Causes symptoms treatment of nocturnal enuresis in Russia

Treatment of enuresis in Russia, Saratov, bedwetting treatment

Enuresis is an important medical and social problem

Currently, the treatment of nocturnal enuresis in children, adolescents and adults is an important medical and social problem. In the ICD XI revision (effective from 2022 in Russia), inorganic enuresis is involuntary persistent urination at night or (and) during the day, which does not correspond to the age of the child, that is, after the age when the child usually takes control of the urination process. According to the criteria of the World Health Organization, doctors diagnose enuresis from the age of 5.

Types of enuresis

In primary enuresis, there is no control over urination from the very beginning of life. With secondary enuresis, which is also called recurrent or acquired, problems arise after the absence of pathology and after constant monitoring of the urination process for at least six months. Such enuresis is often associated with additional neurological or urological factors. Depending on the age, there are children's, adolescent and adult enuresis.

The prevalence of enuresis

The prevalence of urinary incontinence in children aged 5 to 18 years ranges, according to various scientific studies, from 5.2 to 32.7%. Moreover, 12% of children with nocturnal enuresis at an older age also have urinary disorders during the daytime. This circumstance greatly reduces the quality of life and contributes to the development of psychological problems. Boys suffer from this disease more often than girls.

Effective treatment of nocturnal enuresis in Russia

Fortunately, Sarclinic provides effective treatment for nocturnal enuresis at any age, so it is possible to get rid of enuresis once and for all for teenagers and even adults in their 40s and 60s! But why suffer for so many years? You can undergo therapy, which takes only half a month and live a full life. The problem of night urination is extremely relevant, as 72% of parents consider it serious. According to Sarclinic, 38% of parents punish children for a "wet" bed, but in vain! If a child is ill, he does not control the process of urination at night and in no way in the presence of a disease, and enuresis is a disease that was in the 9th, 10th international classifications of diseases, and in the 11th ICD, he cannot cure himself!

Causes of nocturnal enuresis

Numerous studies have shown a large number of reasons for the occurrence of this diagnosis, that is, the polyethologicity of its nature. The causes may be the presence of stress, psychological problems, pathology of the genitourinary system, urination disorders associated with improper functioning of the bladder (detrusor and sphincter), delayed maturation of the central mechanism of urination in the central nervous system, disorders of the autonomic nervous system, impaired activation reaction at night, changes in the rhythm of secretion of antidiuretic hormone, burdened heredity, congenital pathology related to the spine (for example, bifid's back) The problem of maturation of the nervous system is often discussed. The nervous system in the body controls all functions, and, of course, the process of urination. And perinatal encephalopathy of posthypoxic-ischemic, post-traumatic and mixed genesis can cause a delay in motor, mental and speech development in children. But not only that. It can also slow down the formation of a normal urination reflex. Any organic brain lesions that are observed in the pathology of pregnancy and childbirth, trauma, and neuroinfection also negatively affect the further development of the child's body. And at the same time, the autonomic nervous system suffers, which controls, among other things, the process of urination. This leads to neurogenic bladder dysfunctions, impaired blood flow in the kidneys, and vasopressin secretion. Fortunately, new techniques are used in Sarclinic, which have a beneficial effect on vegetative regulation, which significantly reduces the duration of therapy and increases its effectiveness. In Sarclinic, it has long been noted that in 28.3% of cases, enuresis is the only manifestation of problems in the urinary system. Also, of course, it is necessary to exclude congenital malformations of the genitourinary system, spine, vesicoureteral reflux, bladder dysfunction, myelodysplasia, glomerulonephritis, pyelonephritis. This is helped by a comprehensive examination of the patient, which may include MRI of the lumbosacral spine, MRI of the brain, ultrasound of the kidneys and bladder, CUDI (comprehensive urodynamic examination). Monosymptomatic primary enuresis is often noted. With a secondary nature, neurogenic causes must be considered.

Formation of urination function in children

The formation of the urination function in a child goes through a number of stages. In the first and second years of life, reflex-direct parasympathetic stimulation is noted. With it, the filling of the bladder is replaced by uncontrolled emptying. And such a bladder is called infantile. By the age of two, information enters the cerebral cortex, and the bladder is called immature, the child begins to control the process of urination a little. By the age of four, the bladder increases its effective volume, pelvic floor muscles and sphincter contract well, detrusor hyperactivity is suppressed, urination is fully controlled and controlled. Such a bladder is called mature.

