Nocturnal enuresis in children: why does it occur and how is it treated? What are the causes and treatment of enuresis at home? Folk remedies and methods of treating enuresis at home

Prostate cancer and narrowing of the urethra also cause nocturnal enuresis in men. Stressful situations and nervous breakdowns contribute to the occurrence of this disease. In this case, a man should contact not only a urologist, but also a neurologist or neurologist.

One of the causes of incontinence is its hyperactivity. This is due to the fact that the muscles of this organ react strongly to any impact. If a man suffered from enuresis in childhood, he may have a congenital abnormal urination reflex. Nocturnal enuresis in men can lead to a loss of sexual desire, so at the first sign of its appearance, you should immediately consult a doctor.

Nocturnal enuresis in adult women

Women over 45 often suffer from nocturnal enuresis. The main cause of urinary incontinence is a malfunction of the detrusor (the muscular wall of the bladder). In addition, a woman can suffer from enuresis if the sphincters of her bladder and urethra are too weakened. Many of the fair sex begin to suffer from this disease during pregnancy and after childbirth. This is due to the weakening of the supporting structures of the pelvis. Enuresis can manifest itself in case of a violation of the structure of the genital organs of a woman. In addition, this ailment can occur after nervous breakdowns and stress. Many women experience this condition after menopause.

Treatment of enuresis in adults

The treatment of this disease depends on the degree of its neglect. First of all, you need to completely abandon drinks that contain caffeine (coffee, cola, tea). This component contributes to irritation of the bladder. If a person suffers from enuresis, he needs to minimize his fluid intake at night. In addition, beer should be completely abandoned.

As for smoking, it also negatively affects the condition of the bladder. In order to get rid of enuresis, you can do special exercises for the muscles. They are called Kegel exercises. With their help, you can learn how to control the condition of the bladder. To do this, you need to divide the process of urination into parts (pause for 10-15 seconds). Thus, the pelvic floor muscles are strengthened. Today, a very effective way to get rid of this disease in women are minimally invasive sling surgeries. Enuresis is treated with behavioral therapy, physical therapy, and medications.

Enuresis is urinary incontinence. And nocturnal enuresis means that a person is unable to control the process of urination during sleep. Simply put, he wets the bed when he sleeps.

Daytime enuresis is much less common. It appears after suffering a severe psychological trauma, which caused a malfunction in the nervous system.

The problem of bedwetting is as old as humanity itself. Even the doctors of ancient Egypt were looking for ways to control the bladder. Since then, medicine has advanced significantly, but experts do not give a 100% guarantee that you will get rid of this problem.

In modern medicine, nocturnal enuresis is not considered a disease, but rather a stage in development, when a person is just learning to control the functions of his body and develop reflexes. Normally, a child should learn this by the age of 6. But in practice, 10% of six-year-olds do not know how to do this. Over the years, the problem has subsided. At 10 years old, 5% suffer from enuresis, and at 18 only 1%. Among adults, one in 200 people periodically lose control of their bladder during sleep. Thus, among those who suffer from this phenomenon are almost 94% of children, 5% of adolescents and 1% of adults.

Among boys it is observed 2 times more often than among girls. But in old age, bedwetting is more common in women.

Small, thin children are more likely to suffer from enuresis. Infections of the kidneys and bladder also play an important role in the onset of the disease. Often incontinence in children is a way of psychological protest. It may be the result of a lack of attention, or vice versa, a reaction to increased parental care. Enuresis occurs in shy and fearful babies. Most patients with this deviation are from disadvantaged, low-income or large families.

Enuresis is treated by many specialists: pediatric neurologists, endocrinologists, pediatricians, urologists, nephrologists, psychiatrists, homeopaths, physiotherapists. They offer over 300 comprehensive techniques to combat this problem. Among them there are quite exotic methods: acupuncture, hypnosis, dolphin therapy.

Types of enuresis

• Primary- The child has never been able to control the bladder in a dream. This option is considered the easiest. In 98% of cases, it resolves without treatment.
• Secondary- there was a period of at least 6 months in the child's life when the bed remained dry every day.
  There are also complicated and uncomplicated nocturnal enuresis.
• Uncomplicated. - in addition to the fact that the child urinates in a dream, he has no other deviations in health.
• Complicated- accompanied by deviations in mental or physical development, inflammation of the kidneys or bladder.
  There are also neurotic and neurosis-like enuresis.
• Neurotic- occurs among shy and shy children. They often have light, superficial sleep. Such children are very worried about their "wet" nights and are often afraid to fall asleep for this reason.
• neurosis-like- noted in nervous children, who often throw tantrums. They don't worry too much about nighttime urination. This continues until adolescence. Then the picture changes, and the problem begins to oppress them greatly. Such teenagers become withdrawn and gloomy, they may develop neuroses.

Why does enuresis occur in girls?

