Nocturnal enuresis in children 8 years old. Bedwetting, treatment of enuresis in children. Exercises to combat enuresis

Bedwetting or daytime urinary incontinence is a common, unpleasant and very traumatic problem. The child’s psyche can suffer significantly due to such “surprises.” The parents’ task is to quickly help the child cope with enuresis without aggravating the situation, without scolding him for a wet bed. Folk remedies that have been tested by time and many generations of now adults will come to the rescue.

Symptoms and signs

Bedwetting can have many causes, both congenital and acquired. Underdevelopment of the bladder, overwork, hypothermia, infectious diseases, psychological and neurological problems. Not the least of the causes of enuresis is lack of normal nutrition.

Usually the baby pees either closer to midnight or in the morning. In the first case, the bladder relaxes excessively when falling asleep, in the second, it is quite strong and, as it fills, does not expand to the full extent necessary, as a result, there is an uncontrolled release of fluid naturally out. Quite rarely, enuresis occurs during the daytime, during the midday nap.

Most often, children suffering from enuresis sleep much more soundly than others. And usually they don’t remember in the morning what happened at night. You can wake them up in the middle of the night, although this is quite problematic, and put them on the potty, but the result will be unchanged - the baby will not pee until he is back in his bed.

When are traditional methods not enough?

• If incontinence is caused by tumor processes and dysfunctions of the central nervous system.
• If enuresis is a consequence of more serious causes associated with inflammation of the bladder and kidney diseases.
• If the inability to control the bladder is hereditary.

The children's doctor in this program will talk about childhood enuresis, as well as if the cause of “wet panties” is neurological in nature.

Effective folk remedies

• A cotton swab on the back. Take a small piece of cotton wool, wet it with warm water and run it along the child’s spine from top to bottom (from the base of the neck to the tailbone) several times. Then put a dry T-shirt on him and send him to bed. Such an incredible and inexplicable, from a medical point of view, method works very well. In most children, enuresis disappears within the first 2-3 days. The method is effective for incontinence caused by nervous shock and stress.

• Dill seeds. Brew a tablespoon of dry dill seeds in a glass of boiling water. Leave for at least 2-3 hours, then give children half a glass in the morning before breakfast on an empty stomach, and children over 10 years old – a whole glass.

• Lingonberry leaves and berries. Brew dried lingonberry leaves (about 50 grams) in half a liter jar of boiling water. Then you should boil the liquid for 10-15 minutes. Infuse, cool and strain. It is advisable to give this drink to your child in the morning on an empty stomach, and then half an hour before meals each time. The total number of daily doses is no more than 4. A single dose depends on age. Children are usually given half a glass, older children – a whole glass. As a result, during the day the child will visit the toilet somewhat more often than usual, and at night his bed will remain dry.

Lingonberries are great for making fruit drinks, which should be given 2-3 times a day, but not before bedtime.

• Honey therapy. If the baby pees at night, then before going to bed he can be given a teaspoon of honey, of course, if the child does not have allergies. This bee product soothes, relaxes the nervous system and retains moisture. Gradually, the evening dose of honey should be reduced as the child recovers.

• Parsley root. Chop the dried parsley root and make a decoction. Let it sit for about an hour. The child is given this drink 2-3 tablespoons per day with the last dose at least five hours before going to bed.

• Hardening. Fill the bathtub or basin with enough cold water to submerge just the child's feet up to the ankles. Let the baby trample in cold water until he starts to freeze. Then place him on a massage mat or a regular hard bathroom mat and let him walk on it until his feet are warm. It is better to carry out the procedure in the morning.

• Physiotherapy. Try to make gymnastics a mandatory exercise in your baby’s daily routine. Add to it exercises related to strengthening the muscles of the perineum - walking on the buttocks. While sitting on the floor, ask your baby to move forward, pushing only with his buttocks. First forward and then back.

• Warm compresses with ginger water. Grate the ginger, squeeze the juice out of the resulting mass through cheesecloth and mix with a glass of boiled water, which has cooled to 60-70 degrees. Gently dip the edge of a towel into it and apply it to the lower abdomen, in the area of ​​the bladder, until the skin in this area turns red. Such warming with ginger juice perfectly relaxes a tense bladder and is no less effective at strengthening an overly relaxed organ.

• Bread and salt. Half an hour before bedtime, let your baby eat a small piece of bread sprinkled with salt. In the same way, children are given small pieces of salted herring.

• Plantain leaves. 20 grams of dry plantain leaves should be brewed in a glass of boiling water, let it brew thoroughly, strain and give the resulting liquid to the child 2-3 times a day.

• Onion-honey mixture. Grate one onion and mix the resulting mush with a tablespoon of flower honey and half a green apple, grated on a fine grater. Give the mixture to your child for about two weeks, a tablespoon before each meal on an empty stomach. The mixture cannot be stored; it must be prepared anew before each use.

• Lavrushka. Boil three large bay leaves and simmer for half an hour in a liter of water. Cool, let it brew well and let the child drink the resulting decoction 2-3 times a day, half a glass, for a week.

• Thyme and yarrow. Take equal parts of dried pharmaceutical herbs and brew as tea. Give your child food 2-3 times a day, one tablespoon at a time. Children over 8 years old can be given a quarter glass.

When is specialist help needed?

• If bedwetting is accompanied by frequent daytime trips to the toilet and complaints of painful urination.
• If the child complains of pain in the lower abdomen, side or pulling sensation in the lower back.
• If enuresis begins to recur in a child over 10 years of age.

What can't you do?

• Some parents and healers advise using elements of hypnosis to treat childhood enuresis. In the stage of paradoxical sleep (when the baby has not yet fallen asleep, but is no longer awake, his eyes are stuck together), the child is given certain verbal suggestions and instructions. Experts categorically do not recommend that untrained people use any tools from the arsenal of psychotherapy. At best, this will have no effect; at worst, it will negatively affect the baby’s psyche and nervous system.
• You should not begin treatment for incontinence without consulting your doctor. The cause of enuresis must be found, because incontinence can be a manifestation of serious and dangerous diseases of the urinary tract, disturbances in the production of the antidiuretic hormone, and delayed development of the central nervous system.
• Enuresis cannot be ignored and taken lightly. Yes, yes, there are also parents who claim that bedwetting is an age-related and temporary phenomenon that will go away on its own. If you do not provide the child with timely medical care, enuresis threatens to result in severe hysteria, mental disorders, prolonged depression and the formation of a persistent inferiority complex in the child. And if you “overlook” the beginning inflammation in the urinary tract, the infection can develop into a chronic form, become complicated, and then you will have to be treated for the rest of your life.

