What is enresisEnuresy is the repeated episodes of urinary incontinence, which occur at least twice a month for 3 months or more. Most often, involuntary urination occurs at night. The study of this problem has been engaged in doctors since the time of the former Persian scientist Avicenna, and for the first time, the term "enresis" was introduced into medical practice at the end of the 18th century. Since then, it has been possible to find methods quite effective in treating the disease, but the mechanism of its occurrence has not yet been fully studied.Most often, children suffer from an enuee and, in adolescence, in most cases, the disease goes through itself.
In boys, enresy is more common than girlsExperts recommend that they do not ignore this delicate problem even at a young age, because due to the incontinence of the urine, the child can develop diseases of the genitarinary system and psychological problems arise. Studies have shown that in children with lubricates in 70% of cases, the level of anxiety has been increased, they find it difficult to communicate with peers and meet conflicts in the family because of their problem, which they cannot control. The New Zealand judicial psychiatrist, John Makdonald, even included enresis, as well as zoosadism (brutal manipulation of animals) and piruinia (passion for criminal fire), in "behavioral triad", which indicates a predisposition to commit cruel crimes. Personality training is not influenced by Enrez episodes, but a trauma associated with mockery and punishment of parents, friends, brothers and sisters.At 5 years old, enuresis occurs in 15 to 20% of children, at 7 years - in 12% and in 10 - in 5%. The disease is also detected in 1 to 2% of adolescents and 0. 5 to 1% of adults.In adults, enuresis generally develops after 45 years, women suffer three times more often than men. At this age, episodes of enuresis are generally symptoms of diseases of the nervous and genitorerinary system - and spontaneous healing, as in children, does not occur. Causes of EneoreNormally, the urination process occurs as follows. The urine through the ureters moves from the kidneys to the bladder, but does not come out: it is maintained by the muscle ring (sphincter), located in place of the compound of the urethra with the bladder. Gradually accumulating, he presses on the walls of the bubble and annoys the receptors that transmit a signal on the need to urinate at the brain centers of the brain. The brain returns a signal that you can relax the sphincter of the urethra. Normally, with persistent calls for urination during sleep, a person wakes up and can deliberately last for a while.In children under the age of 4, control centers on the brain are not finally formed, so they cannot always control this process. The "wet nights" up to 4 to 5 years are not considered a difference compared to the standard. But after 5 years, enuresis indicates a malfunction at one of the stages of urination.Causes of enuresis in children:The slow development of micational centers in the brain and other disorders of the central nervous system (central nervous system). Most often, it is an individual characteristic of the body and as the central nervous system develops, the ENOZ problem goes alone. The risk of developing the disease for this reason is higher in children who have known the famine of oxygen (even insignificant) during pregnancy and childbirth to the mother of toxicosis, entering the umbilical cord, a bad presentation, etc. ;Polyuria is an excessive urine secretion. This can happen due to the fact that the child drinks a lot of liquids at night or due to hormonal disorders. These include diabetes mellitus, excessive activity of the parathyroid glands (hyperparathyroidism), a reduction in the production of a vasopressin hormone, which helps to regulate the tone of the muscles of the internal organs and to control the volume of the urine. At night, it is generally more actively synthesized, so urine is less formed; Genitorerinary system diseases. The inflammation of the urethra and the bladder, the neoplasms, the narrowing of the urethral channel, for example, due to the growth of the connective tissue, can also lead to enuresis;Stress. The loss of a moving parent, going to kindergarten often causes nocturnal incontinence of urine;A strong dream, because of which children do not wake up with urination.