1. The girl has not yet learned to control her reflexes. This is due to the fact that her nervous system is not yet fully debugged. This happens even with those girls who do not lag behind their peers in other indicators.
2. Psychological trauma, stress. Often the problem appears after the family has a second child, moving, transferring to a new school, divorce of parents. In this case, enuresis is a subconscious protest or an attempt to return to childhood.
3. Very deep sleep . The child sleeps soundly and does not feel that the bladder is full. This may be a congenital feature of the nervous system or the result of the fact that the girl is very overtired. In the latter case, wet sheets are not often, but after eventful days.
4. The child drinks a lot of fluids. Often girls like to have tea parties in the evening. Especially if during the day they ate salty food (chips, crackers). Often this happens during colds, when parents try to water the baby more.
5. A large amount of urine is excreted at night (nocturnal polyuria). Normally, the body produces 2 times less urine at night than during the day. This feature of the body is regulated by the hormone vasopressin, which is produced at night. But in some girls, the amount of this hormone may temporarily decrease.
6. Heredity. Scientists have found that if both parents encountered this problem in childhood, then the probability of developing enuresis in a child is 75%. If only one of the parents is a carrier of this gene, then the risk that the girl will have enuresis is 30%.
7. Infections of the urinary system. Due to the fact that girls have a short and wide urethra, an infection from the genitals easily penetrates into it. Then the microorganisms rise higher into the bladder and cause inflammation (cystitis). This disease is accompanied by frequent urination, which the girl cannot always control.
8. Injuries to the spine or spinal cord. Often such injuries appear due to a complicated pregnancy or injuries received during childbirth. As a result, the nerve impulse from the bladder does not reach the brain well.
9. Lag in development. If a girl has a mental or physical retardation, then her biological age is much less than the calendar one. In this case, she has not yet had time to form the necessary reflex.

Why does enuresis occur in boys?

1. The development of the conditioned reflex has not been completed. Each person's nervous system has its own characteristics. Some get used to controlling their body earlier, while others complete this process later.
2. Hyperactivity- the activity and excitability of the child greatly exceeds the norm. In boys, this condition is noted 4 times more often. Active processes in the cerebral cortex, as it were, suppress the bladder's attempts to talk about its problem. And as a result, the urge to urinate remains “not heard” by the brain.
3. Stress and strong emotions. Some situations that are accompanied by nervous tension or fear can cause enuresis. The child may be frightened of the dog, upset because of the quarrel of the parents, or because he was left alone. Therefore, if possible, avoid situations that can cause psychological trauma to the baby.
4. Overprotection and attention deficit. Enuresis often affects boys who grow up in single-parent families without a father. Often in this case, mother and grandmother overprotect the child. He feels "small" and subconsciously behaves accordingly. In children who experience a lack of parental attention, the situation is the opposite. They really want to return to childhood and feel cared for. Therefore, in a dream they behave like little ones.
5. Violation of the endocrine glands and hormonal balance. Thin, small boys whose height is not appropriate for their age are deficient in growth hormone. But the fact is that at the same time the amount of other hormones that are responsible for controlling the bladder, the amount and concentration of urine also decreases. These are vasopressin and atrial natriuretic hormone.
6. Birth trauma. The brain in boys develops somewhat later than in girls. Therefore, they are more likely to be injured during childbirth. These injuries of the spinal cord and brain cause enuresis in boys.
7. Inflammatory diseases of the kidneys and bladder. Inflammatory processes in the kidneys and bladder very often cause urination disorders. They are easy to identify by general urinalysis. If the boy has congenital features of the urinary tract, they can also affect the formation of the reflex.
8. hereditary tendency. In 75% of cases, the parental genes are to blame for the fact that the boy has enuresis. If mom or dad suffered from this problem in childhood, then the probability that the boy will repeat their fate is 40%.
9. diaper habit. Recently, diapers are increasingly blamed for the occurrence of enuresis in boys. The child gets used to the fact that you can urinate in your pants and at the same time it will not become wet and cold. Therefore, it is so important to abandon diapers until 2 years of age.
10. Allergic reactions and bronchial asthma. The mechanism that links allergy and the onset of enuresis has not been fully elucidated. But boys with allergies are prone to peeing in their sleep. It is possible that the brain experiences oxygen starvation and copes with its functions worse.

Why does enuresis occur in teenagers?

1. Congenital disorders of the nervous system, which are responsible for the formation of a conditioned reflex.
2. Violations of the "watchdog" reflex due to injury. Especially often this reason is noted in adolescent boys who have increased activity.
3. Heredity. The tendency to enuresis is inherited. This happens especially often if both parents had this diagnosis in childhood.
4. Congenital pathologies of the kidneys, bladder and urinary tract. Often they cause inflammatory processes (cystitis and nephritis). During these diseases, it is much more difficult to control urination.
5. Mental disorders. Depression and neuroses often appear at this age. They can contribute to the fact that problems long forgotten in childhood become relevant again. The complexes and experiences that a teenager experiences on this occasion further exacerbate the problem.
6. stressful situations. In adolescence, there are enough nervous shocks, and they are perceived very sharply. Failure at school, problems with peers, stressful situations in the family and physical punishment can trigger the onset of nocturnal enuresis.
7. Hormonal changes in adolescence. The period of sexual maturation causes a failure in the production of hormones. Among them there are those that regulate the processes of emptying the bladder.

Why does enuresis occur in adults?