1. If your baby pees, send him to a sports section, to dancing, to a place where he will need to move a lot and intensely. It is movement that will relieve muscle tension and allow you to relax at night on a qualitatively different level.
2. If enuresis is caused by overwork or prolonged nervous stress, make sure that The child slept exclusively on his side. And in order not to watch the baby all night, tie two towels around the child’s body. The nodes should be on the back and stomach, then the child will be uncomfortable lying in any position other than on his side. Such dressings usually do not last long; the habit of sleeping on the side is formed within a week.
3. To reduce the risk of occurrence, Diapers should be completely abandoned by a maximum of two years of age. It is better if this happens earlier, because only after such a “leave from the comfort zone” will the baby begin to learn to control his urination.
4. Do not bring stressful situations to the point of enuresis. It is better to extinguish and resolve conflicts and problems immediately, without delay. If there is increased nervous excitement, give your child calming teas, light herbal sedatives, and show your child to a child psychologist and psychiatrist. You should be especially attentive to the child’s emotions during “transitional” periods - when he begins to attend kindergarten, school, if the family moves, changes place of residence, during the divorce of parents, the appearance of another child in the family, and so on.
5. Good prevention is timely potty training. In no case should you do it too early, but you shouldn’t delay it either. The optimal age at which a child is able to learn to control his urination without unnecessary stress is from 1 year and 8 months to 2 years.
6. Carefully monitor the amount of fluid your child consumes. Limit drinking after 6 pm.
7. Be patient. Some forms of bedwetting can be very complex, and treatment will require much more time and effort from parents and the child.

The country's leading pediatrician, Dr. Komarovsky, will tell us everything in detail about such a delicate topic as childhood enorezia, the causes of its occurrence and how to deal with it.

The problem of urinary incontinence affects many children. This disease is called enuresis, and boys are much more susceptible to it. Enuresis in boys is diagnosed 2-4 times more often than in girls. According to medical statistics, 12-14% of children under 5 years of age are susceptible to this disease. The percentage decreases with age: 8% at 7 years and 2% at 12 years.

If a child wakes up in a wet crib in the morning, is it possible to judge the disease only by this sign? To answer, we need to remember some features of childhood physiology. And urination is a physiologically complex process. In newborn children it is reflexive, i.e. involuntary. Control over this process is created in the child in the process of growth, gradually. A baby at the age of 1 year begins to feel (feel) the filling of the bladder. “Adult-like” urination develops in children at 2.5 or 3 years of age. This is facilitated by:

• almost 6 times enlargement of the bladder;
• the emergence of control over the muscles involved in this process;
• acquiring the ability to inhibit the urination reflex.

Therefore, you should worry about bedwetting in a child only after 3 years. Enuresis in young children under three years of age is not a pathology at all; this situation is rather the norm. The greatest number of urinary disorders occurs between 4 and 7 years. Just as children develop the skills to speak, walk, etc. independently in different ways, in the same way the skills to control urination appear at different ages.

We can talk about the acquisition of such skills if the baby can recognize the urge to urinate and report it to adults, and can also voluntarily hold urine, “endure.” The connection between children's brains and the bladder forms slowly and is not yet developed in the early years. Boys develop more slowly because the nervous system matures later - hence the greater number of cases of enuresis.

According to statistics, even at the age of 3 years, 70% of children acquire the ability to control urination, 75% achieve this at 4 years old, and at 5 years old, 80% of children can safely sleep dry all night and wake up to pee.

Enuresis is distinguished between nocturnal and daytime. Rarely, but a combination of these two types occurs, which indicates more serious violations in the general development of the child. But more often, people consult a doctor (urologist, nephrologist) only about bedwetting. Urinary incontinence is usually divided into primary and secondary. Primary is situations when the child does not wake up to empty the bladder. Secondary is a consequence of other diseases (cystitis, diabetes, mental illness, central nervous system diseases, etc.) and manifests itself regardless of sleep.

Causes of enuresis

The reasons why bedwetting occurs can be both direct and indirect, physiological and mental. Here are just some of the factors that influence the development of the disease:

• diseases of the genitourinary system, various, congenital or acquired, its anomalies;
• delayed development of the central nervous system;
• disorders of the lumbar portions of the spinal cord that control the bladder (spinal enuresis);
• abuse of disposable diapers, the use of which delays the development of a conditioned reflex;
• psychological (emotional shock, protracted traumatic situations for the child):
• sleep disorders (difficulty falling asleep, restless sleep, too deep sleep);
• heredity (close relatives suffered from alcoholism, epilepsy, psychopathy, etc.).

Psychologically, a very characteristic type of boy is one who lacks self-confidence and courage. In response to too firm demands, for example, mothers, reproaches, they develop enuresis as a unique form of protest. Treatment is prescribed taking into account all prerequisites and reasons.

Symptoms of enuresis

The main symptom, of course, is involuntary urination and increased urge. But a number of other symptoms also appear that affect the central and autonomic nervous systems. It can be:

• slow pulse, decreased body temperature, blue extremities;
• isolation and depression, timidity and indecisiveness, short temper, decreased attention.

If this disease develops as a secondary one, the child may even experience some pain when urinating. The problem of urinary incontinence in a child will be solved much faster if you do not delay the first visit to the pediatrician, who, after a preliminary examination, will refer you to a more “narrow” specialist: urologist, nephrologist, endocrinologist, neurologist. The main thing is to start treatment on time.

Diagnostics

To make an accurate diagnosis, it is very important to correctly describe the entire picture of the development of enuresis. For the doctor, information about the pregnancy, childbirth, the presence of injuries in the child, and the illnesses he suffered will be important. The doctor should talk about the child’s attitude towards this problem and how the people around him react to it. Before visiting a doctor, it would be a good idea for parents to try keeping a diary for several days to reflect the course of the disease.

Whatever the causes of urinary incontinence, the doctor will most likely prescribe an ultrasound examination of all abdominal organs, and necessarily a blood and urine test. If necessary, other studies are also used: X-ray, electroencephalography, cystography, urography, etc.

