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Nocturnal enuresis Komarovsky. Bedwetting - enuresis in children: causes, treatment, symptoms, signs. A brutal way to get rid of enuresis with ice water

Daytime urinary incontinence in children is pathological condition and begins to be considered as such from the age of 4, since it is by this time that the child must 100% learn to restrain the urge to urinate, understand his physiological needs and ask to go to the toilet. In the presence of manifestations of daytime enuresis, treatment should not be delayed. In the future, against the background of this problem, the child may experience certain psychological difficulties associated with the realization of his deviation, which distinguishes him from other children of his age.

Diurnal enuresis is much more common in children than in adults. This problem can have both physiological and psychological causes. Thus, if a child has developed urinary incontinence, or he simply has not learned to correctly analyze his urges, has not learned to go to the toilet on his own in certain age, it is imperative to consult a doctor to determine the nature of the problem. According to statistics, regardless of the etiology of daytime enuresis with proper treatment positive dynamics can be achieved in more than 86% of small patients.

Reasons for the development of daytime enuresis in children

There are many reasons that can lead to urinary incontinence in children in daytime. Highly important point is to identify the root cause of the problem, because if treatment is not carried out in a timely manner, the child may develop a number of psychological disorders that will require even longer therapy. Daytime urinary incontinence in children is often associated with impaired functioning of the innervation of the pelvic organs due to damage to the tissues of the spinal cord and brain, including against the background of:

  • traumatic brain injury;
  • spinal injuries, tumors of the central nervous system;
  • arachnoiditis;
  • myelitis.

The development of urinary incontinence in a child during the daytime may be associated with insufficient maturation of the central nervous system due to difficult pregnancy. In some cases, such immaturity of the central nervous system is due to the threat of miscarriage, birth trauma, oligohydramnios or polyhydramnios, preeclampsia, asphyxia during childbirth, intrauterine hypoxia fetus, anemia and other adverse factors associated with pregnancy and childbirth.

Often, daytime urinary incontinence occurs in children who suffer from various mental disorders, for example, schizophrenia, oligophrenia, epilepsy or autism. Among other things, anatomical defects can provoke daytime enuresis in children. genitourinary system, including:

  • ectopia of the mouth of the ureters;
  • hypospadias;
  • bladder exstrophy;
  • epispadias;
  • obstruction.

In some cases, urinary incontinence in children is observed against the background of endocrine diseases, including sugar and not diabetes, hyperthyroidism and hypothyroidism, especially if the treatment of these diseases was in to a large extent delayed due to late diagnosis. Under certain circumstances, urinary incontinence in a child can be associated with infectious diseases of the genitourinary system, autoimmune diseases, and helminthic infestations. In addition, severe nervous shocks, such as death, are common causes. loved one, peer ridicule, etc.

Considering the causes of enuresis in young children, it is necessary to highlight the hereditary predisposition to the appearance of this problem.

As practice shows, if one of the parents suffered from this problem in childhood, then the risk of its occurrence in children is about 40%. In the presence of similar problem in childhood, both parents have an 80% risk of developing it in a child.

Diagnostic methods

In order for the treatment of urinary incontinence in a child to give a result, first of all, it is necessary to conduct a full examination. As a rule, a number of highly specialized specialists are involved in the process of identifying the cause of the problem, including a pediatrician, pediatric gynecologist, pediatric urologist, psychologist, psychiatrist, pediatric neurologist, etc. general condition. Doctors often have to do a number of invasive and non-invasive tests to confirm a diagnosis, including:

  • assessment of the daily rhythm of urination, general analysis urine;
  • bacteriological culture urine;
  • excretory urography;
  • survey urography;
  • Ultrasound of the kidneys;
  • Bladder ultrasound;
  • cystometry;
  • electromyography of bladder muscles;
  • cystoscopy;
  • urethrocystoscopy;
  • X-ray of the spine;
  • electroneuromyography;

This is far from full list investigations that may be required to determine the cause of daytime urinary incontinence in a child. Only after identifying the cause can treatment be prescribed.

Treatment of daytime enuresis in children

If a child suffers from daytime enuresis, therapy largely depends on the characteristics of the identified pathology. In the presence of congenital anomalies buildings urinary system can be shown surgical treatment. When infectious diseases are confirmed, treatment is carried out by conservative methods with the use of antibiotics and additional medicines. If enuresis in a child is rooted in psychological and mental disorders, correction is carried out using psychotherapy and special medications. As a rule, nootropics are prescribed for children with CNS immaturity.