1. Congenital anomalies of the urinary system. These include: too small bladder size, too thick and inelastic walls.
2. Hormonal changes in women during menopause. These changes cause a deficiency in the hormones that control the bladder. They cause the kidneys to produce more urine at night than usual, and this can cause nocturnal enuresis.
3. Tumors. Neoplasms can interfere with the transmission of a nerve signal from the bladder to the cerebral cortex.
4. Weakness of the muscles of the small pelvis and pelvic floor. Muscles can weaken after pregnancy or with age. This problem is one of the most common causes of enuresis in women.
5. Aging processes in the cerebral cortex and spinal cord. With age, the connection between nerve cells is disrupted, which, as if in a chain, transmit a nerve impulse from the bladder to the cerebral cortex. It is there that the center is located, which wakes us up at night and sends us to the toilet.
6. Weakening of the bladder sphincter. The sphincter is a circular muscle that closes the lumen of the bladder and prevents urine from flowing out. Normally, we consciously relax it when we urinate. But with age, this muscle weakens and therefore, when the bladder fills up at night, it is not able to keep it from emptying.

What are the effective treatments for enuresis in children?

There are more than three hundred different ways to deal with enuresis in children. Each of them is quite effective. All of them can be divided into three groups:

• Medications (various drugs)


• Non-drug (physiotherapeutic and psychological methods)


• Regime (night "landing" on the potty)

Drug treatments for enuresis in children

Sometimes enuresis occurs as a result of delayed development of the nervous system. In such cases, nootropic drugs are prescribed. They speed up the development process. Good results are obtained by the use of the hormone desmopressin, which regulates the amount and composition of urine, and the functioning of the bladder.

Non-drug treatments for enuresis in children

Physiotherapeutic methods improve the functioning of the bladder and nervous system. For these purposes, electrosleep, electrophoresis, magnetotherapy, acupuncture, music therapy, baths and circular showers, massage and therapeutic exercises are often used.

The help of a psychologist and psychotherapist will help the baby cope with an unruly bladder. The specialist will teach him the techniques of relaxation and self-hypnosis. An effective method would be to keep a special diary. Each dry night in it is signified by the sun, and wet sheets by a cloud. Five suns in a row is a great occasion to receive a small incentive prize from your parents.

To successfully fight enuresis, a child should adhere to a certain diet and not drink after dinner. The most famous diet was developed by N.I. Krasnogorsky. It is aimed at ensuring that at night water lingers in the body. To do this, before going to bed, the baby is given bread with salt, a piece of herring and sweet water. During the day, the child's menu is very diverse and rich in vitamins.

Regime methods of treatment of enuresis in children

It is important to strictly observe the regimen and put the child under 10 years old at exactly 21:00. After 17 hours, it is necessary to sharply reduce the amount of liquid that the child drinks. If the rate of a child under 5 years old is 1 liter, then distribute it in this way. 700 ml up to 15 hours, 200 ml up to 18 hours, 100 ml in the evening.

4 hours before bedtime, the baby's games should not be too active. Let the child draw, read, watch a non-scary cartoon.

The bed of the child should be with a slight elevation in the pelvis and under the knees. To do this, just put a small roller of a folded bedspread under the mattress. This special bed will help reduce pressure on the walls of the bladder.

Make sure that the baby does not get cold either day or night. The legs should be especially warm. If they freeze, then the bladder reflexively begins to fill.

Before going to bed, the child must go to the toilet. And during the night it is worth waking him up several times. Potty seat your child an hour after falling asleep and then every three hours throughout the night. But make sure that he does "his job" not half asleep. If he naps on the potty, then this can only worsen the situation. Turn on a dim light, talk to the baby. Get clear answers from him to make sure he is really awake.

Ask your child if he needs a night light. Often children are afraid to get out of bed because of the darkness. It is easier for them to sleep on wet sheets than to crawl out from under the covers. After all, most kids are sure that monsters are hiding under the bed in the dark.

If in the morning you still notice that the bed is wet, then do not scold the child. Mom's screams and despair in the eyes show the baby that the problem is big and terrible. And that means that he, so small and weak, cannot cope with it. Make the bed together and explain to the child that this happens to many children, but every child can lock urine in his tummy until the morning. And he will certainly cope with this task. After all, he is the best!

Any of the methods will give good results only on the condition that the child himself will be interested in solving the problem. He will also need the support of all family members. Believe in your child and inspire him with confidence in his abilities.

How to treat enuresis in adults?

Regime events

Avoid drinks and foods that have a diuretic effect. These are beer, coffee, strong tea, cola, cranberry juice, herbal infusions (corn stigmas, birch buds), watermelon, strawberries.

Stick to the diet developed by N.I. Krasnogorsky. After dinner, eat meals with a small amount of water. Reduce the volume of drinks by 2-3 times after 15.00. Don't drink 4 hours before bed. And before you go to bed, eat a sandwich with salted fish or just bread and salt. Drink it down with half a glass of water. Salt retains water in the body, preventing it from collecting in the bladder.

Putting a pillow under the mattress at your feet will help relieve pressure on the sphincter that closes the bladder. Thus, you will strengthen the protection against leakage.

Your bed should be fairly firm. First, it will provide good support to the spine. Nerve signals from the bladder will be better transmitted to the brain. And secondly, on a hard bed, your sleep will be more sensitive and it will be easier for you to wake up at the right time.

Set an alarm clock, let it wake you up 2-3 hours after you fall asleep. Change your wake-up time every few days so you don't get used to waking up at the same time every night.

Try to avoid stressful situations and not be nervous. When you are calm, it is much easier for you to control your body.

Psychotherapy

Behavioral techniques often work well when good nights can be rewarded. Of course, adults do it themselves. But even these small gifts increase motivation well.