Treatment

Treatment of enuresis usually occurs at home, except in cases where urinary incontinence develops against the background of another acute illness. Urinary incontinence must be treated comprehensively, using both medications and folk remedies, physiotherapy and psychotherapy. And let us remind you once again that we can talk about the disease and its treatment only after the child turns 3-4 years old.

Based on the diagnosis, the doctor decides what medications the child should take. When the cause is formulated as insufficient maturity of the nervous system, nootropic drugs are prescribed that are able to normalize the metabolism occurring in brain cells (Cortexin, Pantocalcin). If the cause is an overactive and irritable bladder, medications will be prescribed that help block the activity of the bladder muscles - Oxybutynin (Driptan). If polyuria (production of an increased amount of urine) is detected in a small patient, treatment is carried out with Minirin tablets or Presaynex spray. Treatment with antibiotics (Suprax, Augmentin, Furamag, Canephron N) is carried out when enuresis is caused by a urinary tract infection (pyelonephritis, cystitis).

In addition to medications, children suffering from enuresis are also prescribed physiotherapeutic procedures. A fairly good effect is observed after using paraffin applications on the pubic area.

Psychotherapy

An important role is played by psychological therapy, which, in turn, uses a variety of techniques and methods: color therapy, autogenic training, etc. There is even dolphin therapy - healing through communication with dolphins. The psychotherapist conducts special sessions, the purpose of which is to free the child from complexes that develop in connection with the problem of urinary incontinence.

Parents can give a child a lot to help with medical treatment:

• create a friendly, calm environment in the family;
• never scold a child for a wet bed;
• spend time with your child before bedtime, help avoid noisy games and watching TV;
• learn special autogenic training with your child;
• engage in drawing with your child, which has a beneficial effect on the psyche;
• put the child on a fairly hard bed;
• avoid hypothermia, which can aggravate the situation;
• monitor your diet (limit liquid intake in the evening).

Boys tend to find it more important than girls to gain approval from their parents. They simply have a desire at the genetic level to achieve independent results, a desire to compete. Therefore, in overcoming this illness, the psychological support of his father is very important for the boy.

Folk remedies

In the treatment of enuresis, it is imperative to use folk remedies; you can treat with their help at home. The use of numerous herbal infusions is effective for the treatment of bedwetting. Collections of medicinal herbs are prepared in the following sequence: the necessary dry herbs are crushed and mixed, then 1-2 tablespoons are poured into 1 liter of boiling water and left overnight in a thermos.

You should take 100-200 ml of the mixture before meals. Herbs can add bitterness; not every child will drink them with pleasure. To improve the taste, it is permissible to add honey, jam, and sugar. All folk remedies give effect only after long-term use, therefore the preparations must be taken in courses lasting up to four months. After a break of two weeks, you can change the collection and continue treatment again. Feeds for the treatment of enuresis are prepared from the following herbs:

• knotweed grass, mint, St. John's wort, centaury, birch leaves, chamomile flowers;
• chamomile flowers, arnica, thyme, yarrow, St. John's wort, shepherd's purse, dill fruits, lingonberry leaves;
• grass of knotweed, lungwort, St. John's wort, centaury, cuff leaves;
• elecampane root, mint herb, horsetail, motherwort, wormwood, meadowsweet, meadowsweet flowers, fireweed leaves.

In the above traditional medicine recipes, all components are taken in equal parts.

Other treatments

As we can see, in the fight against enuresis, you can use a lot of means, both traditional and traditional, and alternative medicine. This problem can also be treated with acupuncture massage. And the “bedwetting alarm clock” device, which you see in the photo on the right, may be of interest to boys if it is popular and accessible to tell them everything. This device is easy to use: the sensor is attached to underwear and when the first drops of urine appear, the signal drops. The following chain is formed: urine excretion - signal - awakening - going to the toilet, which contributes to the gradual development of a conditioned reflex.

As a rule, provided that all the doctor’s recommendations are followed, by the age of 12 the problem of urinary incontinence can be resolved.

Nocturnal enuresis means that a person is unable to control the process of urination during sleep. Simply put, he wets the bed while he sleeps.

Daytime enuresis is somewhat less common. It may appear after suffering severe psychological trauma, which caused a malfunction of the nervous system. Also, daytime enuresis can occur in adolescents during a period of active growth as a result of uneven growth and development of internal organs, in particular the muscles and organs of the genitourinary system. The most common manifestation of daytime enuresis is stress urinary incontinence - involuntary leakage of urine during coughing, laughing, running and other physical activities, leading to an increase in intra-abdominal and, consequently, intravesical pressure. A characteristic feature of stress urinary incontinence is the absence of the urge to urinate.

The causes of enuresis in school and adolescence can be medical: kidney or urinary tract infections, inflammation of the bladder, disruption of the passage of nerve impulses from the bladder, lack of hormones responsible for the amount of urine produced, lag in the development of the pelvic muscles, in particular the muscles bladder and sphincter. Or non-medical: stress, overwork, hyperactivity, protest.
Often, incontinence in children is a way of psychological protest or the result of a lack of attention or, conversely, a reaction to increased parental care.

Many specialists treat enuresis: pediatric neurologists, endocrinologists, pediatricians, urologists, nephrologists, psychiatrists, homeopaths, physiotherapists. They offer more than 300 comprehensive techniques to combat this problem.

Causes of enuresis

There can be many reasons for enuresis in childhood and adolescence, both physical and mental.

It is believed that girls are less likely to suffer from enuresis because they develop faster, develop the reflex earlier and learn to control their bladder. Enuresis in boys is quite common. Up to 10% of boys under the age of 15 experience it, and in almost all of them this problem resolves itself and wet sheets become a thing of the past.

Causes of enuresis common to children and adolescents, boys and girls:

- Psychological trauma, stress, strong emotions
Chronic stress is a fairly common occurrence in children and adolescents, especially those who study in special schools, schools with in-depth study of the subject, and who attend many clubs and sections in addition to school. Currently, the training program is very intense, and the level of teaching material and teaching methods do not contribute to better learning. Often the child simply does not realize that he is overtired. Therefore, parents need to pay attention to how busy the child is and whether he is coping.
Often the problem appears after the birth of a second child, a move, the death of someone close, a transfer to a new school, or the divorce of parents. In this case, enuresis is a subconscious protest or an attempt to return to childhood.
Some situations that are accompanied by nervous tension or fear can cause enuresis. The child may be afraid of something, upset because of a quarrel between parents, etc. Therefore, if possible, avoid situations that could cause psychological trauma to your child. Or prepare your child for similar situations. If there has been psychological trauma, it is wiser to first solve this problem with a psychologist, and then solve the problem of enuresis (it is possible that after solving the first issue, the second will resolve itself).