Due to Eneoriez, the child often becomes the object of ridiculous. This considerably reduces self -esteem and leads to psychological problemsCauses of enuresis in adolescents and adults:Hormonal disorders: diabetes, hyperparathyroidism, reduction in vasopressin;Inflammatory diseases of the genitarian system: pyelonephritis, urethritis, cystitis, prostatitis, orchitis (inflammation of eggs);Regular alcohol abuse;trauma of the spine, spinal cord;Congenital anatomical anomalies (for example, too small bladder) or weakening the muscles of the pelvic floor;Stress.Most often, enuresis develops under the influence of several factors at the same time, and in some cases, it is not possible to distinguish with precision the main cause of incontinence.ENOZ CLASSIFICATIONEnuresy is divided into primary school, when the problem was identified for the first time and periods of complete control over the urination, and secondary, which was preceded by a "dry" period controlled for a long time for six months or more.In the clinical recommendations of the Ministry of Health of our country, the disease is defined as a nocturnal incontinence of the urine that occurs during sleep. But in medical practice, it is sometimes divided during night, day and mixed. Complicated and simple enuresis is also distinguished: in the first case, syndrome is not associated with other diseases, in the second, it is associated with pathologies of the central nervous system, infections and other problems with the urinary system. Eneoves symptomsThe main sign of enuresis is the inability to control urination during night sleep. Less often - during the day. An unusual emptying of the bladder cannot occur every night, but regularly. The diagnosis of enuresis is made if this happens twice or more per month for 3 months.With an ENUE, a person can urinate more often during the day, to face an involuntary urinary leak, to experience false urination or, conversely, to feel that after having visited the toilet, the bladder is not completely exhausted.Children and adolescents with enuresis can become more closed and irritable, to sleep more badly at night, they reduce performance at school.What doctor treats enresisEnuresy causes a variety of reasons, therefore, a large number of specialists are engaged in its diagnosis and treatment. Adult patients are recommended to contact the therapist and urologist. If the enuresis of the child, it is necessary to arrive at the reception at the pediatrician who will perform an inspection and will recommend close specialists. This can be an urologist, gynecologist, nephrologist, neurologist, psychotherapist, endocrinologist. General practitioners and narrow specialists collect family history, listen to the patient's complaints and examine. The diagnosis of enuresis is generally made on the basis of a clinical picture, and instrumental tests and studies are prescribed to clarify the causes.Laboratory diagnostics of EneozEvaluating the general condition of the body and identifying the inflammation of the genitarinar system is helped by a general urine analysis and a urine analysis by Nechiporenko.In some cases, an analysis is prescribed to determine the level of vasopressin (antidiuretic hormone). It controls the water level in the body and affects the intensity of urination. Instrumental diagnosis of enuresisWith an Enuree, the doctor can prescribe an ultrasound of the bladder. This study can be replaced by a magnetic resonance or a bladder computed tomography and other organs of the urinary system.
Ultrasound helps to assess the work of the bladder and to discover the amount of urine that remains there after urinationIf the results of the ultrasound are not sufficient to determine the cause of enuresis and prescribe treatment, the patient is directed towards a cystographic examination. For this procedure, a catheter is introduced into the bladder and fulfills the organ with a contrasting drug or oxygen, after which they take photos of full and empty bladder.Evaluating the speed and volume of urine flow during urination allows the Uroflowory method. During the study, the patient urine in the funnel receiver of the urofloumeter device. With this study, you can obtain information on the rate of urine and fluid volume rate, select indicators (markers) of the differences compared to the standard. This data is entered into the operating system linked to the sensor, processed, and the results are displayed on the computer monitor in graphic form. The doctor deciphers the results.If the patient in the past has undergone injuries or if the doctor suspects anomalies of the structure of the Lombo-Sacré service, which can also cause enuresis, can prescribe a radiography of this vertebral column. In children and adolescents, enuresis most often develops not due to injuries or infections, but due to the late development of the central nervous system and stress. In this case, they are recommended by an examination by a neurologist and a psychotherapist.ENOZ TREATMENTIn adults and adolescents, enuresis is most often a symptom of infection, endocrine or injury disease. Therefore, first of all, it is necessary to identify this pathology as soon as possible and to start treatment.Enures in children is treated by the correction of behavior (motivational therapy), drugs, physiotherapy, psychotherapy or combinations of these methods.DrugsIf the main cause of enuresis is violations of the nervous system, drugs that help normalize their work can be prescribed to the child. These are vitamins of group B, nootropic drugs, glutamic acid, glycine. Antidiuretic drugs are also prescribed and, in some cases, tricyclic antidepressants. But the latter are used less often, because they have a more pronounced side effect. Separately or in the context of complex therapy, drugs are prescribed that normalize the work of the muscle shell of the bladder - Destrozor. If enuresis is associated with infectious disease, they can prescribe an antibiotic course.PhysiotherapyProcedures are prescribed as a type of independent treatment or in combination with drugs. Paraffin applications at the bottom of the abdomen and at the rear in the area of the Lombo-Sacré department, physiotherapy exercises, electrophoresis, magnetotherapy give a good effect.