Some methods of self-hypnosis can be mastered on your own. Try to keep the evening calm. Relax completely before falling asleep. Feel how every muscle in your body is at rest. Then, for a few minutes, say to yourself, or better aloud, the key phrase: “I have complete control of my body and my bladder. When it's full, I'll get a signal and wake up." Be confident in your abilities, and everything will definitely work out. After all, the human body is able to cope with more complex tasks.

If you have a logical mindset and you do not give in to suggestion, then rational psychotherapy will help in this case. The specialist will introduce you to new information about your problem and about the possibilities of your body. He will convince you with the help of logic that enuresis is not a complex and dangerous disease, and it is within your power to cope with it.

Receptions of physiotherapy exercises (LFK)

During the process of urination, try to stop. Block the outflow of urine from the bladder with the help of muscles. Listen to your feelings, what muscles are tense at the same time? Now relax and continue emptying your bladder. Repeat the exercises every time you go to the toilet. Then you can perform the same exercises and just lying in bed. This is a very efficient method.

Physiotherapy for the treatment of enuresis in adults

• electrosleep- normalizes sleep patterns and calms the nervous system. It is excellent for those who have problems with urination associated with neurosis and other nervous disorders.


• Darsonval on the bladder area- strengthens the sphincter that closes the bladder.


• Electrophoresis. Various types of this procedure improve the functioning of the nervous system.


• Magnetotherapy relaxes the walls of the bladder. Reduces the desire to urinate.

1. Medicinal mud, warm paraffin and ozocerite are applied to the lumbar region and above the pubis. The procedure helps to increase blood flow to this area, relieve inflammation and muscle spasms near the spine. This improves the condition of the nerves from the bladder to the spinal cord.


2. Hydrotherapy: shower (rain and circular) baths (nitrogen, pearl, salt-coniferous). The latter type can be done at home.


3. Acupuncture. Special thin needles are inserted into reflex points on the body. This improves not only the functioning of the nervous system, but also the emotional state and sleep.


4. Music therapy, art therapy. Treatment with music and drawing soothes and creates a positive mood.


5. Therapy with animals. The best results are obtained by communication with horses and dolphins. But if dogs and cats improve your mood, then they can also be great helpers in treatment. After all, its success depends on your emotions.

Treatment of enuresis in adults with medication.

• If enuresis is caused by inflammation in the genitourinary organs, then antibiotics are necessary: ​​Monural, Norfloxacin.
• For the treatment of kidney diseases, nitrofuran drugs are used: Furamag, Furadonin.
• Tranquilizers for normalizing sleep: Radedorm, Eunoktin. They have a calming effect, help get rid of negative emotions, tune in a positive way.
• Nootropics: Glycine, Piracetam, Picamilon. They improve the functioning of the nervous system, contribute to the development of a conditioned reflex.
• Antidepressant Amitriptyline. It relieves patients from strong experiences that caused psychogenic enuresis.
• M-anticholinergics: Sibutin Driptan. Relax tense bladder muscles, relieve spasm. This allows you to increase its volume and restrain the urge to urinate. It will be able to hold more urine. Therefore, a person will be able to sleep until morning without having to go to the toilet.
• Artificial hormone desmopressin. It helps reduce the amount of urine that is excreted at night. Adiuretin-SD - nasal drops based on this hormone. Very easy to use form. In severe cases, desmopressin is given intravenously. This increases its efficiency several times.

Folk remedies for enuresis

Honey perfectly calms the nervous system before going to bed and helps retain water in the body. A tablespoon of honey should be eaten before going to bed, you can drink it with a few sips of water.

Walking on the buttocks strengthens the pelvic floor muscles and the bladder wall. It is necessary to sit on the floor, straighten your legs. Alternately move your legs forward, contracting the muscles of the buttocks. You need to go forward 2 meters, and then go back in the same way.

Good results in the treatment of enuresis in adults are obtained by visiting bioenergetics and traditional healers. They know how to adjust the work of the nervous system in a special way and have the gift of suggestion.

What are the alternative methods of treatment of nocturnal enuresis?

What pills are used in the treatment of enuresis?

How can enuresis be treated at home?

This is an involuntary, uncontrolled leakage of urine, mainly at night. This violation is more typical for childhood, but the diagnosis is thorough only after the child has formed control over the urge to urinate, after about three years. In childhood, enuresis tends to resolve spontaneously, approximately one year after the onset of symptoms. Statistics show that enuresis is diagnosed in 15-18% of children of 5 years of age, in 1-2% of adolescents of 15 years of age and in 0.5-1% of adults.

Persons who were diagnosed with enuresis in childhood, and with adulthood it still regressed, are more likely to develop urinary disorders already in adulthood and adulthood.

Enuresis is usually divided into primary and secondary. Primary is traditionally considered enuresis, which developed in childhood and is not accompanied by remission intervals. If the leakage of urine at a certain point stops for at least six months, and then resumes again, such a relapse is commonly called secondary enuresis.

Enuresis, among other things, is divided into complicated and uncomplicated. The latter manifests itself exclusively in urine leakage (mainly during sleep), and enuresis is complicated by such phenomena:

• increased urination;
• urgency - the inability to control and restrain the urge to urinate during wakefulness;
• urinary incontinence during the daytime, during wakefulness.

