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What causes enuresis?
Medical expert of the article
Last reviewed: 20.11.2021
Enuresis is not a diagnosis, but a symptom of various diseases. At the first admission to the hospital before the examination such a conclusion is permissible, but enuresis should not be the final diagnosis.
Enuresis may be a symptom of the following diseases and conditions:
- a neurosis;
- neurosis-like states;
- a consequence of urological pathology;
- pathology of the spinal cord (spinal bladder);
- combination of the above violations.
The most common cause of enuresis are neurosis-like conditions, neuroses and urological pathology. At the same time, prolonged preservation of enuresis in children up to 10-12 years may lead to the formation of a neurosis.
Neurosis is a mental disorder. Asthenic neurosis occurs in a child after overwork, stress. Neurotic incontinence manifests itself impermanently and in a calm environment passes, is observed at night, less often - and in the daytime. Sleep in children with neurosis is superficial, many dreams. After urinating in a dream, the children wake up, very worried.
The treatment of neurotic incontinence is performed jointly with a psychoneurologist. It is important:
- switching attention, calm environment;
- Do not fix attention to his problem, do not blame, do not punish.
- make sleep deeper with the help of a warm bath before going to bed, appointment for the night 1 tab. A desensitizing drug, for example, suprastin;
- sedative psychotherapy: explain to the child that urinary incontinence will necessarily pass;
- the appointment of herbs with sedative effect (motherwort, valerian);
- calming reflexotherapy;
- Therapeutic physical training aimed at strengthening the muscles of the back, the abdominal press;
- take a shower in the morning, to improve microcirculation.
If after 3-6 months. The foregoing therapy of enuresis is not eliminated, one should turn to the psychiatrist of borderline states for the appointment of more potent drugs (seduxen, sonapax, radedorm, etc.).
Neurosis-like conditions are the most common cause of enuresis. This term refers to the manifestations of the organic pathology of the nervous system, the residual phenomena of hypoxic-ischemic involvement of the CNS (eg, small hemorrhages in the ventricles of the brain), head or spinal cord injuries (for example, after falling), neuroinfections (transferred encephalitis, meningitis), genetic diseases. All of the above leads to a violation of the nervous regulation of the organs of urination.
Enuresis in neurosis-like conditions is detected either from birth, or soon after the damage (disease) of the nervous system. Enuresis is usually regular, it can be several times a night, it becomes more frequent with fatigue, but does not depend on excitement. The child does not worry about this. A deep sleep without dreams is characteristic, even when the wet child does not wake up. Often the symptoms of cerebroasthenia are revealed: headache, dizziness, fatigue, symptoms of autonomic dysfunction. Children can not concentrate quickly, they usually do not learn well. There are changes in EEG and EchoEG. All these symptoms should be an occasion for consultation of the child by the neuropathologist.