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Urinary incontinence in children - causes and treatment of enuresis in children

Urinary incontinence in children is often recurrent spontaneous urination at night or daytime, regardless of desire. According to pediatric statistics, this pathology is diagnosed in about 9% of children, it is also called enuresis.

It is important to understand that until 18-24 months the baby's nervous system is not yet mature, so until this age, uncontrolled urination is considered a natural phenomenon, that is the norm.

The ability to delay the act of urinating, if desired, to empty the bladder in a child is fully formed only to 3 years of life, but if the baby has already crossed this age line, and urinary incontinence continues, then the parents must of course look for the cause.


Causes of urinary incontinence in children

Urinary incontinence in children

Specialists identify a number of factors that can lead to urinary incontinence in children during the day or at night, they include:

  • Defeats CNS or spinal cord - received craniocerebral trauma, a hernia of the spine, as a result of which the roots of the spinal cord are compressed, inflammation of the arachnoid membrane of the brain, myelitis, cerebral palsy;
  • Diseases of the psyche - schizophrenia, epilepsy and others;
  • Anatomical congenital pathologies of the urogenital system - ectopic ureteral opening, obstruction of the urethra or ureters, hypospadias;
  • Diseases of the endocrine system - sugar or diabetes insipidus , hyper or hypofunction of the thyroid gland;
  • Treatment with certain medications, for example, tranquilizers;
  • The delay in the development of the central nervous system due to the child's trauma in the child, fetal hypoxia during pregnancy, asphyxia in childbirth, mother's heavy gestosis during pregnancy, malnutrition or polyhydramnios;
  • Violation of the production of the hormone vasopressin (antidiuretic hormone) - nocturnal enuresis in children is most often due to this violation;
  • Infectious and inflammatory diseases of the urogenital system - cystitis, urethritis, pyelonephritis, vulvovaginitis, balanitis or balanoposthitis in boys;
  • Glistular invasion ;
  • Allergic diseases-dermatitis, asthma , urticaria .

Often physicians have to deal with stress urinary incontinence in children, which is caused by scandals in the family, the separation of parents, the loss of a beloved animal, received fright, mockery of peers, change of residence.

The reason for night incontinence in children aged 3 years, according to doctors is also the long use of disposable diapers, as a result of which the child does not feel his body and does not feel the urge to urinate.

Symptoms of enuresis in a child

Symptoms of enuresis in a child

First of all, it is important to understand that urinary incontinence in small patients is not an independent problem, but a set of disorders in the body of a neurogenic, hormonal or infectious nature. Enuresis may be permanent or episodic, prevailing during the day or night.

Clinically, the pathology is manifested as follows:

  • Complete emptying of the bladder, which occurs spontaneously;
  • Leakage of urine during laughter, physical activity, exertion, sleep;
  • Enuresis of an infectious nature is often accompanied by pain and cuts during urination, blood or pus with urine, periodic fever and fever;
  • Concomitant symptoms of enuresis in children are closedness, irritability, psychoemotional instability, stammering, vulnerability, sleep disturbances.

Bedwetting in children

prevalence of childhood nocturnal enuresis

prevalence of childhood nocturnal enuresis, schedule

Most often doctors have to deal with night enuresis, and pathology can be observed not only in children, but also in adolescents up to 12-16 years of age.

If urinary incontinence in children is absent in the daytime, and involuntary urination occurs only during night sleep - in most cases, the pathology is due to a hereditary predisposition and a feature of the maturation of the nervous system.

The correct approach to the problem, the organization of a calm environment in the family and the timely diagnosis and treatment of possible infectious and inflammatory diseases, as the causes of enuresis, can get rid of involuntary urination.

Diagnosis of pediatric enuresis

Examination of a child with involuntary urination is aimed primarily at identifying the cause of enuresis, therefore in diagnostic procedures not only the urologist, but other narrow specialists can take part.

Diagnosis of urinary incontinence includes:

  • Collecting an anamnesis of the child's life - the course of pregnancy in the mother, the transferred diseases of the genitourinary system, the situation in the family;
  • Visual assessment of the general condition - talking with the child, assessing the adequacy of his behavior;
  • Examination of external genitalia and palpation of the lumbar region;
  • Laboratory tests - urinalysis: bacterial culture, Zimnitsky test , Nechiporenko and others;
  • Ultrasound of retroperitoneal space and bladder;
  • Urography with the introduction of contrast medium;
  • If necessary, invasive procedures are performed - cystoscopy, urecystoscopy, cystometry, electromyography of the muscles of the bladder;
  • To assess neurologic status as a possible cause of enuresis in a child - EEG, EchoEG, craniography, MRI or computed tomography;
  • Consultation of narrow specialists - psychiatrist, psychologist, neurologist.

Treatment of urinary incontinence in children (enuresis)

Treatment of urinary incontinence in children

A specific medicine for enuresis in children has not yet been found, treatment of pathology is aimed at eliminating those causes that contribute to urinary incontinence:

  1. Congenital anomalies in the development of the genitourinary system - conducting surgical interventions aimed at eliminating the defect (plastic sphincters, urethra, suturing fistulas);
  2. Inflammatory-infectious diseases - antibiotics and antibacterial drugs;
  3. Psychotrauma - therapy sessions with a psychologist or psychiatrist, the appointment of sedatives, tranquilizers if necessary;
  4. Immaturity of the nervous system, due to heredity or birth trauma - nootropic drugs.

Regardless of the type and cause of development of enuresis in a child for successful treatment of a problem, parents must provide him with the necessary conditions:

  1. Favorable psychological situation in the family;
  2. Awakening and forced landing of the child on the pot at night;
  3. Restriction of fluid before bedtime, in particular with a nervous system-stimulating effect - carbonated drinks, coffee, black tea, cocoa;
    Elimination of stress.

In addition, physiotherapy methods are very effective ways of treating incontinence in infants:

  • D'arsonval;
  • Electrosleep;
  • Electrophoresis;
  • Acupuncture and others.

Treatment of enuresis in children with folk remedies

There are several effective folk remedies for the treatment of urinary incontinence:

Honey - for the night the child is given 1 teaspoon of honey (of course, if the baby is not allergic). This curative product has a calming effect on the central nervous system, reduces the burden on the kidneys, keeps the fluid in the body. The course of therapy is not less than 10 days.

Seeds of dill - 1 tablespoon of seeds pour 0.5 liters of boiling water and insist until complete cooling. Strain, got the infusion to drink on ½ cup 3 times a day.

Cowberry - take 1 tablespoon of leaves and berries cranberries, pour two cups of boiling water and cook in a water bath for 5 minutes, then cool, strain and drink infusion on 1 tablespoon 3 times a day.

Folk methods of treatment of enuresis in children can be a good addition to the medication prescribed by a doctor, but not replace it.

An integrated approach to the problem will help quickly get rid of urinary incontinence and significantly improve the patient's quality of life.


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