Disorders of bladder function

Now let's focus on disorders of bladder function. An overactive bladder is characterized by incomplete imperative urination syndrome, manifested by nocturia, pollakiuria, imperative urges and imperative urinary incontinence. Nocturnal enuresis in childhood is equivalent to nocturia in adults. Often, the cause of enuresis is a very strong and deep sleep. In 92.4% of small patients with Sarclinic, parents say that they cannot wake the child with a gun at night, and even if he still wakes up and goes to the toilet, he does not remember this fact at all in the morning. This is due to a violation of the activation reaction during sleep. In healthy children, there are diurnal circadian changes in urine excretion and its density. At night, an increase in the secretion of the hormone vasopressin helps to reduce the formation of urine normally. And with violations of the secretion of antidiuretic hormone at night, urine becomes very low density and its quantity is very large. According to Sarclinic, in 78.2% of cases, nocturnal polyuria is observed in children with nocturnal enuresis. Scientific research at the Sarclinic revealed the presence of burdened heredity for enuresis in 24.7% of patients. Enuresis is inherited according to the autosomal dominant type, the locus of the disease is located on chromosome 12 on its long shoulder. With the first degree of kinship, 56.9% of relatives suffer from this disease. The psychological causes of enuresis are related to problems in the family. These are parental divorce, relocation, the birth of a second (third) child, the death of one or two parents, showdowns and scandals. Going to kindergarten often has a negative impact. It is connected both with the separation from the mother, which the child is very worried about, and with strict educators and nannies. At preschool age, a child experiences severe psychological trauma, even with minor, in the opinion of an adult, causes. And this injury manifests itself as enuresis. Effective treatment of enuresis in the Sarclinic contributes to the rapid normalization of the child's psychological state, he stops worrying, can safely go overnight to visit, to sports camps, on vacation, to a children's camp.

Symptoms of nocturnal enuresis

Parents of young patients note involuntary nocturnal urination from 1 to 3 to 5 times a night, very sound and deep sleep. Urination can occur both 1-2 hours after falling asleep, and in the morning. And questions arise: why does a child have a wet bed, why does an adult child pee at night, why does a boy have a wet bed at night, why does a girl pee in panties at night, why a 7-year-old child began to pee in bed at night, what to do, where to go if a teenager urinates in bed, which doctor treats, how to wean a child to pee in bed at night? Some naive parents are waiting for enuresis to pass by itself. There is a primitive opinion that with the onset of puberty, enuresis passes by itself. And then they ask questions: the girl started menstruating, but for some reason the enuresis did not go away. And why will it go away if the child has not received any treatment? Some moms and dads ask: how to treat enuresis at home using folk methods. But this is the 21st century, not the Middle Ages. Fortunately, modern medicine offers new methods of complete elimination of enuresis without dill, seeds of exotic plants, herring, shamans and sorcerers, grandmothers and folk healers, psychics and badger fat, chamomile tablets and ointment from manure, herbs and shrubs. Traditional medicine was good 500 years ago, but in the age of nanotechnology it is already obsolete. According to numerous studies, the treatment of enuresis with hypnosis also gives weak results. In the work of Sarclinic, there were cases when parents told them that the pediatrician at the polyclinic at their place of residence offered them to wait. They come to the reception with a child at 5 years old, a pediatrician tells them: "Why rush, the child will go to school, then everything will pass." Parents wait until this age, bedwetting does not go away. Then they go to the reception at the age of 7, and in response: "When puberty begins, it will pass by itself." Parents wait until they are 12-13 years old, enuresis does not go away. They go to the reception, and they hear: "What do you want, the puberty period will end, then the enuresis will pass." Then the age of 18 comes, the child goes to an adult polyclinic, comes to the therapist for prem, and he says: "Why did you come to me with this question, you had to be treated by a pediatrician." Time is lost, psychological trauma is present. Childhood enuresis has passed into adulthood, and in retirement it flows into senile urinary incontinence. And some parents undergo such treatment in a polyclinic as electrophoresis and massage, which is of zero use, and they have a false belief that nocturnal enuresis is not treated at all. When they come to the reception, they tell us that "we have done everything we have not been treated with, nothing helps"! When collecting anamnesis of life and disease, it turns out that everything is massage, electrophoresis, magnet, warming up, nicotinoyl gamma-aminobutyric acid (acidum nicotinoyl-gamma-aminobutyricum). And the effectiveness of such therapeutic measures is less than 5%, so that with any degree of severity, such therapy options are initially doomed to failure.

