The bladder stores the urine due to the unique ability to stretch. Normal if you increase the amount of urine pressure in the bladder remains lower than the pressure in the area of the sphincter. Due to this urine retained in the bladder even when increased intra-abdominal pressure during coughing, laughing, while running or squats. Bladder emptying is ensured by a complex system of neural regulation. Thanks to its coordinated activity of the sphincter of the bladder relaxes for a few milliseconds before the start of contractions of the detrusor (smooth muscle of the bladder wall).
Bladder newborns and infants is filled to a certain volume, and then automatically compressed and emptied. With time there is a “maturing” of the system innervation of the urinary system. As a rule, the children “learn” to control the process of urination during the day and then at night.
Enuresis, or incontinence of urine is a disorder characterized by involuntary urination at any time of the day. Nocturnal enuresis requires treatment by a doctor while maintaining episodes of incontinence in girls after 4, and the boys after 5 years. Approximately 10% of children at this age is incontinence. Boys bedwetting occurs two times more often than girls.
Causes of enuresis
Organic causes include abnormalities of the structure of the urinary tract, urinary tract infections, diabetes and diabetes insipidus, and the violation of the innervation of the bladder.
Medical causes of enuresis:
– the immaturity of the mechanisms of regulation of the bladder;
syndrome hyperresponsiveness urinary (characterized by sudden pozyvam to urinate);
– urination when laughing (associated with a sharp increase in intra-abdominal pressure);
– features of sleep;
– reduced functional bladder capacity;
– constipation (reduce functional bladder capacity);
– emotional stress.
It is known that there is a genetic predisposition to enuresis if the child’s parents suffered from enuresis in childhood.
Enuresis is divided into primary, when the child throughout life there was no control of urination and secondary, when there was control for at least 3 months. Secondary enuresis should cause the greatest concern, as is more often associated with organic disorders.
Diagnosis of enuresis
Appeal to the doctor in the presence of enuresis is necessary first to exclude any serious disease, which can result in incontinence, and secondly to determine the tactics of treatment and programming of the behavior of the parents and the child. You should visit the pediatrician, urologist and neurologist. On examination, the doctor will conduct an inquiry and careful examination with palpation of the abdomen and possibly the finger examination of the rectum. The survey includes, as a rule, urine analysis and ultrasound of abdomen and pelvis. Additional surveys may be conducted bacteriological urine culture, x-ray examination of the urinary system, electroencephalography, neurosonography, etc.
Treatment of urinary incontinence
Self treatment for enuresis
Functional disorders require the correct mode of the day, the correction of the emotional background of the family, elimination of stress factors that affect the child. Generally, children suffering from enuresis need moral support. The child should not feel guilty and inferior. Recovery contribute to the availability of toilets in the kindergarten, school and home at any time, the opportunity to retire, lighting bathroom at night.
Keep a calendar of incontinence. Shortly before bedtime, the child needs to sit quietly in the toilet, the bladder completely relaxed and opened up. In the bathroom should be warm and pleasant, not cold and dark. When nocturnal enuresis Wake the baby 1-2 times a night to go to the bathroom. Don’t put half-asleep child on the toilet – he should be aware of the process of urination. Gradually he formed a biological need to get up to the toilet independently. Useful stretching exercises and increase in bladder capacity (times a day the child is requested as much as possible not to urinate).
Clinical treatment of enuresis
If the examination revealed the underlying disease that led to the emergence of enuresis, your doctor will prescribe you the necessary treatment and will regularly monitor you until complete healing.
Drug treatment of functional disorders include a variety of drugs to stabilize the mental condition of the child, in some cases recommend desmopressin or imipramine.