Regardless of the cause, urinary incontinence in children is treated comprehensively. The child should, if possible, be protected from stress, normalize sleep and wakefulness, and create a friendly atmosphere in the family. In some cases, a special diet and drinking water may be shown. Besides, high efficiency have physiotherapy procedures, including electrophoresis, IRT, darsonvalization, transcranial electrical stimulation, bladder electrical stimulation, magnetotherapy, etc. Positive effect can give spa treatment.

Enuresis in children is uncontrolled urination during sleep. The disorder is most often affected in childhood and adolescence, however, there are cases of the disease in adults. The causes of enuresis in children can be very different: from banal overwork or infectious disease to congenital bladder disease or psychological trauma.

Some children with nocturnal enuresis urinate around midnight, while others do so in the early morning. In the first case bladder relaxes under the influence of sleep and heat, as a result of which it is no longer able to hold urine. Do not drink in this situation fruit juices and sugary drinks, while the consumption of carrots and burdock root, on the contrary, is indicated.

In the second case, urination in children occurs due to the fact that the bladder retains the fluid accumulated in the morning, but this ability is limited. The bladder does not expand enough as it fills. To relax him, the child needs to be given lightly boiled vegetables without salt. Allowed to consume apples and apple juice. If a child over five years old urinates at night more than 1-2 times a month, then you need to contact a neurologist.

Nocturnal enuresis in children suggests long-term treatment medical methods, important place in which the people's funds are occupied. Herbal teas effectively reduce involuntary urination. For the treatment of folk remedies, plants are used that provide beneficial effect on the nervous and cardiovascular system, having a calming and anti-inflammatory effect.

Treatment of childhood enuresis folk remedies

The basis herbal preparations for treatment childhood enuresis folk remedies include calendula, valerian root, immortelle inflorescences, anise fruits, licorice root, nettle, St. John's wort, yarrow, cuff, lemon balm, chamomile and others.

The most popular folk remedies

Kindergarten Teacher Recipe

Ingredients:

Mode of application

A cotton pad is moistened in water at room temperature, squeezed lightly and carried along the spine from the bottom up and back several times. The water does not need to be washed. Cover the child with a blanket and leave to sleep until morning.

Dill seeds for enuresis

Ingredients:

  • a tablespoon of dill seeds;
  • a glass of boiling water.

Mode of application

Seeds are brewed with boiling water, left for one hour. The decoction is drunk in the morning on an empty stomach. Children aged 10-15 years old can drink a whole glass, younger children - half a glass. The course of treatment is ten days. At running form you need to take a break of 10 days, after which the course is repeated.

Treatment of enuresis with honey

Ingredients:

  • a teaspoon of honey.

Mode of application

Children are given honey before bed. The product has a calming effect, reduces the burden on the kidneys. You can't give more than a teaspoon. You can gradually reduce the dose. This method contraindicated in the presence of allergies to honey. Treatment with honey is very effective.

Recipe based on lingonberries

Ingredients:

  • half a liter of water;
  • half a cup of lingonberry leaves.

Mode of application

Half a glass lingonberry leaves pour half a liter of water, boil for about 7 minutes. Leave to infuse for 40 minutes, then filter. A decoction is given before each meal three times a day. Single dose - no more than 60 ml.

Collection of centaury and St. John's wort

Ingredients:

  • centaury and St. John's wort in equal proportions.

Mode of application

Herbs are brewed and drunk like weak tea. With this treatment, watermelon, celery, asparagus and grapes should be excluded from the menu.

A mixture of cranberries and St. John's wort

Ingredients:

  • a tablespoon of cranberries;
  • a tablespoon of lingonberry leaves;
  • a tablespoon of St. John's wort.

Mode of application

The ingredients are mixed, poured with three glasses of water, boiled for 10 minutes. The broth is insisted for one hour, then filtered. Take half a glass several times a day.

Plantain from enuresis

Ingredients:

  • 15 g plantain leaves;
  • a glass of boiling water.

Mode of application

Plantain is brewed with boiling water, left to infuse for 20 minutes. Take a tablespoon no more than three times a day.

violet recipe

Ingredients:

  • a glass of boiling water;
  • 20 g fragrant violets.