Diagnosis of nocturnal enuresis

When parents first contact a child suffering from urinary incontinence, complaints, anamnesis of life and diseases are collected, congenital malformations of the spine and genitourinary system, type 1 diabetes mellitus, inflammatory and infectious diseases of the urinary system, hormonal disorders, diseases of the central nervous system, autonomic nervous system are excluded. When collecting anamnesis, close attention is paid to the periods of pregnancy, childbirth, the first years of life, the presence of a burdened obstetric history in the mother, infectious and somatic diseases of the mother during pregnancy. The child finds out the presence of organic damage to the central nervous system, jaundice of newborns, birth injuries, neuroinfections, delays in motor and speech development, concussions and bruises of the brain, surgical interventions, concomitant pathology. The doctor determines the presence of hereditary burden, the nature of urination disorders, the frequency of urination during the day and at night, the presence of urinary incontinence during the day, leukocyturia, encopresis, chronic constipation, bruxism, sleepwalking, type and type of enuresis, the severity of the disease, the nature of sleep. Much attention is paid to the psychological microclimate in the family, the emotional state of the child. In adults, the presence of diseases such as alcoholism, neurosis, perineal ruptures during childbirth, acute or chronic cystitis, vaginismus, bacterial vaginosis, intestinal dysbiosis, frigidity, chronic prostatitis, urethritis, sexually transmitted infections, candidiasis, genitourinary fistula, spinal hernia, benign prostatic hyperplasia (BPH), cancer is revealed prostate gland, prolapse or prolapse of the pelvic organs, ischemic or hemorrhagic stroke, iron deficiency anemia, tumors of the brain or spinal cord, type 2 diabetes mellitus, injuries to the perineum and organs of the urinary system, multiple sclerosis, transient disorders of cerebral circulation, various neuropathies, hormonal disorders, new coronavirus infection (COVID-19), postcovoid syndrome.

The function of urination is assessed both by means of a comprehensive urodynamic study (CUDI) and by recording the rhythm of spontaneous urination for 3 days. Filling in special tables allows you to determine the syndrome of imperative urination and the mature type of urination. An assessment of the mental and physical development of a boy or girl is of great importance. The organs of the urinary system and abdominal cavity are examined. When examining the lumbar region, hair loss of the skin in the lumbosacral region and epithelial cords are excluded. In assessing the neurological status, the sensitive, motor, reflex spheres, sensitivity of the perineal region, as well as the tone of the anal sphincter are examined. An allergic history, drug intolerance, food and household allergies are taken into account.

The examination plan includes a general blood and urine test, a Nechiporenko urine test, bacterial urine culture with determination of sensitivity to antibiotics, antibodies for hepatitis A, B, C, H1, H2, treponema pallidum, MRI of the brain, MRI of the lumbosacral spine, EEG, REG, ultrasound of the kidneys and bladder, a comprehensive urodynamic study.

After evaluating the results of the examination, the doctor clarifies the main and concomitant diagnosis, develops an individual treatment plan that will take into account the type and severity of enuresis, the presence of concomitant diseases, indications and contraindications to the methods, gender and age of the patient, previously used methods.

Treatment of nocturnal enuresis in Russia in children, adolescents, adults

Sarclinic uses 20 innovative methods for the treatment of enuresis. Comprehensive treatment of nocturnal enuresis in children, adolescents and adults in Russia, Saratov allows you to get rid of problems with urination in a short time in 99% of cases. Over the years, more than 11,000 patients aged 5 to 40 years have got rid of nocturnal enuresis forever! Patients come from both Russia and other countries.

Enuresis treatment methods

To get real results, it is necessary to apply innovative treatment methods. In this case, a quick effect of the procedures and a lasting result are provided. Enuresis is a disease that can be cured completely. The effect of the therapy has been observed for the first month.

Treatment of enuresis is the first step

The first step in the treatment of urinary disorders at night is to contact the Sarclinic enuresis medical center, and not folk methods and home remedies. There is no need to suffer for years, endure, wait for the weather by the sea and worry. The minimum course of therapy is 2 weeks. After completing the course of treatment, the patient leaves for his home and, if necessary, can receive further remote consultations at the clinic. There are certain differences in the therapy of boys and girls, and there are also differences in the treatment of children and adults. We help nonresident patients to resolve issues related to accommodation during the treatment period.

Face-to-face consultations.

Remote consultations.

Reviews of the treatment of nocturnal enuresis in sarclinic.

There are contraindications. A specialist's consultation is required.

Text: ® SARCLINIC | Sarclinic.com \ Sаrlinic.ru

Photos: (©) SARCLINIC | Sarclinic.com \ Sаrlinic.ru

The children depicted in the photo are models, do not suffer from the described diseases and/or all coincidences are excluded.

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Urinary incontinence treatment.

Bedwetting treatment.