Nocturnal enuresis is unexplained urination, which is a fairly common problem in children 4-8 years old. It is very common for preschool children to urinate at night. Initially, many parents do not consider this a problem, but for the time being.
Definition
The pathology got its name from the Greek word enurio, which means "to urinate". The term "nocturnal enuresis" in official medicine refers to the pathology of the genitourinary system, which forms a disorder in the act of urination. According to experts, up to 5 years this is not a problem, so before this age it is not recommended to raise a panic. In boys, enuresis is much more common than in girls, this is due to the structure and formation of the genitourinary system.
Views
There are three varieties of this disease:
- Primary - baby urinates from night to night.
- Periodic - Baby has occasional dry nights.
- Secondary - the little man does not have all the symptoms of nocturnal enuresis for several months,after which he continues to urinate again. First of all, this may indicate an emotional problem, not a medical one.
Symptoms
The main symptom of the disease, of course, is urinary incontinence, but the child may also have related problems that parents should definitely pay attention to:
- chronic depression and depression;
- frequent urination;
- reduced body temperature;
- marbling of legs and arms;
- reduced heart rate.
About all the symptoms of childhood nocturnal enuresis, parents should definitely inform the doctor, since the correct behavior of the parents and the prescribed therapy are incredibly important in this case.
Reasons
If we consider the problem only in children under 5 years old, then they have an organic pathology, which is hidden in the incomplete formation of the urination reflex. Rarely enough, but still, the age threshold of natural incontinence can rise up to 8 years, but this is only night abstinence. If the problem is present in older children or manifests itself at any other time of the day, then the reasons may be different:
- emotional turmoil;
- psycho-neurological disorders and neurodevelopmental delay;
- acquired nocturnal enuresis in a child aged 7 years and older, the main cause of which is neurotic disorders;
- genetics - this problem with a probability of 77% can be transmitted fromboth parents;
- kidney defect;
- traumatic urological disorders;
- inflammatory and infectious processes that affect the bladder, most often it is cystitis;
- failure in the production of the hormone vasopressin, which is just responsible for regulating the volume of urine.
Complications
If there is no correct and timely treatment, then serious problems may arise that affect the psyche of the baby:
- hysteria;
- neurosis;
- depression.
Only competent complex therapy and a sensitive attitude of parents can help prevent the formation of the disease.
Nocturnal enuresis in boys
Boys always want to be confident and strong, but not everyone succeeds. If one of them lacks strength and determination, he begins to feel different and flawed. As a result, complexes form, and he becomes nervous.
Such a malaise develops when a child is under a lot of pressure from adults. If dad or mom in an orderly tone demand to do something or quite often unreasonably forbid him to do what he loves, then the baby can openly express dissatisfaction. Nocturnal enuresis in such cases occurs as a reaction of the body to rudeness.
After parents change their way of communicating, most often the psychological problem ends. For a little man, a warm attitude and support from loved ones is very important.
Talking about enuresis as a painful condition is necessary if the boy urinates frequently and during the daytime. The main accompanying symptoms are considered to be a slow pulse, pale hands and feet, a mentally retarded state, and a low temperature. There are constantly extreme states in the behavior, then he is too quick-tempered and impulsive, then depressed and withdrawn.
In such cases, the boys behave insecurely and have distracted attention. Such nocturnal enuresis is treated quite successfully with complex therapy, diet and sedatives. Physiotherapy, hypnosis, acupuncture and reflexology are also often used.
It is not uncommon for incontinence to be the result of surgery. The most frequent operations are the removal of an umbilical or inguinal hernia, circumcision. It should be noted that the sooner the cause of the disease is identified and the correct treatment is started, the more effective it will be.