Causes of Enuresis in most specific cases remain unspecified, but theoretically they can be represented by one or a combination of several of the following factors:

• in children - slow development of the central nervous system;
• in children - violations of behavioral reactions and daily routine;
• malformations of the spinal cord;
• burdened heredity;
• violation of the daily rhythm of the synthesis of antidiuretic hormone;
• infectious diseases of the urinary tract;
• side effects of medications;
• strong physical tension, jerk;
• limited mobility or recumbency, against which a fecal blockage may develop;
• in old age - confusion, that is, the clouding of the condition that has developed for certain reasons and the patient's misunderstanding of the need to empty the bladder;
• destruction of the mucous membrane of the genital and urinary tract (mainly in women after menopause);
• spontaneous contraction of the detrusor muscles or hypoactivity of the detrusor, which develops when the tissues of the bladder are damaged or its regulation is disturbed by the nervous system.

The most common cause of childhood enuresis is considered to be a violation of the timely development of reflex control of urination, which should normally occur by 3-4 years, and if it deviates from the norm, it happens at a later age. Voluntary control of urination is considered developed in a child when he can independently inhibit the urge that has begun, and this skill inhibits functional underdevelopment of the central nervous system. When the central nervous system, with a definitely slow development, reaches the necessary stage and the formation of neurological control is completed, remission occurs, most often spontaneous, which explains the spontaneous disappearance of involuntary urination. With such a development of events, a violation of urination is usually combined with such manifestations of a developmental delay in the child as the slow formation of control over bowel movements, late development of speech and walking.

Enuresis in childhood is often combined with various psychological abnormalities, which is manifested by nervousness and irritability, inattention and tearfulness, and sometimes aggressiveness. Of course, the occurrence of emotional disorders is also influenced by the wrong reaction to urinary incontinence on the part of others.

Violation of the hormonal regulation of water metabolism due to insufficient production of antidiuretic hormone occurs less frequently. The disorder develops due to the fact that during the daytime and at night the antidiuretic hormone is synthesized in equal amounts, which means that at night the amount of urine produced (which is a consequence of the production of the hormone) corresponds to the daytime, which is abnormal. The consequence of this is an impressive stretching of the bladder at night, which, combined with a violation of the nervous regulation of the lower urinary tract, leads to involuntary excretion of urine.

Infectious inflammatory processes mainly cause secondary enuresis. Bedwetting often recurs (rarely begins), for example, during a period of progressive cystitis. The solution to the problem in this case lies in the appointment of adequate antibiotic therapy, the cure of the underlying disease, which usually leads to another remission of enuresis.

The clinical picture of enuresis is usually laconic. This is an exceptionally uncontrolled excretion of urine at night with an uncomplicated form of enuresis. The frequency of discharges varies significantly - from several in one night to several per month. Complicated enuresis, in addition to nocturnal leakage, is characterized by daytime incontinence, imperative urge to urinate and frequent urination. Along with this, the patient has neuroses and/or emotional lability.

How to treat enuresis?

Enuresis treatment usually involves two scenarios - pharmacotherapy and psychotherapy.

motivational therapy cannot be ruled out in the treatment of children. In this case, any punishments and psychological pressure on the child are categorically contraindicated, which can nullify any positive effect. The success of treatment is influenced by the psychological mood of the patient, and psychotherapy itself should be presented with an integrated approach, this is especially effective again in the case of children who are thus involved in the therapeutic process. The simplest and most effective method of motivational therapy is to reward the child for staying "dry" nightly.

pharmaceutical therapy for enuresis treatment represented by anticholinergic drugs - oxybutynin, driptan, solifenacin. Anticholinergics are often supplemented with tricyclic antidepressants such as imipramine. These medications are designed to increase the functional capacity of the bladder and reduce its spontaneous activity at night.

In cases where the use of these drugs is not effective enough (which is observed in approximately every third case), complex therapy is supplemented with a synthetic analogue of the antidiuretic hormone desmopressin. The drug leads to a decrease in the volume of urine formed at night, and this in turn is reflected in the occurrence of the urge to urinate.

Medical practice shows that the effectiveness enuresis treatment characterized by high efficiency. Full recovery of bladder function occurs with the help of therapeutic methods in nine out of ten cases. The duration of treatment and the number of courses of therapy can vary significantly. Therapy is usually considered to be finally completed, as a result of which the symptoms of enuresis disappear for the next month. At the end of the drug course, in the absence of bedwetting for provocative purposes, it is recommended to deliberately consume an increased amount of fluid at bedtime. The absence of manifestations of enuresis in this case is the reason for the gradual reduction, and subsequently the complete abolition of drugs. The conclusion about the complete cure is made when two years after the end of therapy there are no episodes of nocturnal urinary incontinence.

Pharmaceutical and psychotherapeutic treatment of enuresis can be supplemented with exercises designed by a specialist to strengthen the muscles of the pelvic floor. This can be effective if enuresis develops in the elderly in a state of tension due to the weakening of these muscles.

What diseases can be associated

A child with one or both of whose parents had enuresis in childhood or already in adulthood is more at risk of developing this disorder. Studies in this area suggest that inherited enuresis is localized on chromosome 13q.

Violation of the daily production of antidiuretic hormone, which causes excessive production of urine at night, followed by a violation of the perception of the urge to urinate.

Inflammatory process that develops in the mucosa of the bladder, which leads to a violation of its function. Typically, cystitis turns out to be a trigger factor for the development of secondary cystitis in individuals who have previously encountered this problem. The cause of enuresis can be an inflammatory process of any nature.

