Enuresis

Enuresy is a pathology in which a person is unable to control the emptying of the bladder. In the vast majority of cases (more than 95%), we are talking about an enuee for children, when control over urination has not yet been fully formed. However, the disease is also found in adults (especially the elderly) when the ability to control the emptying of the bladder has already been lost.The problem of involuntary urination manifests itself mainly at night, when a person sleeps (up to 80% of all cases). Much less often, it happens during awakening.There is no exact information on the prevalence of this disease, because far from the parents who turn to the doctor on this subject. According to reports, in children aged 5, enresy occurs in 5 to 10% of cases; among 10 years old in 3 to 5%; Among the age of 15 and over (adults and adolescent enhances) -1%.Night lists

Types of diseaseLists is classified according to various parameters. According to the deep cause of the disease, distinguish yourself:Primary enresis. According to statistics, it represents more than 90% of cases in children under the age of 5. A characteristic of primary enuresis is the absence of any neurological or urological pathology, against which a person could develop urinary incontinence. With this form of illness, the child has no long periods (from 3 to 6 months), when he wakes up dry. With age, the share of primary enuresis in the structure of the incidence is reduced. For example, in children aged 12 and over, around 50% represent it.Secondary enresis. This type of pathology is also called recurrent because it occurs again after a long period of remission. In this case, there is a link with certain urological, endocrine or neurological diseases that can contribute to involuntary urination. It should be noted that this variety of the problem can first appear after the child has reached control of urination (however, no earlier than 6 months after that). Depending on the time of manifestation, the disease may be the following types:Nocturnal enresis. This is the most common version of the disease that manifests at night. It is assumed that a night incontinence of the urine can be associated with late maturation of the bladder in a child or a small volume. Hormonal causes are also possible - for example, a low level of vasopressin. It is a hormone that keeps humidity in the body. The disease can also be associated with a very strong sleep in a child and the difficulties of awakening.Daily enresis. This form of 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 diseases and accompanying complications for enuresis, this happens:Simple. In this case, the patient has no pathological change caused by urinary incontinence.Complicated. This form of the disease is discussed when it takes place in the context of other disorders. For example, they are infections or anomalies in the development of the urinary system, nerve and other pathologies.

Prevention of EnuezParents may recommend certain preventive measures that help prevent the appearance of the disease. Such events include:Timely treatment of urinary tract infections;Control on the volume of liquid consumed by the child during the day, but in this case, it is worth considering the season and the temperature of the air;Baby's health and hygienic education. This involves teaching hygienic care for genitals;Timely rejection of diapers. Often the layers stop using it when the child reaches the age of two;If episodes of urinary incontinence are persisted at night by the child to reach six years, it is necessary to take measures for a complete examination of the baby, establishing the cause of the disease and their treatment.

Reasons for the development of the diseaseThe reason for the development of enuresis is unknown. In this regard, experts have presented various theories, each with a certain number of indirect evidence and, as a rule, is taken into account in treatment. Consider these theories in more detail:Maturation violation. It is assumed that involuntary urination in the night or by day is associated with a delay in the development of the human nervous system. In addition, these violations can have organic and psychogenic in nature. In the first case, we are talking about a direct lesion of certain brain structures, spinal cord or peripheral nerves (for example, due to an infection). Psychogenic factors can be emotional shocks, traumatic experience and others. Heredity. According to some observations, the probability of developing the disease is higher if the child's parents were also suffering from this disease. Due to the delicacy of this problem, it is quite difficult to identify such a model.Hormonal theory. A possible cause of nocturnal enuresis is a violation of the secretion of vasopressin. This hormone contains water in the body and its production increases at night. For this reason, a healthy person during sleep is rarely worried about urination. If the child has reduced hormonal production at night, this contributes to the development of enuresis. It must be said that such hormonal imbalance is observed with certain pathologies, for example, non-naichar 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 factors and other mental factors. For example, inexplicable fears, low self -esteem and others. At the same time, when the problem of enuresis is solved, the patient's mental state often improves. Consequently, it is possible to unclear and served as a factor in an unstable mental state of a person.The theories above mainly concern children. As for adult enuresis, violations and the following circumstances act here negative factors:Pathology of the nervous system, for example, a stroke, damage to spinal cord, neurogenic bladder and others; Diseases of the urinary system, including renal failure, the pathology of the prostatic gland, a decrease in the tone of the pelvic floor muscles, frequent urinary tract infections and other diseases;The pregnancy, because in this state, a strong pressure of the uterus (in particular with a large size of the fetus and / or its active movement) is on the bladder.This problem can also be caused by taking medication, for example, contraceptives.