Every parent needs to know that raising boys must be literate. Both parents should follow the same line in various matters. Contradictions between adults most often lead to inadequate behavior of their child. The kid begins to take the side of the one who allows more and does not scold him under any circumstances. Therefore, demanding mothers and fathers, who teach them to restrain themselves when urged and run to the toilet as soon as possible in order to stay clean, seem unfriendly and evil to the baby. Protesting against the set rules, he pees in his pants. The kid gets pleasure from the fact that he annoys and angers the "right" adults. For solutionsproblems, parents must establish a trusting relationship and contact, as the child must understand that he is loved. Then he will want to be nice and respond with understanding.
Teenagers
Children over the age of 12 should have regular urination. According to statistics, this problem occurs only in 2% of adolescents, and after 16-18 every hundredth child suffers from it. Causes of nocturnal enuresis in older children include:
- problems with the endocrine system;
- adverse reaction to "Thioridazine" and valproate;
- consequences after upper airway obstruction.
Diagnosis
This problem is not uncommon, therefore, in order to make an accurate diagnosis, the pediatrician takes an anamnesis. Since there is a possibility of a connection between this ailment and a hereditary factor, in cases of urinary incontinence, doctors interview both parents of the baby. For an accurate diagnosis, the doctor needs to know the duration and frequency of episodes of incontinence, as well as the nature of urination (jet strength and whether discomfort is present). If there is a suspicion of a urological disease, as well as a pathology of the urinary tract, the doctor will definitely refer you to an ultrasound (ultrasound examination) of the bladder and kidneys.
As an additional procedure, the patient is recorded:
- on x-ray of the spine in two projections;
- primary urine laboratory;
- defectological comprehensive examination (for neurological diseases).
Treatment
There are a huge number of different methods for the treatment of nocturnal enuresis in children. In order to figure out which will help a particular child, you need to consult a doctor, and then make a decision.
It happens that expectant tactics simply do not suit parents, besides, the doctor insists on the use of drugs. As practice shows, the percentage of children who were helped by medications is very small. If the magic pill does not work after 2 weeks, then therapy is recommended to be canceled. The following drugs are often prescribed:
- "Driptan";
- "Desmopressin";
- Spasmex.
These funds, as stated by the manufacturers, contain and reduce the involuntary urge to urinate, and also increase the volume of the bladder.
Antidepressants can also be prescribed by a doctor for increased anxiety:
- "Dosulepin";
- Imipramine;
- "Dothiepin";
- Amitriptyline.
Motivational Therapy is a highly effective treatment for nocturnal enuresis in children 5 years of age and older. It should be noted that in this case, the best psychotherapist is the baby himself. There is an opinion that until he himself wants to get rid of the problem, it will not disappear. This method is designed for older children, as this requires personal motivation. The essence of the method is to reward the child for dry nights. You can make a kind of holiday out of this.
EveryoneThe man has his own motivation. One is incredibly important praise, and someone will need a dog, a bike, a trip to the sea, a new toy or going to the movies. The reward may or may not be financial. In the baby's room, it is recommended to hang a calendar and mark dry nights in it. The obligatory task of parents is to focus on success, and not on wet deeds.
Sessions of psychotherapy - a method that is effective only when the child himself wants to get rid of the problem. Usually the technique works on older children from 8 years old. Nocturnal enuresis in this case is a serious problem, as it manifests itself due to psycho-emotional disorders. The main components of therapy are:
- full confidence in the specialist;
- it is also required to take into account that work on the child will affect the deep layers of the psyche, so often there are emotional negative outbursts;
- recovery of the cause of incontinence takes time;
- often this aggravation occurs in vulnerable, anxious and touchy children who hide their emotions throughout the day and relax at night.
- there is an opinion that enuresis reflects the relationship between the child and the parent, mainly mother and son.
- if adults have strong control over the child and a significant desire to make him better, as well as excessive guardianship, then all these bursts can contribute to the appearance of nocturnal enuresis in children.
- important in therapy is that without the participation of parents it is impossible.
Controlled amount of liquid - a method, the distinguishing feature of which is that after 17 hours the baby should drink no more than 20% of the liquid from the daily norm. And a couple of hours before bedtime, parents should generally give the minimum amount of drink. It is important that the air in the room is cool and humid, and the child is wrapped in a warm blanket. In such conditions, the feeling of thirst will be inevitable and natural. It is also not recommended to allow physical activity and active games before bedtime so that the child does not sweat and does not ask for water.