Mode of application

Grass pour boiling water, warm over low heat for 10 minutes. Strain the broth, take 2 tablespoons three times a day.

Treatment of enuresis with herring

Ingredients:

  • herring.

Mode of application

Peel the herring, remove all bones, cut the fillet into small pieces. Store cuttings in the refrigerator. Give your child a small piece before bed.

Enuresis exercises

Sit on the floor and move the right buttock with a straightened or bent leg back and forth. While looking at the right shoulder. Move one and a half meters forward in this way, then return to the starting position.

Enuresis compress

Such a compress stimulates blood circulation in the lower abdomen. Grated ginger is placed in cheesecloth, juice is squeezed out of it into a container with hot water. A towel is dipped into a solution of ginger juice, squeezed and applied to the lower abdomen. Dry matter is placed on top. Apply a wet towel every two to three minutes. Apply compresses before going to bed. Compresses are quite strong folk remedies.

Treatment with a collection of six herbs

Ingredients:

  • knotweed;
  • mint;
  • St. John's wort;
  • centaury;
  • birch leaves;
  • chamomile inflorescences.

Mode of application

Herbs are mixed and ground in a meat grinder. 30 g of raw materials are poured with a liter of boiling water, kept in a thermos for eight hours. The decoction is taken half an hour before a meal, 50 ml. Decoction can be sweetened a small amount honey or sugar. The course of treatment is three months.

Treatment with a collection of five herbs

Ingredients:

  • blackberry leaves;
  • bird mountaineer;
  • immortelle inflorescences;
  • yarrow;
  • St. John's wort.

Mode of application

Herbs are mixed in equal proportions, crushed. 9 g of raw materials are poured with one and a half glasses of boiling water, kept for two hours in a thermos. The infusion is filtered, drunk 20 minutes before meals, half a cup. Reception is stopped one hour before going to bed.

Parsley for enuresis

Ingredients:

  • 3 g of roots.

Mode of application

Insist for half an hour filled with a glass of boiling water 3 g of roots. Take strained infusion in a glass a day. You can also infuse 3 g of crushed seeds poured with a glass of boiling water for eight hours.

Laurel decoction

Ingredients:

  • 3 bay leaves;
  • glass of water.

Mode of application

Pour three small leaves with a glass of water and heat on fire for 10 minutes, then let it brew for an hour. Take half a glass three times a day. The course is a week. A decoction of bay leaves increases the effectiveness of drug treatment of nocturnal enuresis in children.

Thyme recipe

Ingredients:

  • 15 g thyme;
  • ¾ cup of water.

Mode of application

Pour 15 g of dried thyme with hot water, put on moderate heat, evaporate until a volume of one third is reached. Take 5 g of infusion three times a day. The course of treatment is one and a half months. After the end of the course, you can take a break for a month, then resume taking it.

Traditional medicine can be good helper in the treatment of enuresis in children. You can try to treat the child with different folk methods. It should also be remembered that the treatment of enuresis in children does not involve any emergency actions, and the disorder in most cases disappears with age. Before using this or that herb, it is better to consult a doctor.

Children's enuresis. School of Dr. Komarovsky.

Answers

- a disorder of voluntary urination, the inability of the child to control the act of urination. Urinary incontinence in children is characterized by the inability to store and retain urine, which is accompanied by involuntary urination during sleep or wakefulness. To find out the reasons, children undergo urological (ultrasound of the urinary system, cystoscopy, radiography of the kidneys and bladder, electromyography, uroflowmetry) and neurological (EEG, EchoEG, REG) examination. Treatment for urinary incontinence is based on the cause and may include drug therapy, physiotherapy, psychotherapy, etc.

In children under the age of 1.5-2 years, urinary incontinence is considered physiological phenomenon associated with the immaturity of somatovegetative regulatory mechanisms. Normally, the skills of urinary retention when filling the bladder are formed in a child by 3-4 years. However, if urinary control skills have not been established by this period, the causes of urinary incontinence in the child should be looked for. Urinary incontinence in children is a social and hygienic problem, often leading to the development of psychopathological disorders that require long-term treatment.

Causes of urinary incontinence in a child

Urinary incontinence in children may be due to a violation of the nervous regulation of the function of the pelvic organs due to organic lesions of the head and spinal cord: injuries (craniocerebral, vertebral and spinal), tumors, infections (arachnoiditis, myelitis, etc.), cerebral palsy. Often, urinary incontinence affects children with various mental illnesses (oligophrenia, autism, schizophrenia, epilepsy).