- Overprotection and attention deficit: Children who grow up in single-parent families without a father often suffer from enuresis. Often in this case, the mother and grandmother overprotect the child. Surprisingly, this applies not only to children, but also to teenagers, whose parents cannot believe that “the baby has grown up and can take care of himself.” For 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 their sleep they behave like little ones.

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 if this muscle is not sufficiently developed, then it weakens at night and therefore, when the bladder fills at night, it is not able to keep it from emptying.

- Very sound 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 severe overwork. In the latter case, wet sheets do not happen often, but after eventful days.

- Lots of fluids in the afternoon.
Especially if during the day they ate salty foods (chips, crackers). This often happens during colds, when parents try to give their child more water.

- Passing a large volume of urine 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 for some people, the amount of this hormone may temporarily decrease. A stable decrease in antidiuretic hormone (vasopressin) is a rather rare disease characterized by a large volume of urine, thirst and dry skin and mucous membranes. (http://biokhimija.ru/lekcii-po-biohimii/25-gormony/172-vazopressin.html)

- Disruption of the passage of nerve impulses from the bladder to the brain. This is a congenital dysfunction of the parts of the nervous system that are responsible for the formation of a conditioned reflex.

- Infections of the urinary system, inflammatory diseases of the kidneys and bladder. Inflammatory processes in the kidneys and bladder very often cause urination problems. They can be easily identified by a general urine test. If a boy has congenital features of the urinary tract, they can also affect the formation of the reflex.

- Allergic reactions, bronchial asthma, difficulty breathing. The mechanism that links allergies and the occurrence of enuresis is not fully understood. But boys with allergies are more likely to urinate in their sleep. It is possible that the brain is starved of oxygen and copes with its functions worse.

- Diaper habit. Recently, diapers have been increasingly blamed for the occurrence of enuresis. The child gets used to the fact that he can pee in his pants without getting wet and cold. That’s why it’s so important to stop wearing diapers before age 2.

- Heredity. In 75% of cases, parental genes are to blame for a girl’s enuresis. If mom or dad suffered from this problem in childhood, then the probability that the boy will repeat their fate is 40%.

- Tumors. The tumors can interfere with the transmission of nerve signals from the bladder to the cerebral cortex. This is a very rare occurrence in children and adolescents, but cannot be ruled out.

Features of enuresis in girls?

- Infections of the urinary system. Due to the fact that girls have a short and wide urethra, infection 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. Some microorganisms are normally present in the mucous membrane, but hypothermia or decreased immunity allows them to develop into inflammation.

- Weakness of the pelvic muscles and pelvic floor. During the period of active growth and puberty, the genital organs develop and changes under the influence of hormones.

Features of enuresis in boys?

- Disturbance of the endocrine glands and hormonal balance. Thin, small boys whose height is not appropriate for their age (in either direction) 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/increases. This is vasopressin.

Why does enuresis occur in teenagers?

In adolescence, enuresis is somewhat less common than in children. It can appear after injury or stress. Or it has been going on since infancy. Let's take a closer look at the reasons for this problem.

- Mental conditions. At this age, depression and neurosis often appear. They can contribute to the fact that problems long forgotten in childhood will become relevant again. The complexes and worries that a teenager experiences about this further aggravate the problem.

- Hormonal changes during adolescence. Alas, hormones are responsible not only for urine production and puberty, but also for height and weight, sleep and wakefulness, good mood and nervousness. Since almost all hormones behave like crazy during the period of active growth and puberty, their levels can fluctuate from low to high and back again in a significantly short time. And this is probably why being a teenager is very difficult. And when this already difficult time is further complicated by the problem of incontinence, the situation becomes simply terrible. This needs to be understood not only by teenagers themselves, but also by adults.

Treatment options for enuresis in children and adolescents?

First of all, it should be noted that the treatment of enuresis must be comprehensive. It is not enough to limit yourself to just drug therapy or just psychotherapy. Even if the cause of enuresis is infection or inflammation, do not forget about the mental trauma of the child or teenager from the “wet” incident itself, as well as its possible consequences (in the form of “friends who will not let you forget”).

First of all, it is necessary to conduct a medical examination to determine the presence or absence of medical health problems: pathology, neurological disorders, inflammation, infections, hormonal problems. So, to rule out inflammation, you need to do a urine and blood test, and a PCR smear for infections from the urethra (for girls). Kidney disease will also show up in blood and urine tests. It is better to look for neurological problems with the help of specialists: a neurologist and a neuropathologist. Hormonal problems (such as vasopressin levels) can also be determined using a blood test for these hormones. A blood test for: Potassium (K+, Potassium), Sodium (Na+, Sodium), Chlorine (Cl-, Chloride) will help identify electrolyte imbalance.

It would not be superfluous to do an ultrasound of the bladder and kidneys. The doctor may additionally prescribe an X-ray of the spine or an MRI.

If the examination does not reveal any diseases, then the basis of the treatment strategy for enuresis will be exercise therapy and psychological support. In this case, the interest of the teenager himself is very important.

!!! For teenagers who are reading these lines in search of a solution to the problem, I want to add this: no one but you will make your life better. It doesn't matter how old you are, 8 or 16, if you can read and can make decisions, even things like when and where to defecate, you can handle solving your problem. And you don't need anyone's help for this. Just yourself, your brain and your body is all you need to succeed. If your parents support you in your endeavors, that's great. If not, well, to hell with them. If your friends don't laugh at you because of your illness, but try to help, you're lucky. If your friends are assholes, leave them. You can solve your problem and find new normal friends. !!!

What to do? How to treat? Treatment usually consists of: physical therapy - exercise therapy, medication, psychological assistance. Or combinations thereof.

Physical therapy techniques (physical therapy) - Therapeutic Exercises

An important step in the treatment of enuresis is systematic physical exercise and special gymnastics. Exercise therapy for enuresis aims to strengthen the bladder sphincter muscles and the pelvic floor muscles that control urination. You don't need any training equipment for this. There are many options: from morning exercises to specialized physical complexes.