Enuresis treatment at home

Enuresis treatment most often implemented at home, the disease is amenable to outpatient treatment. Hospitalization is justified only when enuresis is due to pathological processes in the kidneys and bladder. Along with therapeutic methods, the daily routine plays an important role in accordance with the following nuances:

• stop fluid intake two hours before bedtime;
• in the daytime, exclude the consumption of highly carbonated drinks, it is better to give preference to plain water, compotes, uzvars;
• three hours before bedtime, refuse dinner, and even more so kefir, milk, fruits, and drink dinner with a few sips of St. John's wort and yarrow;
• empty the bladder an hour before bedtime, repeat immediately before bedtime.

An additional measure for the treatment of enuresis at home can be the use of herbal decoctions that have a calming effect.

Carrying out enuresis therapy at home, you can not go into self-medication. Any decision should be discussed with a professional physician and during the entire treatment follow his recommendations and take the full course of prescribed drugs. This is especially true of enuresis caused by an infectious lesion of the bladder. You can not ignore enuresis in children, believing that the baby will outgrow this problem. Consultation of a specialist in this case is more than relevant.

What drugs are used to treat enuresis?

Anticholinergics that contribute to the normalization of bladder function. Doses are determined individually, depending on the characteristics of the violation.

Synthetic analogue of antidiuretic hormone, which is prescribed with a relatively low effectiveness of drug treatment of enuresis.

Tricyclic antidepressant, acting as a means of influencing the psychological mechanisms of the development of enuresis.

Treatment of enuresis with folk methods

Folk remedies can be an independent or additional method in the fight against enuresis, but it is more correct to discuss their feasibility with your doctor. The following recipes are popular today:

• 1 tbsp crushed rhizomes of couch grass, pour 1 tbsp. boiling water and soak for ½ hour in a water bath, cool, strain; take 1/3 cup three times a day for 2 months, then take a break for several weeks, and if there is no relief, continue the course again;
• 3 tbsp chopped herb shepherd's purse place in a thermos and pour 2 tbsp. boiling water, strain after 3-4 hours; take ½ cup 4 times a day half an hour before meals and at bedtime for one month;
• 10-15 grams of dried plantain leaves brew in 1 tbsp. boiling water and insist for 20 minutes; take 1 tbsp. infusion 3-4 times a day;
• combine 30 grams of acacia inflorescences, 20 grams of yarrow herb, 15 grams of lemon balm, 5 grams of violet herb; 1 tbsp pour a glass of boiling water over the mixture, strain after half an hour and take 50 ml three times a day half an hour before meals;
• combine in equal parts the grass of St. John's wort, horsetail, lingonberry leaves, blueberries; 1 tbsp the resulting mixture is placed in a thermos, pour 1 tbsp. boiling water, insist for 2 hours; take in two doses - half an hour before any meal and at bedtime;
• combine 2 tbsp. leaves and berries of cranberries, St. John's wort, pour 3 tbsp. boiling water, boil for 10 minutes over low heat, cool, strain; take in small portions in small sips from four in the afternoon until bedtime;
• 40-50 grams brew dried sage herb with a liter of boiling water, leave for 30 minutes, strain;take a decoction of ½-1 tbsp. three times a day;
• combine 4 parts of rose hips and 1 part of foxglove berries; pour water and boil for 30 minutes, remove from heat, add a little rosehip flowers, bring to a boil twice, strain, cool; take 1 glass twice a day.
  
  

Treatment of enuresis during pregnancy

Enuresis in pregnant women tends to develop with an increased risk. This is explained by the fact that with an increase in the term, the size of the uterus increases, and this puts pressure on the bladder. The sharp movements of the fetus and the increase in its mass play a role. The weakening of the tone of the muscles located in the pelvic floor area also contributes to this. As a result, by the middle of the term there is a risk of developing enuresis, which manifests itself from time to time.

Rare manifestations of enuresis during pregnancy should not cause much concern, since the body preparing for childbirth is rebuilt in accordance with the norm. The muscles and ligaments of the pelvic floor should be weakened by this period, and their recovery, as well as a complete revival of functionality, will occur after childbirth, during the rehabilitation period.

Considering the influence of all these factors together, it can be understood that this phenomenon is close to the norm. If the manifestations are not too strong, everything can be solved by using sanitary pads, and after childbirth, usually the symptoms of enuresis gradually weaken and the body recovers until the violation disappears completely.

The violation passes when the muscles begin to recover, and nothing presses on the bladder. However, if a woman had several births in a row, or the birth was difficult, or the fetus turned out to be large, recovery may be difficult. In this case, professional help is needed, and in the most severe cases, minor surgery may be necessary to restore normal urination. An alternative to it may be the diligent performance of Kegel exercises and the like to strengthen the muscles and ligaments in the pelvic area. Similar exercises are recommended at the stage of pregnancy as part of prevention. Another way to prevent enuresis in pregnant women is to empty the bladder regularly, while leaning slightly forward.

It should be noted that sometimes the cause of a painful condition is an infectious lesion of the urinary tract, to which pregnant women are more prone to due to the restructuring of the body and partly weakened immunity.

