hygienic education of the baby. It means teaching hygienic care for the genitals;
Timely rejection of diapers. Often, diapers rest completely to use when the child reaches the age of two;
If the episodes of urinary incontinence continue at night by the child to reach the age of six, it is necessary to take measures for a comprehensive examination of the baby, establishing the cause of his disease and treatment.
Reasons for developing the disease
The reason for the development of the enuresis is unknown. In this regard, experts submit different theories, each of which has a number of indirect evidence and, as a rule, is taken into account in treatment. Consider these theories in more detail:
Baking violation. It is assumed that involuntary urination at night or day is associated with a delay in the development of the human nervous system. Moreover, these violations can have an organic and psychogenic nature. In the first case, we are talking about a direct lesion of some brain structures, spinal cord or peripheral nerves (for example, due to infection). Psychogenic factors can be emotional shock, traumatic experience and others.
Inheritance. According to some observations, the probability of developing the disease is higher 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 model.
Hormonal theory. A possible cause of the night enule 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 during sleep is rarely concerned about urination. If the child has reduced hormone production at night, then this contributes to the development of enuresis. It should be said that such a hormonal imbalance is observed with some pathologies, for example, non -char diabetes.
Stress 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 fear, low self -esteem and others. At the same time, when the enuresis problem is resolved, the patient's mental state often improves. Therefore, it is possible not to control and serve as a factor in a person's unstable mental state.
The above theories mostly concern children. As for the adult enurse, the following violations and circumstances act here adverse factors:
Nervous system pathology, for example, stroke, spinal cord injury, neurogenic bladder and others;
Diseases of the urinary system, including kidney failure, prostate gland pathology, a decrease in pelvic floor muscle tone, frequent urinary tract infections and other diseases;
Pregnancy, because in this condition, strong pressure from the uterus (especially of large fetal size and/or its active movement) is in the bladder.
This problem can also be provoked by taking some medicines, for example, contraceptives.
Symptoms of the disease
The main symptom of Enorez is involuntary urination. Most often, this happens at night, but it also occurs during the day (during waking). Despite the backdrop of urinary incontinence, the following symptoms are also possible:
Shyness;
Closure;
Cruck complexity;
emotional instability;
Aggressive behavior (in rare cases).
Adult enuresis can be associated with frequent urination (often against the backdrop of some diseases). Due to the weakness of the pelvic floor muscles (which develops with age), urine flow during sudden movements, coughing, and even at rest, is possible.
Complications
There are two main sets of complications with an enuresis:
Complications from the psyche and the nervous system. Mostly this applies to children. The child feels inferior, closed. Some aspects of children's lives become inaccessible, for example, camps. Adult enuresis can also cause such problems. All of this is a serious factor in the development of anxiety and depression.
Complications from the organs of the urinary system. The risk of infectious and inflammatory diseases of the urinary tract increases. These are cystitis, urethritis, prostatitis and other pathologies, which are manifested by painful urination, atypical discharge from the urethra, as well as pain in the turning region and lumbar.
Troubleshooting
With an enuresis, it is initially recommended to contact a pediatrician (if we are talking about a child) or a therapist. After an initial examination and survey, the doctor can direct the patient to narrow specialists - urologist, nephrologist, psychiatrist or neurologist.
The diagnosis, as a rule, includes the following events:
survey and neurological examination;
Kidney and bladder ultrasound;
general urine analysis as well as nechiporenko analysis;
X -Ray of the lumbar region.
In rare cases, the patient is directed to other studies, for example, CT or MRI.
Treatment of Enorez
Enorez treatment is comprehensive. Consider the main ingredients of such therapy:
Drug treatment. Medications that reduce the volume of urine produced are prescribed. This is analogous hormone vasopressin. The dosage and method of waiting is chosen so that moisture remains mainly at night (if we are talking about a night enuresis).
The way of getting the juice and food. The doctor will make recommendations regarding the use of liquids and the power system. In this case, it is necessary to consider the nutritional diet of a child or adult, the level of his physical activity, the presence of concomitant diseases and a number of other factors. In particular, it is recommended to abandon the use of caffeine -containing drinks as they improve diuresis and help get extra juice. If the patient is playing sport (which means he is actively sweating), then let's accept the intake of increased volume of fluid.
Enurant alarm clock. At the beginning of the last century, a special hour of Enuremary's alarm for the treatment of Enorez took place. The first such alarms operated on the principle of closing the electrical circuit when the first urine drop appeared. At the same time, the patient was upset by a small electric discharge, due to which a person woke up. The modern alarm clock projected is acoustic and equipped with a sensitive moisture sensor. The most common option is a clip that is attached to the interior. Once the first urine drop enters the sensor, the alarm clock works. The task of this treatment is the formation of the reflex "requirement for urination - awakening". However, there are separate sheets with sensors, unlike a clip an alarm clip, in which case the signal is further driven, when the urine current already reaches the sheet. The effectiveness of treatment of the monosymptomatic nightmare of the night with the use of an enuleular alarm clock is about 70-80%.
Depending on the associated disorders, the treatment of the enuresis can also be assumed by the correction of mental or neurotic disorders. Complex treatment of this problem also provides sessions with a psychologist. At the same time, it would not hurt to consult with the specialist and parents of the child. The psychologist will show you how to motivate children correctly so that they can meet all your doctor's instructions to achieve control over urination. Punishing the child or forming an adverse emotional environment in the family (due to urinary incontinence) is unacceptable and will only exacerbate the situation.
RePRinT
As a rule, in children, this pathology develops after treatment or independently, which cannot be said for the adult enurse (as it occurs against the backdrop of some chronic diseases). As such, rehabilitation is not required after treatment. In some cases, the child needs classes with a psychologist or psychotherapist who will help him to accompany if the patient had previously experienced certain difficulties in a psychological nature.
PREVENTION
There are no specific measures to prevent the enurse. It is important for parents to join the problem in the early stages, without expecting the disease to pass on its own. As for adults, there may be preventive measures in this case:
timely treatment of bladder diseases and other urological pathologies;
Active lifestyle;
Preventive exams at the doctor, especially after 45 years.