For a complete treatment of enuresis, gymnastics and physiotherapy are usedPsychotherapyIn cases where enuresis has developed as a result of stress or neurotic disorder, a psychotherapist prescribes treatment. If a child suffers with an Enuree, a good effect is given by family psychotherapy sessions and sedatives that are suitable for a small patient per age. But it is even more important to create a favorable atmosphere for him at home, to show that adults on his side helps him to face this problem. In no case should you rumble and shame the child: the least is to blame for his illness. Pressure and aggression will lead to the fact that the symptoms will not disappear, but will increase. In adolescents and adults, enuresis can also be caused by psychological causes and, in this case, they can recommend individual therapy.Experts do not advise to use layers with an Enureur, which hide the unpleasant sensations and level the problem - it is best to protect the bed with an adhesive or disposable layer. There are special devices - enumeration awakenings which are attached to pajamas or underwear and respond to the first drops of urine excreted with a sound signal. This is gradually inhabiting a person to respond to the desire of the body and to wake up in time to go to the toilet. Compliance strictly with the diet of the day and regular visits to the toilet play an equally important role. Before going to bed, it is better to go to the toilet twice: up to evening hygiene procedures (washing, brushing, shower) and after them. During the day, you should drink enough water, but an hour or two before bedtime, it is worth limiting the use of liquids, as well as products that irritate the bladder - it is mainly citrus and juice. Adolescents and adults must also abandon alcohol, tea, coffee, energy and other drinks containing caffeines.Forecasts and PreventionSummer treatment, compliance with the doctor's recommendations, daily routine and, above all, the adequate and benevolent reaction of parents and other parents give good results and allow you to completely get rid of the problem of involuntary night urination.It is impossible to prevent enuresis, but the risk of development is reduced if the pregnant mother carefully monitors her health during pregnancy: refuses bad habits, leads a healthy lifestyle, observes the daily routine and follows the doctor's recommendations in order to avoid complications during pregnancy and childbirth. If the child has already encountered the problem of Enerore, the favorable environment in the family and children team will help prevent their rehearsal. It is worth doing everything possible to avoid stressful situations that can cause a relapse of the disease. Adults are recommended to carefully monitor their health and in time to identify and treat infections of the genitarinarial system, as well as to use condoms during sexual intercourse to avoid sexually transmitted infections.Frequent questionsWhat is enresis?Enuresy is an involuntary urination in adults and children over 5 years old, which occurs more often twice a month, generally during sleep. This disease in children often occurs independently and does not affect their health. But enuresis seriously affects the child's self -esteem and their relationship with parents and peers, many experts recommend treating urine incontinence from 6 to 7 years old. Why was an adult described at night in a dream?Nocturnal urinary incontinence can cause infections of the genitarine system, hormonal failures, a trauma of the spine and spinal cord, a weakening of the pelvic floor muscles and even serious experiences. This can also happen if a person is in a state of alcohol or narcotic poisoning. If an involuntary urination at night occurs regularly, you should consult a doctor who can determine the cause of this delicate problem and prescribe treatment.How to get rid of ENOZ?The cause of enuresis can be infectious diseases, stress, hormonal dysfunctions. In children, the nocturnal incontinence of urine is often associated with the characteristics of the development of the central nervous system. The treatment is prescribed according to what exactly caused nocturnal incontinence of the urine. Most often, combine drugs (synthetic hormones, sedatives, tricyclic antidepressants) and physiotherapy methods - electrophoresis, gymnastics, magnetic therapy and laser. If enuresis is associated with a neurotic disorder or with chronic stress, it is recommended to request the help of a therapist.Which doctor treats enresis?Enuresy causes a variety of reasons, therefore, a large number of specialists are engaged in its diagnosis and treatment. Adult patients are recommended to contact the therapist and urologist. If the enuresis of the child, it is necessary to arrive at the reception at the pediatrician who will perform an inspection and will recommend close specialists. This can be an urologist, gynecologist, nephrologist, neurologist, psychotherapist, endocrinologist.