Of the exercises that help strengthen the pelvic muscles: the pelvic floor and the urethral sphincter, the most effective are the Kegel exercise (for women) and perineal muscle training (for men).

Exercise for the female half of humanity:
Squeeze the pelvic muscles that stop the flow of urine and hold in this state for 5 seconds. Rest 10 seconds, then the next approach. Perform 3-4 approaches. At the next stage, squeeze the pelvic muscles and hold for 10 seconds, then the muscles are in a relaxed state for the same time. Do this 3-4 times. Next cycle: squeeze the muscles for 30 seconds. Repeat 2 times. The exercise must be done 2-3 times a day.

Exercises for the male half:
For boys and young men, exercises for training the muscles of the perineum are simple and effective in combating enuresis. In the process of urination, it is necessary to use the muscles to make 3-4 interruptions (for 5-10 seconds) in urination each time you visit the toilet for a “small” need. Each time it is necessary to increase the interruption time. Within a month the result becomes noticeable.

If you have already learned how to stop the flow of urine during the process of urination and can easily cope with it, listen to your sensations, feel which muscles tense? Now try to tense and relax the muscles that control urination, regardless of the process of urination, outside of this process. Then you can perform the same exercises at any time: during urination, before bed, on the road, sitting, standing, lying down. It is necessary to do these exercises 2-3 times a day, in 3-4 sets of 15-20 repetitions. This is a very effective method.

This exercise is especially useful for girls, as it simultaneously trains the vaginal muscles, making them more mobile and controllable. But they will be able to appreciate the results of these exercises only after the start of sexual activity.

Advice from Dr. Fetisova for solving the problem of incontinence. Excerpt from the book "For the Young and the Brave":

The problem you write about is quite common among boys at your age. It can be dealt with. Many people who are very successful as adults peed at night as children.
But it is important to know: have you always had this problem or does it appear in connection with some events? In the first case, solving the problem may take more time and effort, in the second case, less.
But you will have to work hard. I will suggest several exercises that you can do regularly. The more conscientious you are about exercise, the faster you will cope with your problem.
Option 1. If the problem has always been there, most likely
- Your bladder cannot stretch and hold large amounts of urine,
- Your brain does not hear the bladder calls during your sleep.

Exercises.

1. To stretch the bladder, hold urine for as long as possible after the first urge to urinate. - Just as the bladder wants to be freed from urine, it sends a signal to the brain to tell you that it is time to go to the toilet. The next time this happens, instead of immediately running to the toilet, see if you can wait a little longer. Be patient as long as possible. If you do this consistently, you will train the bladder to hold urine longer and longer and, in addition, you will learn to stretch it so that it can hold more urine. Therefore, this must be done at least once a day and it is better if there is a toilet nearby. To take your mind off your bladder at this time, you need to focus on something else. This way your bladder will be able to hold urine all night without bothering you.

2. To strengthen the bladder muscles and make them manageable. Every time you urinate, you need to interrupt the stream of urine ten times and release it again. This does not need to be done only when you go to the toilet for the last time before going to bed. Then you just need to let all the urine come out.

3. In order for the bladder and brain to learn to communicate better at night, it would be good to use your imagination. For example, imagine that your bladder calls your brain on the phone and does not whisper into the receiver, as it usually does, so as not to disturb the brain at night, but yells at it so that it wakes up. Perhaps your brain switches its phone to silent mode at night, so as not to disturb your sleep. Convince him to turn on at least the vibration mode at night so that he hears the signal from the bladder. And explain that you must be woken up in time so that you have time to get to the toilet. This exercise is good to do when you are relaxed. More on this in the next exercise.

4. Relaxation exercise. Imagine that you are turning into a rag doll. Start with your left hand. She becomes lethargic and relaxed. Then move on to the entire arm and so on until you have covered the entire body. When all the muscles become relaxed, imagine something pleasant, fantasize. If this problem occurs periodically due to stressful situations, perform exercises 3 and 4.

Diet and regimen

To successfully combat nocturnal enuresis, you should adhere to a certain diet and regimen. Redistribute water consumption: consume more water during the day, and 4 hours before bedtime, reduce water consumption or not drink at all after dinner. Before going to bed, eat bread with salt and a couple of sips of sweet water.

The bed for sleeping should be hard enough so that turning during sleep does not create additional tension and pressure on the bladder. This will also provide good support to the spine. Nerve signals from the bladder will be better transmitted to the brain.

It is also important to maintain body temperature during sleep: keep your feet warm and your head “cool” - this is how you can characterize the temperature in the room that is useful for sleep. Put warm socks and warm pajamas on your feet. And ventilate the room well before going to bed. Wrap a child in a blanket, unless it is a sleeping bag with a hood - if a person cannot wake up to go to the toilet, he will not wake up and wrap himself in a blanket if he is cold. If your feet get cold, your bladder reflexively begins to fill..

Before going to bed, be sure to go to the toilet. Also, it is necessary to wake up the child 2-3 hours after falling asleep and take him to the toilet. It is important that the child wakes up completely for this.

Children and teenagers are often afraid to get out of bed because of the darkness. It is easier for them to sleep on wet sheets than to get out from under the covers. After all, most children are confident that something terrible is hiding in the dark. In this case, you can leave a small light source in the room at night.

It is important for those with daytime enuresis to remember that some foods and drinks are diuretic, i.e. help remove water from the body - beer, coffee, strong tea, cola, cranberry juice, herbal infusions, watermelon, strawberries. Also, those with daytime stress incontinence are advised to visit the toilet as often as possible so as not to create excessive pressure in the bladder.

Try to avoid stressful situations and not get nervous. It is better for children and teenagers not to watch scary movies at night.

Drug treatments for enuresis

Depending on the cause of incontinence, various medications can be used.

If the cause of enuresis is hyperactivity or nervousness, then sedatives (usually homeopathic) are prescribed.
Preparations for normalizing sleep: Radedorm, Eunoctine - They have a calming effect, help get rid of negative emotions, and tune in to a positive mood.
M-anticholinergics: Sibutin Driptan - Relaxes tense bladder muscles, relieves spasms. 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 the morning without feeling the need to go to the toilet.

If the examination reveals infections and inflammation, then you must take a course of antibiotics. They kill bacteria that cause inflammation of the kidneys and bladder. And eliminate itching and irritation.