Urinary incontinence may be due to anatomical disorders in the development of the genitourinary system of the child. So, the organic basis of urinary incontinence can be urachus non-closure, ectopia of the mouth of the ureters, exstrophy of the bladder, hypospadias, epispadias, infravesicular obstruction, etc.

In some cases, urinary incontinence in children occurs against the background of sleep apnea syndrome, endocrine diseases (diabetes mellitus, diabetes insipidus, hypothyroidism, hyperthyroidism), taking medicines(anticonvulsants and tranquilizers).

In some cases, bedwetting is due to a violation of the rhythm of secretion of antidiuretic hormone (vasopressin). Due to the insufficient concentration of vasopressin in the plasma at night, the kidneys secrete a large volume of urine that overflows the bladder and leads to involuntary urination.

Urinary incontinence may be accompanied by urogenital diseases (pyelonephritis, cystitis, urethritis, vulvovaginitis in girls, balanoposthitis in boys, vesicoureteral reflux, nephroptosis, pyeloectasia), helminthic invasion. Hyperexcitability bladder and urinary incontinence in children can contribute to allergic diseases: urticaria, atopic dermatitis, bronchial asthma, allergic rhinitis.

In children, especially preschoolers, urinary incontinence can be stressful. Often traumatic situation divorce of parents, death of a loved one, conflicts in the family, ridicule of peers, transfer to another school or Kindergarten, change of residence, the birth of another child in the family. AT recent times among the causes contributing to urinary incontinence, pediatricians call wide application disposable diapers, delaying the formation conditioned reflex for urination in a child.

In most cases, urinary incontinence in children is provoked by a combination of these factors.

Classification

In the event that involuntary leakage of urine occurs through the urethra, they speak of vesical incontinence; if urine is excreted through other unnatural channels (for example, urogenital and ureteric fistulas), this condition is regarded as extravesical urinary incontinence. In the future, only forms of vesical urinary incontinence in children will be considered.

In pediatric urology, it is customary to distinguish between incontinence and urinary incontinence: in the first case, the child feels the urge to urinate, but cannot hold urine; in the second, the child does not control urination, because he does not feel the urge. In the event that urinary incontinence occurs during sleep (in children older than 3.5-4 years at least 2 times a month) in the absence of mental illness and anatomical and physiological defects of the urogenital sphere, they speak of enuresis (night or daytime).

Urinary incontinence in children can be primary or secondary. Primary (persistent) refers to the delay in the formation physiological reflex formation and control of urination. This usually occurs against the background of neuropsychiatric disorders or organic disorders urinary system. Cases of secondary (acquired) urinary incontinence include situations where the skill of inhibition of urination is lost after a period of control over urination for more than 6 months. Secondary urinary incontinence in children can be of psychogenic, traumatic and other origin.

According to the mechanisms of development, urinary incontinence can be imperative, reflex, stress, from bladder overflow, combined.

With imperative (imperative) urinary incontinence, the child fails to control urination at the height of the urge. This variant, as a rule, occurs in children with a hyperreflex form of a neurogenic bladder.

stress incontinence urine in children develops in connection with efforts accompanied by a sharp increase in intra-abdominal pressure (coughing, laughing, sneezing, lifting weights, etc.). This type is most often caused by functional muscle weakness. pelvic floor and urethral sphincter.

Dissociation of the cortical and spinal centers that regulate the function of the pelvic organs, including voluntary urination, leads to reflex urinary incontinence in children. In these cases, there is an involuntary leakage of urine drop by drop or in small portions.

Paradoxical ischuria, or urinary incontinence associated with bladder overflow, can be small - up to 150 ml; medium -150-300 ml and large volume - more than 300 ml. This violation characterized by involuntary excretion of urine due to overfilling and overdistension of the bladder in children with hyporeflex neurogenic bladder, infravesical obstruction.

Symptoms of Urinary Incontinence

Urinary incontinence is not an independent disease, but a disorder that occurs in various nosological forms. Urinary incontinence in a child can be permanent or intermittent; be noted only in a dream or also in a waking state (usually during laughter, running); have the character of a small leakage of urine or complete spontaneous emptying of the bladder.

Children with urinary incontinence often have accompanying illnesses: recurrent urinary tract infections, constipation or encopresis. Due to the constant contact of the skin with urine, dermatitis, pustular lesions often occur.