At 5 years old, enuresis occurs in 15 to 20% of children, at 7 years - in 12% and in 10 - in 5%. The disease is also detected in 1 to 2% of adolescents and 0. 5 to 1% of adults.In adults, enuresis generally develops after 45 years, women suffer three times more often than men. At this age, episodes of enuresis are generally symptoms of diseases of the nervous and genitorerinary system - and spontaneous healing, as in children, does not occur. Causes of Eneore
Normally, the urination process occurs as follows. The urine through the ureters moves from the kidneys to the bladder, but does not come out: it is maintained by the muscle ring (sphincter), located in place of the compound of the urethra with the bladder. Gradually accumulating, he presses on the walls of the bubble and annoys the receptors that transmit a signal on the need to urinate at the brain centers of the brain. The brain returns a signal that you can relax the sphincter of the urethra. Normally, with persistent calls for urination during sleep, a person wakes up and can deliberately last for a while. In children under the age of 4, control centers on the brain are not finally formed, so they cannot always control this process. The "wet nights" up to 4 to 5 years are not considered a difference compared to the standard. But after 5 years, enuresis indicates a malfunction at one of the stages of urination. Causes of enuresis in children: The slow development of micational centers in the brain and other disorders of the central nervous system (central nervous system). Most often, it is an individual characteristic of the body and as the central nervous system develops, the ENOZ problem goes alone. The risk of developing the disease for this reason is higher in children who have known the famine of oxygen (even insignificant) during pregnancy and childbirth to the mother of toxicosis, entering the umbilical cord, a bad presentation, etc. ; Polyuria is an excessive urine secretion. This can happen due to the fact that the child drinks a lot of liquids at night or due to hormonal disorders. These include diabetes mellitus, excessive activity of the parathyroid glands (hyperparathyroidism), a reduction in the production of a vasopressin hormone, which helps to regulate the tone of the muscles of the internal organs and to control the volume of the urine. At night, it is generally more actively synthesized, so urine is less formed; Genitorerinary system diseases. The inflammation of the urethra and the bladder, the neoplasms, the narrowing of the urethral channel, for example, due to the growth of the connective tissue, can also lead to enuresis; Stress. The loss of a moving parent, going to kindergarten often causes nocturnal incontinence of urine; A strong dream, because of which children do not wake up with urination. Due to Eneoriez, the child often becomes the object of ridiculous. This considerably reduces self -esteem and leads to psychological problems Causes of enuresis in adolescents and adults: Hormonal disorders: diabetes, hyperparathyroidism, reduction in vasopressin; Inflammatory diseases of the genitarian system: pyelonephritis, urethritis, cystitis, prostatitis, orchitis (inflammation of eggs); Regular alcohol abuse; trauma of the spine, spinal cord; Congenital anatomical anomalies (for example, too small bladder) or weakening the muscles of the pelvic floor; Stress. Most often, enuresis develops under the influence of several factors at the same time, and in some cases, it is not possible to distinguish with precision the main cause of incontinence. ENOZ CLASSIFICATION
Enuresy is divided into primary school, when the problem was identified for the first time and periods of complete control over the urination, and secondary, which was preceded by a "dry" period controlled for a long time for six months or more. In the clinical recommendations of the Ministry of Health of our country, the disease is defined as a nocturnal incontinence of the urine that occurs during sleep. But in medical practice, it is sometimes divided during night, day and mixed. Complicated and simple enuresis is also distinguished: in the first case, syndrome is not associated with other diseases, in the second, it is associated with pathologies of the central nervous system, infections and other problems with the urinary system. Eneoves symptoms
The main sign of enuresis is the inability to control urination during night sleep. Less often - during the day. An unusual emptying of the bladder cannot occur every night, but regularly. The diagnosis of enuresis is made if this happens twice or more per month for 3 months. With an ENUE, a person can urinate more often during the day, to face an involuntary urinary leak, to experience false urination or, conversely, to feel that after having visited the toilet, the bladder is not completely exhausted. Children and adolescents with enuresis can become more closed and irritable, to sleep more badly at night, they reduce performance at school. What doctor treats enresis