Sometimes enuresis occurs as a result of delayed development of the nervous system. In such cases, nootropic drugs are prescribed. They speed up development processes. Good results are also obtained in these cases by using drugs based on desmopressin, which regulates the amount and composition of urine, and the functioning of the bladder.

In cases of psychological problems, a complex of drugs that calm the nervous system (glycine) and promote nighttime urinary retention is most often used (drugs based on Desmopressin, a synthetic analogue of the hormone vasopressin: Adiuretin SD, Adiuretin, Apo-Desmopressin, Vazomirin, Desmopressin, Desmopressin acetate, Minirin, Nativa, Presaynex, Emosint). Nootropic drugs: Piracetam, Picamilon - improve the functioning of the nervous system, help to develop a conditioned reflex.

If enuresis occurs sporadically, and the child needs to go somewhere overnight (on a visit, to a camp, on vacation), you can use mirinin as an emergency remedy, but you must first consult a doctor and not use it for long periods of time without control, as this may lead to a violation production of its own hormone.

Summary table of drugs used in medicine for the treatment of enuresis.

Non-drug ways to treat enuresis

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

Honey perfectly calms the nervous system before bed and helps retain water in the body. A tablespoon of honey should be eaten before bed; you can wash it down with a few sips of water. Therefore, even if you do not believe in folk remedies, a spoonful of honey with your morning and evening tea will not be superfluous.

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

Preparation of decoctions, teas and infusions: Cherry and blueberry decoctions are considered the most popular among people. Tincture of oak bark, agrimony seeds, sunflower stems.

Psychotherapy

Traditionally, hypnotic techniques are used. The essence of the method is to use hypnosis to suggest to the patient that in a dream he will feel the urge that a full bladder sends. And these sensations will make him wake up. Thus, a “guard” reflex is formed in the cerebral cortex, which allows you to completely get rid of enuresis.

Some methods of self-hypnosis can be learned independently. Try to keep the evening calm. Relax completely before falling asleep. Feel how every muscle in your body is at rest. Then, for several minutes, say to yourself, or better yet out loud, the key phrase: “I have complete control over 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 capable of coping with more complex tasks.

The help of a psychologist and psychotherapist will help the child cope with an unruly bladder. The specialist will teach him relaxation and self-hypnosis techniques. An effective method would be to keep a special diary. Behavioral techniques work well when you can get a reward for successful nights. Of course, adults make it for themselves. But these little gifts also boost motivation.

Calmness and composure

Urinary incontinence in most cases is the result of disorders of the nervous system. Occurs as a result of stress, fear, and emotional experiences. Therefore, all incontinent sufferers should avoid stressful situations.

However, I want to note that self-control and presence of mind are the lot of adults. This condition is very rare in childhood and adolescence. Therefore, it is important to practice methods of self-hypnosis and auto-training. Or use glycine.

When treating urinary incontinence at home, it is very important to develop self-discipline. This is achieved by strict adherence to the daily routine. It is important to eat and go to bed by the hour.

Particular attention is paid to the drinking regime. You need to control what, when and how much you drink.

Try to limit your fluid intake after lunch. 85% of the total daily fluid intake should be drunk before 15:00.

When treating enuresis at home, you should never give up walking in the fresh air.

With an integrated approach, in 1-2 months you will forget what enuresis is.

A patient came to me and brought her eleven-year-old daughter. As soon as I heard that the girl was wetting the bed, I asked the mother to wait in another room, hoping that the girl would be able to tell me her story. She told me that when she was very little, she had a bladder infection and that she was treated by a urologist, but the inflammation did not go away for five or six years, maybe longer. She had cystoscopy regularly, hundreds of times, until they finally discovered an infection in one of her kidneys. The kidney was removed, and she has not had inflammation for four years. But due to hundreds of examinations, her bladder muscles and sphincter muscles had become so stretched that she wet the bed every night as soon as the muscles relaxed in her sleep. Throughout the day, she could control her bladder muscles by force of will until she began to laugh. The relaxation of muscles that comes with laughter caused her to pee in her pants.
Her parents believed that since the kidney had been removed and the source of infection had been eliminated several years ago, she should learn to control herself. She had three younger sisters who called her names and made fun of her. All her friends' mothers knew she wet the bed. And the whole school, two or three thousand kids, knew what happened to her at night and that she would have wet panties if she laughed. She became the subject of much ridicule.
She was tall, very pretty, with long blond hair that reached her waist. Truly charming. She was rejected, laughed at, demanded of her more than she could. Neighbors pitied her and ridiculed her sisters and friends. She couldn't go to a sleepover or stay overnight at a relative's house because she wet the bed. I asked if she had seen other doctors. She said that she had been to many people and had already taken a huge amount of all sorts of medications, but nothing helped.
I told her that I liked all the doctors she went to. I can't help her either. "But you know something, although you don't know that you know it. Once you know what it is - what you know, without knowing that you know, you will sleep in a dry bed."
Then I told her: “I want to ask you a very simple question and I want to get a very simple answer. And the question is this: If you were sitting on the toilet and urinating, and at that moment a stranger looked in the door, what would you do? ?" "I would have died!"
"That's right. You would freeze and stop writing. Now you know that you already knew this, without knowing what you know about it. Namely, that you can stop writing at any moment, in response to any irritant that you yourself you can choose. In fact, you don't need someone else to come into the toilet. Just the idea of ​​it is enough. And you will stop. You will freeze. And when he leaves, you will start peeing again.
Keep in mind that sleeping in a dry bed is very difficult. The first time this can happen is two weeks later. And you will need a lot of practice - starting to write and stopping. There will be days when you forget to start and stop. It's nothing. Your body will be kind to you. He will always give you a new opportunity. There will be days when you'll be too busy to practice starting and stopping, but that's okay. Your body will always give you the opportunity to start and stop. I will be very surprised if your bed remains constantly dry for three months. I'll also be very surprised if your bed doesn't remain consistently dry for six months. And not wetting the bed for the first time will be much easier than sleeping in a dry bed twice in a row. And three days in a row is even more difficult. And four times in a row is even more difficult. And then it gets easier. You will be able to wake up in a dry bed five, six, seven times for a whole week straight. And then you will know that you can sleep dry one week and the next week too."
It took a long time to work with the girl. There was no other way. We spent another hour and a half before I let her go. A week and a half later, she brought me this gift - the first gift that she gave in her new capacity, in the knowledge that she was sleeping in a dry bed (it was a knitted burgundy cow). I value it very much. And six months later she was already staying overnight with friends, relatives, at sleepovers, in hotels. This is because the therapy is carried out by the patient himself. I didn't think it was necessary to work with my family, even though my parents were impatient, my sisters called her names, and my friends at school made fun of her. I felt that her parents would have to get used to her not peeing at night. Her sisters, friends and neighbors too. In fact, I saw no other choice for them. I didn't think it would be necessary to explain anything to my father, mother, sisters or anyone else. I told her what she already knew, although she did not know that she knew.
And you all grew up with the idea that when you empty your bladder, you empty it continuously. And you accept it. The important thing, however, is that each of you has had a situation in which you were forced to abruptly stop urinating. Everyone has this kind of experience - but she forgot it. All I did was remind her of what she knew, but forgot what she knew.

