urinary incontinence in children (enuresis) - a disorder characterized by involuntary urination, both day and night.Children enuresis difficult social and psychological adaptation in the family and children's groups, and adolescents - often leads to complex medical and social conflicts.
Causes of urinary incontinence in children
to choose the right tactics treatment, it is important to establish the cause of enuresis.The main causes of incontinence:
- immaturity of the central nervous system and bladder;
- delayed maturation of the nervous system;
- psychological factors and stress: a change of scenery, separation from the mother, the emergence of new parties, quarrels in the family;
- heredity: if the child's parents suffered the problem of urinary incontinence, it is likely, and it is waiting for it.I
f enuresis was one of the parents, the probability is 44%, and if the two - 77%.
- disturbed the rhythm of secretion of antidiuretic hormone - vasopressin, regulating the amount of urine produced: the longer this hormone in the blood, the less urine is formed.Normally, vasopressin levels rise at night, when enuresis - on the contrary;
- diseases of the genitourinary system;
- urinary tract infections.
daytime incontinence in children is usually caused by psychogenic factors: a strong joy, fear, etc.It is also observed that many children who suffer from daytime enuresis, are inherent traits such as procrastination and stubbornness.
Bedwetting in children can be:
- consequence nocturnal seizures;
- feature nightly apnea episodes, partial upper airway obstruction;
- manifestation of some endocrine diseases;
- result of side effects of medications, particularly valproate and thioridazine (sonapaksa).
Treatment of urinary incontinence in children by using drugs
Drug treatment should be appointed physician (no self!).Most often, for the treatment of urinary incontinence in children used the following drugs:
- Hormones: Adiuretin diabetes.It is used in cases where incontinence is associated with problems in hormone levels - decreased production of vasopressin.Adiuretin diabetes helps reduce the amount of urine and frequency of urination.According to the means of treatment lasts several months in parallel with psychotherapy.
- Stimulants: mesocarb.It affects the overall tone of the smooth muscle structures, including the bladder.
- Antidepressants: Amitriptyline, Imipramine.The exact mechanism of action of two antidepressants data when enuresis is unknown, but the efficacy of Amitriptyline and imipramine established empirically confirmed by many studies.
- Andrenomimetiki: Ephedrine.Adrenomimetiki have a psychoactive effect.
General tips for parents of children suffering from enuresis
- sure to keep the child.Explain that he is not alone, and similar problems have many children.
- Never punish or scold the child when he wakes up wet.After all, he is not guilty.This is a problem which must be fought together.
- not wear diapers at night.Most 4-5 year old children with enuresis do not leave the diapers for a long time.They are only required in certain cases, for example, while sleeping in their home and on the road, on walks.
- Limit fluid intake in the evening and at night (4 hours prior to sleep).
- Let the child goes to the toilet before you go to bed.
- child older than 6-7 years old must comply with a strict regime of the day and go to bed no later than 21:00.
- Do not wake the child so that he went to the toilet.So you just fasten the mechanism of enuresis.
- Praise him for his "dry" nights.