Enuresy causes a variety of reasons, therefore, a large number of specialists are engaged in its diagnosis and treatment. Adult patients are recommended to contact the therapist and urologist. If the enuresis of the child, it is necessary to arrive at the reception at the pediatrician who will perform an inspection and will recommend close specialists. This can be an urologist, gynecologist, nephrologist, neurologist, psychotherapist, endocrinologist. General practitioners and narrow specialists collect family history, listen to the patient's complaints and examine. The diagnosis of enuresis is generally made on the basis of a clinical picture, and instrumental tests and studies are prescribed to clarify the causes. Laboratory diagnostics of Eneoz
Evaluating the general condition of the body and identifying the inflammation of the genitarinar system is helped by a general urine analysis and a urine analysis by Nechiporenko. In some cases, an analysis is prescribed to determine the level of vasopressin (antidiuretic hormone). It controls the water level in the body and affects the intensity of urination. Instrumental diagnosis of enuresis
With an Enuree, the doctor can prescribe an ultrasound of the bladder. This study can be replaced by a magnetic resonance or a bladder computed tomography and other organs of the urinary system. Ultrasound helps to assess the work of the bladder and to discover the amount of urine that remains there after urination If the results of the ultrasound are not sufficient to determine the cause of enuresis and prescribe treatment, the patient is directed towards a cystographic examination. For this procedure, a catheter is introduced into the bladder and fulfills the organ with a contrasting drug or oxygen, after which they take photos of full and empty bladder. Evaluating the speed and volume of urine flow during urination allows the Uroflowory method. During the study, the patient urine in the funnel receiver of the urofloumeter device. With this study, you can obtain information on the rate of urine and fluid volume rate, select indicators (markers) of the differences compared to the standard. This data is entered into the operating system linked to the sensor, processed, and the results are displayed on the computer monitor in graphic form. The doctor deciphers the results. If the patient in the past has undergone injuries or if the doctor suspects anomalies of the structure of the Lombo-Sacré service, which can also cause enuresis, can prescribe a radiography of this vertebral column. In children and adolescents, enuresis most often develops not due to injuries or infections, but due to the late development of the central nervous system and stress. In this case, they are recommended by an examination by a neurologist and a psychotherapist. ENOZ TREATMENT
In adults and adolescents, enuresis is most often a symptom of infection, endocrine or injury disease. Therefore, first of all, it is necessary to identify this pathology as soon as possible and to start treatment. Enures in children is treated by the correction of behavior (motivational therapy), drugs, physiotherapy, psychotherapy or combinations of these methods. Drugs
If the main cause of enuresis is violations of the nervous system, drugs that help normalize their work can be prescribed to the child. These are vitamins of group B, nootropic drugs, glutamic acid, glycine. Antidiuretic drugs are also prescribed and, in some cases, tricyclic antidepressants. But the latter are used less often, because they have a more pronounced side effect. Separately or in the context of complex therapy, drugs are prescribed that normalize the work of the muscle shell of the bladder - Destrozor. If enuresis is associated with infectious disease, they can prescribe an antibiotic course. Physiotherapy
Procedures are prescribed as a type of independent treatment or in combination with drugs. Paraffin applications at the bottom of the abdomen and at the rear in the area of the Lombo-Sacré department, physiotherapy exercises, electrophoresis, magnetotherapy give a good effect. For a complete treatment of enuresis, gymnastics and physiotherapy are used Psychotherapy