- a syndrome of involuntary, uncontrolled urination, urinary incontinence, mainly during sleep. It is more common in children of preschool and early school age with a history of concomitant neurological pathology. It causes psychological trauma in the child, conflicts with peers in the team, punishment by parents in the family, neurosis, which further aggravates the course of enuresis. Often occurs together with other urological diseases (cystitis, pyelonephritis). The main task of diagnosing enuresis is to identify its cause. For this, a complete urological examination is carried out, as well as neurological and psychological testing of the patient.

Specialists examine the volume and rhythm of urination. If a pathology of the urinary system is suspected, nephroscintigraphy, intravenous urography, cystography, urofluometry and cystoscopy can be prescribed. To exclude the pathology of the spinal cord of the child, a neurologist examines. To assess the patient's emotional state and identify possible mental pathology, a consultation with a psychiatrist or psychotherapist is required.

Cortical centers of urination are located near the pharyngeal tonsils. In some cases, an increase in the tonsils can lead to difficulty breathing during sleep, the spread of signals to the cortical centers and involuntary urination. Patients with nocturnal enuresis should be examined by an otolaryngologist to rule out inflammatory diseases and enlarged tonsils.

Enuresis treatment

The patient is prescribed a special drinking regimen. It is recommended not to take liquid for two hours before bedtime. It should be monitored that the child receives a sufficient amount of liquid during the day. Primary enuresis is often caused by a violation of the rhythm of vasopressin release, so patients with bedwetting are prescribed a synthetic analogue of this hormone - desmopressin. The dose of the drug is selected individually. Self-administration of desmopressin is unacceptable, since enuresis may be due to another pathology (for example, developmental pathology or infection of the urinary organs).

Patients with increased bladder tone are prescribed oxybutin. The drug acts on the smooth muscles of the bladder, increasing its volume and reducing spasms. In some cases, Driptan therapy is combined with desmopressin. Patients with decreased bladder tone are advised to urinate every 2-3 hours, prescribe drugs that increase the tone of smooth muscles (neostigmine).

Psychological correction is indicated for patients suffering from neurotic enuresis. For neurosis and neurosis-like conditions, vitamin therapy courses are recommended, drugs that improve metabolic processes in the brain (phytopreparations, picamilon, piracetam). Comprehensive treatment of enuresis includes physiotherapeutic procedures (thermal procedures, ultrasound, treatment with currents), therapeutic exercises to strengthen the muscles of the pelvic floor and general strengthening massage.

To develop a conditioned reflex, it is recommended to use special devices. When the first drops of urine appear, the device gives a sound signal that wakes the patient and teaches him to wake up when he needs to urinate. The use of devices gives a good effect if parents manage to develop the right tactics of behavior and agree with the child. Conflict situations that arise during multiple nighttime awakenings can lead to the child's refusal to use the device.

It should be remembered that the treatment of enuresis of almost any etiology is a long process. Parents need to be patient and not wait for immediate results of therapy. Pressure on the child and high expectations can lead to the child's neuroticism and complicate the treatment process.

Enuresis changes the psyche of the child, leads to an exacerbation of feelings of inferiority. Patients are embarrassed by peers, withdraw into themselves, seek solitude. A chronic traumatic situation can cause low self-esteem, timidity, isolation, and indecision. Sometimes children become aggressive. Changes in character can go unnoticed by parents and come to light only in adolescence. In order to minimize the negative impact of enuresis on the psyche, you should support the child in every possible way. Any manifestation of condemnation or disgust is unacceptable.

Children's enuresis causes and treatment

In most cases, the child learns to use the potty independently by the end of the fourth year of his life. Pampers become unnecessary and the child's parents breathe a sigh of relief. However, sometimes the situation changes and suddenly the child stops going to the pot on his own, wakes up wet and starts to pee in his pants. The parents of the child are shocked and perplexed, not understanding what is happening.

Distinguish day and night form of children's urinary incontinence. Nocturnal enuresis is called involuntary urination in a child over the age of five years. Its cause most often occurs in organic lesions of the central nervous system of a child during its intrauterine development. Also, the reason may be hidden in a neuroinfection that was carried by the child and affected his ability to involuntary hold urine at night.

Daytime urinary incontinence in a child occurs due to the impact on him of various factors of a psychological nature. Enuresis in such cases is the body's response to a stressful situation. If the situation is removed from the subconscious of the child, enuresis will disappear by itself.

Home treatment for enuresis in children

When conducting home treatment of enuresis in a child, first of all, his general emotional state should be stabilized. The timely elimination of a traumatic situation for a child can in itself have a beneficial effect on the child and lead to a cure for the disease. Discussing such a sensitive topic with a child should be as tactful as possible, avoiding talking about it in the presence of strangers.

Drugs for childhood enuresis

Glycine, Piracetam, Pantogam have a good nootropic effect. They help the smooth flow of metabolic processes in the cells of the nervous system, which helps to ensure healthy sleep. Valerian tincture, Novopassit, Persen have a high-quality sedative effect. These drugs are recommended to be taken by the child if there is a need for the treatment of enuresis, due to their sedative effect. Tranquilizers such as Nitrazepam and Diazepam well bring sleep back to normal and stabilize the general emotional state. If it is definitely established that enuresis is due to an infectious disease, the child is shown a course of treatment with antibiotics.

It is recommended to use Driptan in cases where the cause of enuresis was a violation of the nervous regulation of the bladder. Especially if at the same time there is a predominance of the muscle tone of its smooth muscles, due to which the volume of the bladder is reduced. Taking the drug helps to increase the volume of the bladder, and the spasm is also relieved, the muscles begin to contract much less frequently.

