It is important to understand that enuresis is a symptom, not a disease. Unfortunately, until now the cause of enuresis is not exactly established, and the pathogenesis is not fully understood. It is believed that enuresis can be caused by various causes. In particular, there are the following reasons: a violation of the formation of CNS control over the function of the lower urinary tract, sleep disorders, the disturbance of the secretion of the antidiuretic hormone during sleep. Genetic factors.
Enuresis is often observed in children with developmental lag. Such children late start talking and walking. There is a strict correlation between the overall development of the child and the timing of the formation of CNS control over the function of the lower urinary tract.
Sleep disturbance is one of the causes of enuresis. In children with urinary incontinence, deep sleep is noted, so signals from the subcortical centers that suppress the urinary reflex reflex do not perceive the cortical centers of the brain.
Involuntary urination can occur at any time of the night and in any phase of sleep.
It has been established that in children with enuresis, the night secretion of antidiuretic hormone is reduced. Therefore, such children at night form a significant amount of urine and this can lead to enuresis.
Genetic factors are another cause of enuresis. Statistical studies show that enuresis is more common if the parents had bed-wetting as a child. So. If both parents had nocturnal incontinence, then in 77% of cases it is also in children. At night incontinence in one of parents in 43% of children observe similar infringements. The changes in chromosome 13 are established. They are often found in patients with enuresis.
In the pathogenesis of enuresis, three factors play an important role, namely: increased urine production during the night; decreased bladder capacity and increased detrusor activity; disturbance of awakening. Thus, there is a discrepancy between increased urine production and reduced accumulation capacity of the bladder overnight. This leads to the appearance of urge to urinate. In the case of a decrease in the ability to awaken, bedwetting occurs.
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