Nocturnal enuresis, sleep enuresis, bedwetting, treatment, enuresis in children, in adults

Enuresis, nocturnal bedwetting, treatment of enuresis

What is enuresis? How to stop enuresis?

Enuresis is involuntary urination during night or day sleep. The term enuresis is translated from Greek with the meaning ´´to urinate at night´´. In contradistinction to other varieties of urinary incontinence enuresis is singled out in independent nosological form.

Enuresis (bedwetting) is a disease with a combination of different syndromes which include involuntary urination during night sleep, change of motor activity in the daytime, disorder of sleep process, disorder of emotional and volitional behavior, and non-adequate consideration of the disease. The frequency of children´s enuresis is from 3 % to 38% depending on age. Boys suffer from nocturnal enuresis (sleep enuresis in children) 4 times more often. Diurnal enuresis occur more rarely. According to Sarclinic 2,8% five year old children have it. Girls suffer from diurnal enuresis more often than boys.

The causes of nocturnal enuresis

The following factors matter in the appearance of enuresis: psychological disorders, defects of upbringing, hereditary burden, and mild organic cerebral disfunction. Ability to feel an urge to urinate during sleep is acquired by most 2 year old children. So, nocturnal involuntary urination up to this age is not considered as pathology. According to the theory of reflected reflex enuresis is defined as distinctive response of urinary bladder to reflectoral irritation from any organ or pathological focus.
Immaturity of the mechanism of cerebral cortex control over urinary bladder function, absence of proper care of a child, constantly wet bed also result in forming of conditioned reflex when all the sleeping conditions become stimulus causing enuresis.

During sleep stimulus impulses come from filled urinary bladder (owing to the urine tension of bladder wall) to cerebral cortex. In response to these signals awakening or relaxation of detruzors (suppression of urination impulse) may come. In case of inhibition process prevalence due to deep sleep (it is often associated with enuresis of neurosis character) the activity of bladder cortex center inhibit and involuntary urination occur. Growing older children suffering from enuresis get additional neurotic factor. Enuresis is rather related to the group of systematic neurosis and not to urological diseases.

Sometimes enuresis appears at the age of five – seven and later (secondary enuresis). Recurrence of enuresis is usually connected with psychic traumas, infectious diseases or overstrain.

Types of enuresis

Nowadays specialists single out primary and secondary enuresis. Primary enuresis starts from birth and continues permanently. Secondary enuresis appears after the development of neatness skill. Primary enuresis occurs five times more frequently than secondary one. Depending on the cause of appearance doctors distinguish neurotic and pathogenetically close to neurosis enuresis (neuropathological).

Neuropathological enuresis can be disontogenetic (primary) and secondary. Shy timid diffident children have neurotic enuresis more often. Such children feel pain from their defect, they sleep in a state of agitation, and later they get a deficiency complex. Neuropathological enuresis is characterized by frequent recurrence of nocturnal urinations, very deep sleep, and indifferent attitude to one´s state. When teenagers suffer from this disease they acquire self-dissatisfaction, they worry about their defect, and they are often irascible and in a bad mood.

The forms of enuresis

According to etiology, clinical aspects and internal medicine approach specialists distinguish six forms of enuresis: simple, neurotic, neuropathic, endocrinopathic, epileptic, dysplastic.

The symptoms of enuresis

Most children with enuresis sleep very deeply, they cannot fall asleep for a long time and they awake with difficulty. Often enuresis is combined with other attendant peculiarities of sleep (motor anxiety, talk during sleep, walking sleep). The main causes of enuresis development are: delay of nervous system maturity (subcortical and cortical centers of urination), sleep disorders, psychological factors, stressful situations, disorders of antidiuretic hormone secretion, disadvantageous heredity, and urological diseases.

Treatment of enuresis in Russia, treatment of nocturnal enuresis in Saratov

Sarclinic has elaborated a new complex scheme of treatment of children, teenagers and adults suffering from enuresis. Our therapy is aimed at recovery of cortex function and conditioned urination reflex, standardization of agitation and inhibition processes in the central nervous system. We help to precipitate maturity processes of urination regulation mechanisms and to correct neurotic disorders which arise during the disease.

The treatment efficacy is 99% for boys, girls and adults (including patients with myelodysplasia). Sarclinic offers outpatient treatment with individual approach. All our methods are safe and painless. We have been working since 1992 and have helped to recover many patients with enuresis at the age of 4 to 40.