How is bedwetting treated?

Treatment of neurosis-like urinary incontinence is carried out in conjunction with a neurologist:

• make sleep less deep: take a cool shower before bed instead of a warm bath, take tonic medications in small doses at night (ephedrine, atropine, belladonna, for example - bellataminal, theophedrine);
• mobilizing psychotherapy: explain to the child that urinary incontinence is not good, if he himself does not want to be cured, no one will help him;
• developing a reflex: wake up the child at the same time, be sure to push hard, that is, take him to the toilet at night fully awake, so that the child does everything consciously;
• be sure to consult a neurologist regarding the prescription of nootropic drugs at night (nootropil, encephabol) and, in severe cases, antidepressants (amitriptyline, etc.);
• psychiatrist consultation;
• reflexology;
• physiotherapy: paraffin applications to the bladder area to improve trophism, daily for 12-15 days; electrophoresis to the bladder area with atropine;
• Physical therapy to strengthen the pelvic floor muscles;
• drugs that improve microcirculation: vitamins B ₆, B ₁₂, B ₂;
• adiurecrin - increases reabsorption of sodium and water in the tubules, therefore, less urine is formed and the child urinates less. Vasopressin-based drugs cannot be given constantly, but in combination therapy for children over 5 years old - the effect is good;
• enuresol: powder, given before bedtime (ingredients: belladonna extract, ephedrine, vitamin B _, etc.).

"Spinal bladders" are a severe pathology associated with spinal cord damage, difficult to correct, occurring, for example, with severe spinal hernias or transverse myelitis. Consultation with a neurologist and urologist is mandatory.

Treatment of enuresis in children:

1. Find out a detailed obstetric history to determine the "nature" of enuresis: neurosis or a neurosis-like condition.
2. Prescribe laboratory and instrumental research methods:
   • analysis of the rhythm and volume of urination on Saturday and Sunday;
   • Zimnitsky test;
   • several urine tests (3-5) general and according to Nechiporenko;
   • Ultrasound of the urinary system to detect gross urological defects.
3. If there are changes during the examination, according to point 2, an X-ray urological examination (cystography, urography) is performed to identify nephrological and urological pathology.
4. If there are no changes in the examination presented in paragraph 2, EEG and EchoEG, myography are performed, consultation and treatment of a nephropathologist (for neurosis-like conditions) and a psychiatrist (for neurosis) are prescribed. In the absence of an effect within 6-12 months, an X-ray urological examination is also indicated.

All of the above conditions can lead to the development of neurogenic bladder dysfunction.

Treatment measures for any type of enuresis:

• adequate psychotherapy (different for neurosis and neurosis-like conditions);
• a calm environment, without overload and stress (reduce the time spent watching TV programs, eliminate quarrels, etc.);
• diet: dinner 3 hours before bedtime, excluding diuretic foods (exclude apples, cucumbers, dairy products, coffee);
• During the last hour before bedtime, recommend that the child go to the toilet 3 times (every 20 minutes);
• sleep on your back in a warm bed;
• Physical therapy, swimming, cycling to strengthen the muscles of the back, abdomen, and perineum;
• Continue treatment for 3-6 months after enuresis has stopped. It is better to treat on an outpatient basis or in a sanatorium.

In the vast majority of cases, if there are no gross developmental defects or injuries to the spinal cord and brain, children by the age of 9-11 develop correct reflexes and enuresis stops. However, without timely treatment, a urinary tract infection (pyelonephritis) or neurosis (if there was none) may develop, requiring treatment by a psychiatrist.

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