Children with enuresis are characterized by emotional lability, isolation, vulnerability or irascibility, irritability, and behavioral deviations. Such children may suffer from stuttering, bruxism, sleep disturbances, sleepwalking, sleep-talking. Autonomic symptoms are typical: tachycardia or bradycardia, sweating, cyanosis, and cold extremities.

Diagnostics

A specialized examination of children with urinary incontinence is aimed primarily at finding out the causes given state. Therefore, a team of pediatric specialists may be involved in the diagnostic search, including a pediatrician, pediatric urologist or pediatric nephrologist, pediatric gynecologist, pediatric neurologist, child psychiatrist, child psychologist. The study of the somatic status involves the collection of a detailed anamnesis, assessment of the general condition, examination of the lumbar region, perineum, and external genital organs.

At the stage of uronephrological examination, the daily rhythm of urination is assessed, laboratory research(general urinalysis, bacteriological urine culture, Zimnitsky, Nechiporenko test, etc.), uroflowmetry,

Many parents are concerned about the problem of childhood enuresis. Faced with him, they do not know what to do. How to treat suddenly manifested nocturnal enuresis in children of 11 years old, as well as in older adolescents - this article discusses the most FAQ arising from parents. The causative factors of the disease are diverse, so the treatment is selected depending on the determining factor.

Why does a teenager have enuresis?

primary factor

This type of enuresis is caused by hereditary predisposition. If there are people with a similar disease among family members, you should especially carefully monitor the child. The disease can manifest itself with epilepsy or psychopathy. In adults, enuresis is often caused by alcoholism. In women, primary enuresis is often provoked by childbirth or a difficult pregnancy. This fact especially affects the health of a young teenage girl.

Acquired factor in boys and girls

This type of enuresis is not associated with hereditary factors. Its manifestation can provoke:

  • Stress. It could be a difficult situation at school, constant pressure from parents, quarrels, scandals in the family, strained relationships with peers.
  • psychological reasons. For example, manifestations of nocturnal enuresis in a teenager are perceived by him as something shameful, which further exacerbates the disease. Often nighttime urinary incontinence psychological reasons accompanied by nervous tics and stuttering.
  • Urological diseases and diseases of the reproductive system.
  • Some pathologies, for example, an overactive bladder.
  • Diseases of the spinal cord in the form of a disorder affecting the areas responsible for the activity of the bladder.

The use of products containing caffeine may be the cause of nocturnal enuresis.

Another factor that causes enuresis in adolescents is caffeine, or rather, its overuse. In addition to coffee and tea, don't forget to consider other foods that contain caffeine, such as chocolate ice cream. Interesting stats:

  • most often this disease manifests itself in boys, but girls are not immune from it either;
  • mostly boys suffer from enuresis at night, while the form of daytime enuresis is more characteristic of girls;
  • patients with daytime enuresis make up only 5% of the total number of patients.

Symptoms: when to worry?

Parents should not worry if a baby under the age of 5 does not control urination, this is due to the still immature activity of the genitourinary system. But if this happened later, you should contact a specialist. If a child of 6-11 years old is easier to cure enuresis, then in children of 12 years old, the treatment becomes more complicated. Until the age of 15, it is worth taking measures to stop the disease, otherwise difficult social adaptation. Enuresis in adolescents is of two types - daytime and nocturnal. Day time differs from night time of its manifestation. The problem of nocturnal enuresis is bedwetting, that is, voluntary urination occurs when a teenager is sleeping. Daytime manifests itself during wakefulness.

What to expect at the doctor's appointment?


Specialized assistance required for enuresis.

The attending physician should ask parents about the frequency of urination, whether there were concomitant symptoms, and according to the results of what they heard. After examining the teenager, the doctor will determine the further course of treatment. The specialist draws attention to appearance child according to the criteria of grooming or neglect, the smell of urine and other visible manifestations. It reveals behavioral changes, and if they are, then they are directed towards hyperactivity or, conversely, isolation or timidity. Pays attention to memory, absent-mindedness, school failure, evaluates social life teenager (atmosphere in the family, school), looks at a map of diseases, including asking parents about probable hereditary diseases.

Why is all this necessary?