In cases where enuresis has developed as a result of stress or neurotic disorder, a psychotherapist prescribes treatment. If a child suffers with an Enuree, a good effect is given by family psychotherapy sessions and sedatives that are suitable for a small patient per age. But it is even more important to create a favorable atmosphere for him at home, to show that adults on his side helps him to face this problem. In no case should you rumble and shame the child: the least is to blame for his illness. Pressure and aggression will lead to the fact that the symptoms will not disappear, but will increase. In adolescents and adults, enuresis can also be caused by psychological causes and, in this case, they can recommend individual therapy. Experts do not advise to use layers with an Enureur, which hide the unpleasant sensations and level the problem - it is best to protect the bed with an adhesive or disposable layer. There are special devices - enumeration awakenings which are attached to pajamas or underwear and respond to the first drops of urine excreted with a sound signal. This is gradually inhabiting a person to respond to the desire of the body and to wake up in time to go to the toilet. Compliance strictly with the diet of the day and regular visits to the toilet play an equally important role. Before going to bed, it is better to go to the toilet twice: up to evening hygiene procedures (washing, brushing, shower) and after them. During the day, you should drink enough water, but an hour or two before bedtime, it is worth limiting the use of liquids, as well as products that irritate the bladder - it is mainly citrus and juice. Adolescents and adults must also abandon alcohol, tea, coffee, energy and other drinks containing caffeines. Forecasts and Prevention
Summer treatment, compliance with the doctor's recommendations, daily routine and, above all, the adequate and benevolent reaction of parents and other parents give good results and allow you to completely get rid of the problem of involuntary night urination. It is impossible to prevent enuresis, but the risk of development is reduced if the pregnant mother carefully monitors her health during pregnancy: refuses bad habits, leads a healthy lifestyle, observes the daily routine and follows the doctor's recommendations in order to avoid complications during pregnancy and childbirth. If the child has already encountered the problem of Enerore, the favorable environment in the family and children team will help prevent their rehearsal. It is worth doing everything possible to avoid stressful situations that can cause a relapse of the disease. Adults are recommended to carefully monitor their health and in time to identify and treat infections of the genitarinarial system, as well as to use condoms during sexual intercourse to avoid sexually transmitted infections. Frequent questions
What is enresis? Enuresy is an involuntary urination in adults and children over 5 years old, which occurs more often twice a month, generally during sleep. This disease in children often occurs independently and does not affect their health. But enuresis seriously affects the child's self -esteem and their relationship with parents and peers, many experts recommend treating urine incontinence from 6 to 7 years old. Why was an adult described at night in a dream? Nocturnal urinary incontinence can cause infections of the genitarine system, hormonal failures, a trauma of the spine and spinal cord, a weakening of the pelvic floor muscles and even serious experiences. This can also happen if a person is in a state of alcohol or narcotic poisoning. If an involuntary urination at night occurs regularly, you should consult a doctor who can determine the cause of this delicate problem and prescribe treatment. How to get rid of ENOZ? The cause of enuresis can be infectious diseases, stress, hormonal dysfunctions. In children, the nocturnal incontinence of urine is often associated with the characteristics of the development of the central nervous system. The treatment is prescribed according to what exactly caused nocturnal incontinence of the urine. Most often, combine drugs (synthetic hormones, sedatives, tricyclic antidepressants) and physiotherapy methods - electrophoresis, gymnastics, magnetic therapy and laser. If enuresis is associated with a neurotic disorder or with chronic stress, it is recommended to request the help of a therapist. Which doctor treats enresis? Enuresy causes a variety of reasons, therefore, a large number of specialists are engaged in its diagnosis and treatment. Adult patients are recommended to contact the therapist and urologist. If the enuresis of the child, it is necessary to arrive at the reception at the pediatrician who will perform an inspection and will recommend close specialists. This can be an urologist, gynecologist, nephrologist, neurologist, psychotherapist, endocrinologist.