Enuresis in children and adults - Causes, Symptoms and Treatment .MF .

August 12, 2017 17:52 | Urinary Systems.

Enuresis, like Ariadne's thread to find the disease, it is not a disease, it is just one manifestation of any disease.Enuresis - the involuntary urinary incontinence.In medical practice, it turned out that this name is most often understood involuntary bedwetting in children.It should be understood that the word "involuntary" is supposed to complete lack of control on the part of the cerebral cortex, ie,consciousness.Thus, if a person feels the urge to urinate, but is not able to hold urine - it is a fundamentally different disease process, which is called incontinence (urinary incontinence).

And how newborn babies?It turns out, they are born with "enuresis"?Yes.But for them it is normal, because control over urination is formed up to 5 years of age.So talking about the pathology is competent, if the child was 5 years old.

Causes of enuresis

Implementation of involuntary urination occurs through the nervous system, regardless of the cause of such violations.The fact that the regulation of urination

occurs on two levels: the first - the spinal cord (outside of our consciousness, due to his involuntary urination occurs in infants up to about 1.5-5 years), the second - the brain (pons, cerebral cortex).The latter is known, ensures the availability of our consciousness, by which we are able to control our behavior, actions, and including urination.
Now you yourself know what the cause of enuresis - off effect of the cerebral cortex.For illustrative scheme:

disease, a symptom which can be enuresis

The first place belongs to the frequency of occurrence of the violation directly to the formation of reflex, or lack of its sustainability and vulnerability.It is, of course, for young children.Due to extreme emotionalism children, any conflict situation produces trauma , and just formed neural pathways responsible for urinary control, exposed to intense nerve impulses from the neighboring centers of the brain.And at night, when the cortex of the brain is disabled, this effect leads to a complete shutdown control, and filling of the bladder nerve impulses from the last close the reflex arc at the spinal cord level, there is involuntary urination.

Sound sleep, in which the feeling of the urge to urinate wakes the child does not, can also lead to enuresis.

Less common cause of enuresis following diseases can act: - urinary tract infection -

inflammation of the bladder, urethra, prepuce in boys vulva in females.In this case, drastically increases the number of pulses sent from the bladder, and reaching up to a certain limit, they can initiate a reflex to the spinal cord;
- spinal cord injury , accompanied by the detection of pelvic organs.

In adults, plus the psychological problems, injuries and infections:
- diabetes insipidus - a violation of production of antidiuretic hormone (ADH), the main effect of which is to water retention in the body during the night;
- multiple sclerosis ;
- bladder stones ;
- chronic renal failure .

should be noted a rather rare form - it enuresis in boys on a background of complete physical well-being.It occurs most often between the ages of 15-18 years, in the period of greatest sexual activity.The fact that the regulation of sexual behavior center, and the cortical representation of the bladder are located quite close.Thus, when the first hyperstimulation, nerve impulses are thrown on the micturition center, and a command is sent to the bladder.There is involuntary urination.In the future, these states are themselves in the presence of a regular sexual life.In this case sexual arousal center is reduced, and the processes in the brain occur correctly.

To which the doctor ask for signs enuresis

the case of a sick child, you first need to visit the pediatrician.It will assign all the necessary tests, and figure out the cause, send yourself profile expert.The latter may be a psychologist, psychotherapist, psychiatrist, pediatric urologist, andrologist, neurologist, endocrinologist.

Adults suffering from enuresis, initially must refer to the urologist, except when there was a back injury or head.In this case, the neurologist's consultation is required.

To diagnose the disease, which has become a cause of enuresis is possible to assign a number of surveys:

1) Urinalysis, complete blood count, blood chemistry (urea, creatinine, blood sugar ...) to avoid infections and chronic diseases.
2) ultrasound of the kidneys, bladder, internal organs.
3) Review and intravenous urography with cystography.
4) Cystoscopy.
5) The level of antidiuretic hormone (ADH).
6) Consultation of a neurologist, psychiatrist or psychotherapist.

Treatment of enuresis in children and adults

At the present level of development of medicine, there are many methods of treatment of enuresis.With proper diagnosis and treatment effect can be achieved almost always.The main principle - an integrated approach to the impact on the causes of the disease process.The following mechanisms of action:

• decrease in urine production at night;
• reducing the number of pulses coming from the bladder;
• effect on the emotions;
• removal of inflammation.

First of all it is necessary to comply with special drinking mode, which is not recommended fluid intake for two hours before bedtime.Compliance sleep and wakefulness according to age is as important as the regime is able to normalize sleep.What is important is the psychological peace and , including the need to exclude the cartoons and computer games before bed.Sometimes, the mere observance of the regime's ability to quickly save the child from enuresis.

In identifying neurotic factor psychocorrection shown in conjunction with vitamin therapy, and with the appointment of sedatives.I would like to pay attention to the little specific situation, which is very common - it is a conflict between the parents.This is what causes the strongest experiences of the child.Externally you can not notice the change in the child's behavior, and at the polls, he could not admit it.If the parents are not relevant to this issue, with due care, the little man is compounded by an inferiority complex, and the consequences can be much more serious enuresis.Therefore, I make a small farewell to all the young parents to be considerate and respectful to your children, because it is a separate planet, a separate world in which the concept and the rules are very different from reality.

When determining whether a child with enuresis urinary tract infections shows antibiotics, herbal remedies and uroseptikov (3.0 manural once, FURAMAG 50 mg 3 times a day, 7-10 days, Lingonberry broth 1/2 cup 1 time a day, 10 days).

recommended the appointment of Mr. anticholinergics (eg, tolterodine 1 tablet (2 mg) 2 times a day, 2-3 months), which relax the muscle layer of the bladder, and as a consequence, the latter is able to accumulate When identifying high tone of the bladder more urine, without causing feeling the urge to urinate.

When proven violation of the rhythm of ADH release (antidiuretic hormone), shows the assignment sinteticheskigo analogue - Minirin (1 tablet (100mcg) before bedtime, 1 month).So at night will produce less urine, and it will give a certain effect.

The complex is also desirable to use physical therapy, phototherapy, music therapy, etc.

When enuresis has a beneficial effect aerophytotherapy:. In the room sprayed a mixture of essential oils of sage, lavender, coriander in a ratio of 3: 2: 1.For each procedure used 2 - 5 drops of oil mixture in 30 ml of one of these charges.For spraying use an ultrasonic nebulizer.The session lasts 5 - 15 minutes every day or two.The first session lasts for 1 - 2 minutes.The course of treatment 15 - 20 sessions.

In cases of spinal injuries or urolithiasis - operative treatment.

Adults the basis of treatment of enuresis - treatment of the disease, which led to the involuntary leaking of urine.

Enuresis elderly

In elderly people, often with chronic diseases (prostate adenoma, diabetes mellitus, hypertension, low back pain, etc.) Nerve fibers thinning, atrophy and they become unable to conduct nerve impulses to the cerebral cortex,urination occurs and, therefore, as well as in infants through the spinal cord.Such cases are extremely difficult to correct, that is the nature.To go against the laws of nature is almost impossible.More often than not you end up installing cystostomy (in other words, the tube into the bladder).

Remember: never start the treatment on their own!All exactly as prescribed the doctor, and under his control!

forecast

Summarizing all the above, it should be noted that children enuresis has a functional nature, and with timely treatment to the doctor Forecast overwhelmingly favorable.Therefore, if you notice in your child wet the mattress, in any case, do not worry, be patient, go to the hospital, and all will be well.
But in adults, even in case of serious diseases, injuries, enuresis always amenable to correction.Important note: the success of treatment always depends on the timely treatment to the doctor!

doctor Soloyan DV