An important factor is to determine the cause of enuresis - psychological or physiological. Depending on the reason assigned suitable type treatment. Allocate neurotic and neurosis-like enuresis. How to distinguish them? Neurotic enuresis occurs against the background of experiences, psychotrauma and is accompanied by a child's sense of shame and guilt for. Neurosis-like enuresis appears due to damage to the central nervous system and is not accompanied by feelings and shame.

In the neurotic variant of the disease, the sleep is superficial, anxious, the adolescent wakes up after urination, in the neurosis-like variant, the opposite is true - the sleep is deep, the adolescent does not wake up after urination. Both options suggest vegetovascular disorders, but in the first case they are present initially, in the second they appear as they grow older, when the level of neuroticism increases.

Treatment: how to get rid of enuresis?

Medical method


When taking drugs, the urge to urinate decreases.

From nocturnal enuresis, doctors successfully use the drug Desmopressin, also known as Adiuretin, Adiuretin SD, Apo-Desmopressin, Vazomirin, Desmopressin Acetate, Minirin, Nativa, Nourem, Presignex, Emosint. Pharmacological group - hormones of the hypothalamus, pituitary gland, gonadotropins and their antagonists. Similar in action to oxytocin and have antidiuretic properties. It is given to children at bedtime, due to which the frequency of urination at night decreases or they stop altogether. The medicine is harmless. However, it is worth remembering that this is not a panacea, and upon discontinuation of the drug, the disease may resume.

Desmopressin is available in various dosage forms, but children are more likely to be prescribed tablets or nasal spray for enuresis. When using Desmopressin, precautions should be taken to avoid giving the teenager a lot of fluids in the evenings to avoid the risk of water intoxication. The drug should be prescribed by a doctor, as there are some contraindications.

Some doctors prescribe low-dose tricyclic antidepressants or Oxybutynin. With neurosis-like enuresis, nootropics, vitamins of group B, "Cortexin" are used. In neurogenic course, anticholinergics, vitamin therapy, antioxidants, "Glycine" are used. The use of sedatives, such as Novopassit, Persen, is justified. AT difficult cases small doses of antipsychotics are used, for example, Sonopax.

Psychological problems may cause nocturnal enuresis in adolescents.

In childhood and adolescence, play psychotherapy is used to divert attention from the problem and switch from it. With neurotic enuresis, mood correction is carried out - such as increased tearfulness, irritability, increased anxiety, various fears, dissatisfaction with oneself, one's life, and one's environment.

If a child has urination in bed during a night's sleep, they talk about nocturnal enuresis. This problem is very common in childhood. modern medicine does not attribute it to diseases, but calls it a developmental stage during which the child masters the functions of his own body.

Kinds

Depending on the time of formation of the "watchdog" reflex, the following types of incontinence are distinguished:

  • Primary. The child has not yet learned to control urination. This is the mildest form, which in 98% of children resolves on its own without therapy.
  • Secondary. The child has already learned to control the bladder in the past and has had a dry bed for more than 6 months.


If a child develops enuresis after six months of urinary control, the problem is more difficult to correct.

Depending on the symptoms, enuresis can be:

  • Uncomplicated. The child has no other abnormalities besides enuresis.
  • Complicated. The baby has inflammatory diseases, developmental disorders and other pathologies.

Depending on the reaction of the child to the problem, the following types are distinguished:

  • Neurotic. This form of incontinence is typical for a shy and very shy child with shallow sleep. The baby is very worried about failures at night, which leads to sleep disturbance.
  • neurosis-like. This form of enuresis occurs in children with hysterical behavior. The child is not very worried when he sees a wet bed before adolescence when incontinence can cause isolation and neurosis.

At what age is this normal?

Normally, a child learns to control his urination at night by the age of 6. At the same time, about 10% of children who are 6 years old have not mastered such control. Over time, the problem becomes rarer. By the age of 10, incontinence at night is noted in 5% of children, and by the age of 18 - only 1%. Boys are twice as likely to have the problem.


If your baby under 6 years old does not always control urination during sleep, do not worry.