Treatment of children's nocturnal enuresis with homeopathy

Treatment of enuresis in a child with homeopathy shows excellent results and should be used primarily because of the absence of contraindications for use. In the event that the cause of enuresis in a child is psychological or physical trauma, it is recommended to take Arnica for its treatment. If enuresis appeared due to strong fear, sudden fright of the child, it is recommended to prescribe Stramonium, Aconite or Opium for use. All these funds are in the free pharmacy sale and do not require a special medical prescription for their purchase. The selection of a homeopathic remedy for the treatment of enuresis should be carried out in accordance with the cause that caused it. Means can be used by children, regardless of their age. All drugs have a natural basis, which explains the absence of side effects from their use. After the use of drugs for the treatment of enuresis at home, there are no cases of manifestations of relapse of the disease.

Home treatment of enuresis in children by suggestion

If you apply correctly the method of treating enuresis with the help of suggestion alone, you can achieve excellent results. The method of suggestion involves conducting confidential conversations with the child. In no case should you scold him, this can only exacerbate the problem. No psychological and even more so, physical harm to the child will not be inflicted. If, however, habitual ethical norms, attitudes and upbringing impede the implementation of such a method, one should not rush to use it.

In a confidential conversation with the child, you should try to find out what worries him, what he is afraid of and what hinders him, why he does not control his feelings. You can’t put pressure on it, it will close and it’s unlikely that after that it will be possible to do something else. Suggestion should be done in the morning, after the child wakes up again on a wet sheet. If after several attempts the method does not work, it is better to entrust its implementation to a psychologist or neurologist. It is noted that suggestion can give excellent results, the child then stops writing and the problem disappears forever. It is only necessary to correctly apply this method.

Diet for the treatment of enuresis at home

The selection of products for the diet in the treatment of enuresis at home is best done strictly under the supervision of the attending physician. It is recommended not to consume carbonated liquid at all, it is best to drink more juices on a natural basis. In addition, when compiling a diet for the treatment of enuresis, meals with a reduced salt content should be included in it. Do not drink liquid at night. Dinner should be as dry as possible, it is recommended to limit yourself to bread and two boiled eggs. There are many types of diets for the prevention and treatment of enuresis in children. The prerogative of a specific choice remains with the attending physician.

Enuresis in children: treatment with folk remedies

The method of treating enuresis in children with folk methods and means has been known for a long time. The means used are different and their choice depends on the severity of the situation and the age of the child.

Dill from enuresis

The following method of preparation of dill is recommended as a treatment for enuresis. Dry dill seeds in the amount of one tablespoon are poured into a thermos. After that, boiling water is poured into the vessel in the volume of one glass. The thermos is carefully sealed and left overnight in a dry, dark place. In the morning, the composition must be filtered. If desired, it is recommended to use honey for sweetening. The composition should be taken in the morning on an empty stomach, once before breakfast, one glass each. The total duration of the course of treatment is ten days. After that, you should take a break for ten days and then drink the composition again for ten days, one glass before breakfast. Statistical data testify to the excellent results of the application of the described method. If the child does not have organic damage to the genitourinary system, the results of treating enuresis with dill will be excellent.

Enuresis millet

The following method of using millet as a treatment for enuresis is recommended. Nine tablespoons of millet are washed to remove debris and litter. The water is then drained, and the millet is transferred to a glass jar with a volume of one liter, into which a glass of water is poured at room temperature, previously boiled. The composition is infused for three hours, while it should be periodically mixed. After that, the infusion is filtered and given to the child in small doses. The process continues for three days, while the infusion is constantly refreshed, its new portions are being prepared. As a rule, the child wakes up on the second night when he wants to go to the toilet. Gradually, frequent urges stop. Millet from enuresis calms the child, put in order the central nervous system, which begins to function normally. To completely eliminate the situation, a course of treatment lasting two weeks is recommended. If there were pain in the bladder and urethra, they immediately stop.

St. John's wort for enuresis in children

St. John's wort teas are widely used as a treatment for enuresis in children. Various options for preparing infusions using this herb are recommended. With prolonged use of tea based on St. John's wort, as a rule, the child is cured of enuresis.

A combination of St. John's wort with other herbs such as centaury grass and horsetail is recommended. When preparing infusions with a combination of different herbs, the proportions between them are the same. A tablespoon of St. John's wort and any of the above herbs are poured with a glass of boiling water, after which you need to insist in a water bath for half an hour. Reception is carried out on one fourth part of the glass three times a day.

Dates for enuresis

For the treatment of enuresis in children, dry, ground dates are used. Two tablespoons of crushed date powder should be poured into a thermos, then pour a liter of boiling water and leave to infuse for eight hours, or overnight. The thermos should be kept in a dry, dark place. After straining the infusion, the remedy is taken in half a glass three times a day before meals. The course of treatment is two weeks, after which a ten-day break should be taken. If necessary, the treatment is then repeated. As a rule, changes occur after the first course of treatment. In practice, the largest number of courses of admission sufficient to cure were three courses.

Enuresis honey

For the treatment of enuresis in children with honey, this method is recommended. Every day for a month, before going to bed, you should bury the navel with honey and seal it with adhesive tape. Also daily it is necessary to take inside a spoonful of fresh honey. The first results can be seen already in the second week of taking honey.