In other words, in psychotherapy you consider the patient as an individual, and no matter how serious the problem of a wet bed may seem in the eyes of her parents, sisters, neighbors and school friends, it was primarily her problem. And all she needed to know was what she already knew, and therapy with everyone else was about giving them the opportunity to adapt to the new state of affairs.
Psychotherapy should be an orientation for the patient, and an orientation towards the original problem itself, towards its root. Don't forget this. Remember that each of us has his own individual language, that when listening to a patient, you should listen with the awareness that he is speaking in a language foreign to you, and that you should not try to understand him in the terms that make up yours. own language. Understand the patient in his own language. (Note: "by entering his system of thought.") This is one of Erickson's favorite stories, perhaps because Erickson always prefaced it with a comment like, "This story will be of particular interest to you, Ced." For a long time I could not figure out what he wanted to tell me, and finally I was able to understand two main ideas.
The first is that I can learn to control my thoughts, work energy and symptoms such as anxiety. However, I must do this not by willpower, but by finding incentives that will make me “start and stop.” Then I have to start taking advantage of opportunities to start practicing “starting and stopping.”
The second thought was that "you all grew up thinking that when you empty your bladder, you empty it without stopping, that the process is continuous. In the book Training Seminars with Milton Erickson, edited by Jeffrey Seig, Erickson added to this The story contains a few new sentences to make its meaning clearer, especially with regard to this second point: “All she needed to know was that she could, with the right stimulus, stop urinating at any moment.” And: “We grow up with the idea that we need to finish what we start. It's not true that we have to continue until we die." This attitude has helped me a lot in completing things, such as writing a book. The feeling that we have to finish what we started can easily block spontaneity and creativity. Much more a more effective way of doing anything is to "start and stop" according to your own internal rhythm.I have seen the effectiveness of this story when helping patients overcome psychological obstacles such as writer's block.

Reading time: 8 minutes. Views 637 Published 11/12/2018

Childhood is not only a period of active growth and carefree pastime. This is a time of development and great achievements. Each skill and ability has its own time for formation and consolidation. But sometimes not everything goes according to plan, and parents and their children have to face some problematic situations. One such problem is childhood enuresis. What is it, when and why does it become a problem, and, of course, what to do about it - we’ll figure it out in the article.

What is childhood enuresis?

Many people have heard about the concept of “enuresis” and understand it as urinary incontinence. This is only partly correct. Enuresis is a type of incontinence that results in involuntary urination during sleep. Up to 20% of children aged 5-12 years face the problem.

In itself, childhood enuresis is not a disease in the usual sense. Its driving mechanism is the immaturity or disruption of the conditioned reflex to the fullness of the bladder.

By the age of 3-4 years, most children are able to control urination during daytime and nighttime sleep. This is an unconscious process, and if for some reason this does not happen by age 5, then you should seek help from a specialist.

For themselves, parents can determine the presence of a problem if a child over 5 years old does not hold back urination during sleep more than a couple of times a month. But only a qualified doctor can diagnose enuresis in girls and boys and differentiate between normal and pathological conditions as a result of a comprehensive examination. This is required if you also notice an uncharacteristic odor.

Nocturnal enuresis in children

The most common cause of concern for parents is childhood nocturnal enuresis. It is extremely rarely a symptom of a serious illness and is currently more associated with parental “addiction” to using disposable diapers. The child does not experience discomfort from wet pants, so the formation of the reflex may take a little longer.

But even in the absence of serious physical problems, occasional failures during night sleep can be psychologically traumatic for the child. And the older the child is, and the more intolerant and unrestrained the parents are in their statements, the more this can affect the child’s psychological state.

Parents should not only be as correct as possible and support their child, but also not hesitate to ask for help in a timely manner and participate in establishing all the details of the problem.

Types of enuresis

In order to develop the correct algorithm of action in the fight against urinary incontinence in children, it is necessary to honestly and carefully analyze the problem. And you should start by determining the type of childhood enuresis.

Well-known domestic specialist in the field of pediatrics, Dr. Komarovsky, suggests relying on the following classifications of types of enuresis.

1. By time of occurrence :

• primary– lack of formation of reflex control over urination from birth, i.e. there was no period in the child’s life when he slept “dry” for more than six months;
• secondary (acquired) – violation of a previously formed reflex to a full bladder, i.e. The child had been successfully controlling urination during sleep for more than six months, but suddenly “misses” began to occur. Occurs in children after 4 years of age.

1. According to the characteristics of symptoms:

• monosymptomatic– nighttime incontinence without other symptoms or disorders;
• polysymptomatic– daytime enuresis in combination with neurological, endocrinological, urological, psycho-emotional or nephrological symptoms.

Understanding the physiological characteristics of a child’s body, knowing at what age the ability to control the process of urination should appear, it is quite easy to determine the form of enuresis present in a child. However, identifying the triggers of the disorder may not be so simple.

Causes of childhood enuresis

Establishing the true causes of childhood enuresis is difficult for several reasons:

• a large number of possible and fundamentally different reasons for the appearance of this problem;
• inattention or dishonesty of parents in the process of collecting information about the peculiarities of enuresis;
• incorrect approach to diagnosis: not knowing which doctor treats enuresis, choosing the wrong methods to study the problem, etc.

The main and most common causes of incontinence in children can be divided into physiological and neurological.