The reasons

Boys

Incontinence is more common in boys. It is driven by the following factors:

  • Birth injury, affecting the spinal cord or brain.
  • Prolonged formation of a conditioned reflex. In some boys, the development of such a reflex occurs later than in peers.
  • stressful situations. Enuresis can occur due to severe fright, constant quarrels parents, changing schools, moving and similar factors that greatly influenced the psyche of the child.
  • Heredity. If incontinence was noted in both parents, then the problem is possible in 70-80% of cases. If one of the parents suffered from enuresis, the boy will have such a problem in 30-40% of cases.
  • Inflammatory diseases of the bladder. They are determined by the results of a urine test. It can also lead to incontinence. congenital pathology urinary tract.
  • Prolonged use of diapers. The child gets used to the fact that after urination the bed is not cold and not wet.
  • Hormonal disorders. At underproduction hormones that affect the functioning of the bladder, the volume of urine released and its concentration, the child develops incontinence.
  • Hyper-care. It is often seen in incomplete family when the boy is raised by his grandmother or mother. Due to too much custody, the child subconsciously behaves like a baby, because he has a feeling that he is small.
  • Hyperactivity. When a child is highly excitable, the activity of the processes in the brain prevails over the signals of the bladder. And the brain simply does not “hear” the urge to urinate at night.
  • Lack of parental attention With such a deficit, the child subconsciously does everything in order to feel cared for by loved ones.
  • Allergies. It is noted that boys with allergic reactions, as well as with bronchial asthma episodes of enuresis are a fairly common problem.


To eliminate enuresis, it is necessary to identify the cause of uncontrolled urination during sleep.

Girls

Due to the peculiarities of the nervous system, girls learn to control the functioning of the bladder faster and start going to the potty earlier, so the problem of enuresis occurs much less often, and if it does occur, it is easier to cure it in a girl.

Incontinence may occur in the following situations:

  • If the development of reflexes is slightly delayed. Some girls learn to control reflexes later than their peers.
  • As a result of stress or psychological trauma. The girl may be affected by the divorce of her parents, the appearance of a second child in the family, a change of residence, a transfer to a new kindergarten, and similar factors.
  • At very sound sleep. It can be a sign of either congenital features of the girl's nervous system, or overwork.
  • If the girl drinks a lot at night. Soldering during a cold can also lead to a “wet bed”.
  • Under the influence hereditary factor. It causes the release of the hormone vasopressin, which reduces the production of urine at night. Lack of this hormone can be transmitted from parents. If one of them had enuresis as a child, there is a 30 percent chance of incontinence in the daughter. If both parents had the problem, the girl's risk of enuresis rises to 75%.
  • With injuries of the spinal cord and spine. They disrupt the pathways for impulses from the brain, as a result of which they do not reach the bladder.
  • If there is a delay in development. When a girl lags behind, the formation of all reflexes occurs later.
  • If an infection develops urinary tract. Due to the wide and shorter urethra in girls, microorganisms that develop on the genitals can enter the bladder.


Enuresis is much less common in girls than in boys.

Teenagers

At this age, enuresis is noted in 5% of children and it is often secondary, but it can also drag on from an early age.

The main reasons due to which incontinence in a teenager is possible are:

  • Stress. The child may overly acutely perceive the tense situation at school or family, suffer from physical punishment, conflicts with peers, moving, loss of a loved one and other stressful situations.
  • Mental illness. Neuroses can lead to incontinence and depressive states, which is further exacerbated by experiences and teenage complexes.
  • Congenital pathologies. They can be both in the nervous system and in the organs of the urine. excretory system.
  • hereditary tendency. As in younger age, enuresis in adolescents may be due to such a problem in his parents.
  • Injuries. They can lead to a violation of the urination reflex.
  • Hormonal reorganization. Hormone levels change during puberty, so there may be a failure in the production of hormones that affect urination.


In adolescents, enuresis can lead to various psychological problems.

Psychological problems

Nocturnal enuresis is almost always a significant problem for a child, and if incontinence has developed in a teenager, it can cause a serious inferiority complex. Children with enuresis find it difficult to communicate with their peers, even if other children do not know about this problem.

The child feels inferior, closes, seeks to avoid contact with other children, seeks solitude. This can leave an imprint on the character - children with incontinence have anger, indecision, aggressiveness, insecurity, which are carried over into adulthood.

Especially often, such changes occur when the child is ridiculed by parents, if the baby is punished and scolded for wet sheets. That is why parents should be sensitive and caring, and their reaction to enuresis should be delicate and correct.


The successful solution of the problem largely depends on the reaction of the parents.

Diagnostics

If the child is 6 years of age and does not yet have full bladder control, further testing should be done. The child is prescribed urinalysis (general urinalysis and Zimnitsky test) and ultrasound of the excretory system. In many cases, MRI, cystoscopy, EEG, X-ray examination, examination by a neuropathologist, endocrinologist, psychiatrist and other specialists are additionally prescribed.