Symptoms of the diseaseThe main symptom of Eneore is involuntary urination. Most often, it happens at night, but also occurs during the day (during awakening). In the context of urinary incontinence, the following symptoms are also possible:timidity;Closing;Complexity of cheerfulness;emotional instability;Aggressive behavior (in rare cases).Adult enresis can be accompanied by frequent urination (often in the context of certain diseases). Due to the weakness of the pelvic floor muscles (which develops with age), a urine leak during sudden movements, cough and even at rest is possible.

ComplicationsThere are two main groups of complications with enuresis:Complications of the psyche and the nervous system. Most of the time, it applies to children. The child feels lower, closed. Certain aspects of children's life become inaccessible, for example, from travel to camps. Adult enresis can also cause such problems. All of this is a serious factor in the development of anxiety and depression. Complications of the organs of the urinary system. The risk of inflammatory and inflammatory diseases of urinary tract increases. It is cystitis, uretritis, prostatitis and other pathologies, which manifest itself in painful urination, atypical flows of the urethra, as well as pain in the mounte region and the lumbar region.

DiagnosisWith enuresis, it is initially recommended to contact a pediatrician (if we are talking about a child) or a therapist. After the initial examination and the investigation, the doctor can direct the patient to narrow specialists - urologist, nephrologist, psychiatrist or neurologist.Diagnosis of EneozThe diagnosis, as a rule, includes the following events:survey and neurological examination;Ultrasound of kidneys and bladder;General analysis of urine, as well as the analysis of Nechiporenko;X-ray of the lumbar region.In rare cases, the patient is directed to other studies, for example, CT or MRI.

ENOZ TREATMENTENOZ TREATMENT is complete. Consider the main components of such therapy:Drug treatment. Medicines that reduce the volume of urine products are prescribed. These are analogues of the vasopressin hormone. The dosage and the reception method are selected so that humidity persists mainly at night (if we are talking about a night enresis). Liquid and nutrition mode. The doctor will give recommendations regarding the use of liquid and the power system. In this case, it is necessary to take into account the food diet of a child or an 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 drinks containing caffeine, as they improve diuresis and help to take additional liquid. If the patient does sports (which means that he actively transpires), accept the contribution of the increased volume of the liquid.Alarm clock. At the beginning of the last century, a special enoric awakening was developed for the treatment of Eneoz. The first alarms of this type worked on the principle of closing the electrical circuit when the first drop of urine appeared. At the same time, the patient was bored by a small electric discharge, because of which a person was awake. The modern alarm clock listed are acoustic and equipped with a sensitive humidity sensor. The most common option is a clip attached to underwear. As soon as the first drop of urine enters the sensor, the awakening works. The task of this treatment is the formation of the reflex "the desire for urination - awakening". There are also special sheets with sensors, however, unlike a clip, an alarm clip, in which case the signal is triggered later, when the flow of urine already reaches the sheet. The efficiency of treatment of nocturnal monosymptomatic lumes with the use of a huge alarm clock is around 70 to 80%. Depending on the disorders that accompany it, the treatment of enuresis can also be supposed by the correction of mental or neurotic disorders. The complex treatment of this problem also provides sessions with a psychologist. At the same time, it would not hurt the specialist and the child's parents. The psychologist will explain to you how to properly motivate children so that they carry out all the doctor's instructions to achieve control over urination. The punishment of the child or the formation of an emotional environment unfavorable in the family (due to urinary incontinence) is unacceptable and will only increase the situation.

RehabilitationAs a rule, in children, this pathology takes place after treatment or independently, which cannot be said about adult enuresis (because it occurs in the context of certain chronic diseases). As such, rehabilitation is not required after treatment. In some cases, the child needs courses with a psychologist or a psychotherapist who will help him socialize if the patient had already experienced certain difficulties of a psychological nature.

PreventionThere are no specific measures to prevent enuresis. It is important that parents join the problem of the problem at the early stages, without waiting for the disease to go through themselves. As for adults, they may be preventive measures in this case:appropriate treatment of bladder diseases and other urological pathologies;Active lifestyle;Preventive exams at the doctor, especially after 45 years.