Physiological ones include:

• small bladder capacity– in this case, the bladder fills (and overflows) faster than there is a tangible need to go to the toilet;
• hereditary predisposition– we are not talking about genetic inheritance, but only about the child being at risk if one or both parents had problems with urinary incontinence in childhood. This reason is based on the inheritance of the functioning of the nervous system;
• hormonal disbalance– the body’s production of insufficient amounts of the hormone argipresin leads to the production of more urine and the child’s bladder becomes full;
• diseases of the urinary system– problems in the field of urology (inflammatory processes, deviations in the structure and development of the system) can also cause the development of childhood enuresis.

In other cases, urinary incontinence may be a consequence of neurological problems:

• immaturity of the central nervous system– the child is not able to control the process of urination independently, and delayed maturation of the central nervous system disrupts the activity of the bladder;
• sleep disorders– too much sleep, problems with waking up, an excess of emotions before bedtime, extreme fatigue, using mobile devices before bedtime;
• stressful situations– problems at school, at home; strong negative and traumatic situations, a radical change in the usual environment (for example, moving), etc.

If you cannot find the cause of childhood enuresis among the list of the most common ones, then you should also pay attention to exceptional factors:

• epilepsy with nocturnal attacks;
• failure/stopping breathing during sleep (apnea);
• endocrine problems in the body;
• adverse reactions to some drugs.

The choice of a doctor who will eliminate this delicate problem and the methods of “treating” it depend on the causes of enuresis in a child.

How to deal with childhood enuresis

A pediatrician or family doctor will help parents identify the problem, confirm the diagnosis, and establish the cause of childhood urinary incontinence. You should contact him immediately if there is any suspicion of enuresis:

• systematic incontinence in children under 5 years of age during the daytime;
• incontinence during night sleep in children over 6 years of age;
• cases of regular incontinence after the child has already formed a control reflex.

Despite the fact that the causes and treatment of childhood enuresis are closely interrelated, the pediatrician is involved in solving this problem only at the diagnostic stage. Further, depending on what factors became the trigger for the development of childhood enuresis, the child and parents are referred either to a pediatric urologist-surgeon or to a neurologist/psychologist.

In general, there are about three hundred approaches to the treatment of enuresis.

But, unfortunately, there is no pill in nature that would instantly and forever save a child from this problem, both physically and psychologically. Therefore, in any case, an integrated approach and parental support are required.

How to fix the problem without doctors

Most often, child incontinence during night sleep can be eliminated by following some routine rules:

• do not give the child anything to drink a couple of hours before going to bed;
• exclude diuretic products from the dinner menu;
• at the slightest feeling of the urge to urinate, go to the toilet, do not endure it;
• remind the child to go to the toilet more often, and especially before bed;
• do not wake the child several times at night, giving the nervous system a chance to rest;
• create conditions under which the child can relieve himself at night independently and quickly (night light on, proximity to a toilet or potty);
• Praise the child for success in adhering to the treatment regimen! keep a “diary of “dry” nights.”

Without special indications, treatment of childhood enuresis does not require hospitalization. Only if certain physical or physiological pathologies are suspected or present, examination and treatment in a hospital is required.

Other ways to combat enuresis

Among other treatment methods used in the fight against urinary incontinence, the following should be highlighted:

• medications (hormones, antidepressants, psychostimulants);
• psychotherapy (auto-training, motivation, hypnosis);
• physiotherapy;
• herbal medicine (treatment with folk remedies).

Any of the above methods is used only after there is no effect from regimen changes, and is prescribed exclusively by a doctor in accordance with the characteristics of childhood enuresis in each specific case.

Conclusion

Like any other situation related to the health and well-being of a child, the problem of childhood enuresis requires immediate attention and a professional approach to treatment.

The task of parents is not just to take the issue of “wet sheets” seriously, but to provide support to the child, to provide him with a comfortable environment in which he will not experience tension and pressure. This is often the best “cure” for childhood incontinence.

Be healthy and love your children for who they are.

According to urologists, up to 4-5% of children suffering from enuresis have manifestations of this pathology for up to 10 years or more. In addition to waking up in a wet bed, which is physically uncomfortable, the child experiences emotional discomfort. Although he is not to blame, he is haunted by a feeling of shame because of such a problem, he may become an object of ridicule, which will give him complexes.

All causes of enuresis can be divided into physical (impairments in the structure or functioning of organs), neurogenic (impairments in the regulation of the bladder or urination) or mental. Physical causes include pathologies of the kidneys or the bladder itself, abnormalities in the structure of the genitourinary tract, problems in the innervation of the bladder. For girls, the occurrence of enuresis at this age may indicate the presence of urinary and genital infections, or helminthic infestations.

If a 10-year-old child pees at night, even occasionally, this is a reason for immediate consultation with specialists - a urologist and a neurologist. By this age, all children should have clear control over daytime and nighttime urination, and if urine leakage occurs at night, this is a reason to identify the causes of such an anomaly.

Also of considerable importance are disturbances in hormonal balance and regulation, disruptions in the functioning of the nervous system, overwork, and heavy physical activity. Sometimes, if previously the child was often woken up to go to the toilet due to a slight need, at this age the reflex may work when waking up at night. Enuresis often occurs due to hypothermia, wet feet, freezing of a child predisposed to this problem, or severe infections.

Also, bedwetting in children 10 years old can be associated with a lot of psychological factors and influences - nervous overload, fears, stress, sudden changes in environment, moving, changing schools, conflicts in it. Incontinence can be triggered by the death of loved ones, divorce in the family, tests, exams. Typically, such problems arise in children with a hereditary predisposition, if mom or dad themselves suffered from incontinence in childhood.

It is important to begin treatment for nocturnal enuresis in children 10 years of age as soon as the problem is identified. First of all, you need to eliminate all psycho-traumatic factors and undergo a full detailed urological examination and consultation with a neurologist. Depending on the reasons that provoke urinary incontinence, a course of treatment will be planned. it could be:

Surgical treatment in the presence of abnormalities in the structure of the genitourinary system, the spinal region or nerves responsible for the control of urination. Medication in the presence of urinary tract infections, metabolic disorders or inflammatory processes, in the detection of worms. Prescription of specific drugs that regulate the process of urine separation during the day and night , sedatives, tranquilizers, sedatives. Special bladder training, drugs to increase bladder volume. Psychotherapeutic measures, correction of the daily routine and nutrition, drinking regimen, the use of physiotherapy, sanatorium treatment.

Parents play an important role in the treatment of enuresis at this age. Much depends on them in the fight against the disease. If they do not scold the child, but gently and tactfully help and encourage him, this will help him get rid of the problem more quickly and completely.