Treatment

There are quite a few ways to eliminate incontinence, but the effectiveness of their impact differs in the situation with each individual child.

medicines

  • If enuresis is associated with hyperactivity and excitability of the nervous system, the child is prescribed sedatives.
  • When detecting inflammatory and infectious processes, antibiotics are prescribed.
  • If the development of the nervous system is delayed, the child may be prescribed nootropics.
  • With violations of the production of hormones that affect the composition and volume of urine, as well as the functioning of the bladder, desmopressin is prescribed.

urinary alarm

This is very effective technique the fight against incontinence, which consists in using a special alarm clock. A sensor is connected to it, which is placed in the child's panties. At the first droplets of urine that hit the sensor, it is also triggered by sending a signal to the alarm clock, as a result of which the child is forced to wake up, turn off the device and go to the toilet.


Urinary alarm is considered effective way enuresis

Other Methods

Physiotherapy is recommended to improve the functioning of the bladder and nervous system. The child can be prescribed magnetotherapy, electrophoresis, therapeutic shower, acupuncture, electrosleep, a course of therapeutic baths and other methods of physiotherapy. Also recommended physiotherapy and massage.

Note the effect and application of psychotherapy. The psychologist will teach the child to relax and use the technique of self-hypnosis. Keeping a diary helps many people, in which dry nights are denoted by suns, and for a certain amount of such suns in a row the child is supposed to be encouraged.

In addition, a child with enuresis is recommended to establish a daily routine and follow a certain diet. Drinks are limited in the evening, and at night the child is given food that helps retain water in the body. It is important to ensure an adequate supply of children's diet vitamins.


A well-established daily routine will help the child psychologically calm down before going to bed.

Folk recipes

One of excellent funds to treat enuresis in the people consider honey. It is advised to eat it before going to bed to retain fluid in the body during the night and calm the nervous system.

You can also give your child:

  • A decoction of young cherry branches and dried blueberry stalks. After insisting the brewed plants for 15 minutes, add a little honey to the drink and give this decoction to the child twice or thrice a day in a glass between meals.
  • A decoction of dill seeds. Seeds dried in a frying pan (2 tablespoons) are brewed in an enamel container with 0.5 liters of boiling water and left for four hours. Drink this remedy should be before meals for 14 days twice a day.
  • Infusion of centaury and St. John's wort. Each plant in a dry crushed form is taken in half a glass and brewed with 500 ml of boiling water. After insisting for three hours, the decoction is given to the child before meals 3-4 times daily for two weeks.
  • tea from corn silk with honey. A teaspoon of stigmas is poured with boiling water, and after 20-30 minutes a teaspoon of honey is added to the drink. Drink this tea twice a day.
  • Tea from dried berries and leaves of cranberries and dried St. John's wort. Plants are taken in a ratio of 1 to 1, for one serving, two teaspoons of crushed raw materials are brewed with a glass of boiling water. After 15 minutes, the broth should be drunk in small sips (preferably after dinner).
  • Balls of crushed egg shells and honey. The components are mixed 1 to 1, make balls with a diameter of 2 centimeters and give the child 4 pieces daily for a month.

Please keep in mind that using any folk recipe it is worth discussing with your doctor before trying out its effect on the problem.


Usage folk remedies should be combined with other activities

  • Try to protect the child from various stressful situations.
  • Let the child go to bed at the same time every day, and 3 hours before that, the volume of fluid should be sharply limited.
  • Don't let active games just before bed. At this time, you can read, draw, watch scary cartoons together.
  • To reduce pressure on the bladder, you can place a cushion under the baby's mattress in the baby's pelvis or under the baby's knees.
  • Make sure that the child does not have hypothermia. As soon as the baby's legs freeze, the bladder will fill reflexively.
  • The child must certainly go to urinate before going to bed. If you wake your child up at night to urinate, do not allow him to doze off in the toilet.
  • Buy a night light for the children's room so that the baby is not afraid to go to the toilet in the dark when he wants to.
  • Noticing a wet sheet in the morning, do not swear or be upset in front of the child. Seeing your reaction, the baby will begin to think that he has a very serious problem. Tell your child that this often happens in children, but it goes away with time.
  • Any method of treatment will give an effect if you inspire the child with confidence that he will succeed.