The causes of nocturnal enuresis are different, so it is necessary to understand what can provoke incontinence problems in everyday life. It is important to follow the lifestyle:
- how long is the baby outside;
- time of his falling asleep;
- what does he do during the day;
- does he lead an active lifestyle and observe the daily routine;
- how often the child sits at the computer;
- what films, TV series and programs does he prefer;
- who is talking to in the yard.
Everything that children feed on emotionally throughout the day spills out during sleep. Any incontinence can be the result of emotional reboots in the evening. It is important that there is a calm atmosphere in the house before going to bed.
Many parents who face this problem need to know how to treat bedwetting. To do this, you can use the training of the bladder, but only if there are no problems with urology. no badthe method does not affect the genitourinary system. It is possible to accustom to endurance children since 3 years. This does not mean that you need to stand for 30 minutes or 1 hour. Literally 5 minutes is enough for the baby to gradually develop a sense of control.
Urinary alarm clock - a method that not many people use in Russia and in the CIS countries. Although when using this technique for the treatment of nocturnal enuresis in children, everything goes positively by almost 100%.
How it works:
- a sensor is attached to the panties, which is aimed at regulating moisture;
- the other part is attached to the alarm clock;
- as soon as the child begins to relieve his need, the bell rings;
- then the child wakes up and can fix the beginning of urination, he turns off the device and sits on the potty. The essence of the method is to consolidate the control of nocturnal urination. Modern wireless models are also available, making it easy to use.
This machine can also be replaced. To do this:
- mom has to set an alarm for a certain time;
- then for two weeks it is required to wake the child at the same time before midnight and put him on the potty;
- after the alarm is set at 1 am, a few weeks later - at 1:30, and so on until it reaches the morning.
In this way you can develop control over urination. It is important that the child must wake up and the process of urination must take place inconscious, not half asleep.
Folk Therapy
There are different treatments and causes of nocturnal enuresis, but many parents prefer to use grandmother's recipes, which concentrate centuries of experience in treating the disease. The following decoctions are effective remedies:
- One tablespoon of dill seeds should be poured with boiling water and infused for one hour. It is necessary to drink a drink for half a glass for children under 10 years old and 1 glass for those who are older. The course is designed for 10 days, after which you need to take the same break, and then repeat the procedure again.
- As you know, honey has anti-inflammatory and sedative effects. Before going to bed, the baby needs to give a tablespoon of the product for 1 month.
- 15 grams of dried plantain leaves brew a glass of boiling water and insist for 20 minutes. Drink 4 times a day, 1 tablespoon.
- 1 tbsp aspen bark is poured with a glass of boiling water and boiled for 10 minutes. Drink half a glass 3 times a day for 3 weeks.
- 3 bay leaves are steamed with a glass of boiling water and boiled for 10 minutes. The decoction is drunk half a glass 3 times a day. The course of therapy is designed for 7 days.
For the treatment of nocturnal enuresis, other medicinal plants are also used, namely:
- bow;
- parsley;
- lingonberries;
- sage;
- St. John's wort.
The only thing is that these herbs are not always applicable to young children. Asnot every child is able to drink half a glass of liquid that is unpleasant to him, and violent treatment instead of benefit can bring significant harm.
Prevention
Of course, any disease is better to prevent than to treat later. In order for the baby not to be subjected to emotional experiences due to the occurrence of incontinence, measures should be taken to prevent this ailment:
- potty train your child from an early age;
- control fluid intake;
- timely treatment of diseases and overall he alth control;
- protecting the baby from stressful situations;
- quality family environment;
- in difficult moments for the child, the support of parents should be present.
When parents notice a depressed or anxious state, as well as tearfulness, it is imperative to identify the cause of this and help the child adapt. If there are friendly relations in the family and there is attention from the parents, then all difficulties can be overcome with ease.
