Enuresis in adolescents at night
Enuresis is involuntary urination during the day and night. Normally, a child gains control over his urination at 4 years of age. According to medical statistics, from 2 to 30% of children have this pathology. By adolescence, urinary incontinence remains in 4% of children, from 14 to 18 years old, approximately 1% of boys and girls suffer from urinary incontinence. In most cases, this is nocturnal enuresis. The problem may remain after the period of growing up, bringing moral suffering to a mature person.
Enuresis appears selectively, more often boys suffer from it due to an increased tendency of the brain to overexcitement. In adolescence, during the period of personality formation, urinary incontinence has a negative impact on the psyche of children. They worry, withdraw into themselves, avoid visiting sports camps and holiday homes, and are unable to make long trips.
If a teenager suffering from urinary incontinence lives in a social institution (boarding school), he has conflicts with peers, depression may develop, the desire to escape from there. In a family where parents have a negative attitude to such a problem, they punish teenagers, parent-child relations are violated, and negativism is growing.
Content:
- Forms and causes of bedwetting in adolescents
- Diagnostics
- Treatment
- Enuresis and the army
- Recommendations for parents of a teenager
Forms and causes of enuresis in adolescents
Distinguish between primary and secondary enuresis. The primary form of urinary incontinence develops most often in a family scenario, when relatives of a teenager in a straight line suffered from this pathology. The features of sleep, the type of reaction of the central nervous system to psychological stress, the production of antidiuretic hormone of the pituitary gland are inherited. A combination of 2-3 unfavorable factors of influence leads to the fact that from the moment of birth the child almost never wakes up in a dry bed.
The secondary form is formed when the urinary control reflex was formed at one time, but for some reason disintegrated. Most often, the negative factors are diseases of the genitourinary system, endocrine disorders (diabetes mellitus).
Causes of bedwetting in adolescents:
- Infections of the urinary system, when the kidneys and bladder are affected (cystitis, pyelonephritis, pyelitis, nephritis).
- Congenital absence of a conditioned reflex to control urination.
- Genetic predisposition inherited from relatives in a straight line.
- Injuries of the lumbar spine, pelvic organs.
- Prolonged stressful situation, adolescent crisis.
- Hormonal changes in the body.
The psychological factor significantly affects bedwetting. These can be conflicts with peers, teachers and parents, excessive workload at school, moving to a new place of residence, sleep disturbances, character traits, and self-doubt.
Diagnostics
A teenage child is not always able to bring his problem to the public and decide to visit a doctor.
His problems are first dealt with by a pediatrician, who, if necessary, refers the patient to such narrow specialists as:
- Pediatric urologist,
- Endocrinologist,
- Neuropathologist,
- Psychiatrist.
For a more accurate assessment of the health of a teenager, a full examination is prescribed:
- General analysis of blood and urine;
- Ultrasound of the bladder, kidneys;
- Bacterial urine culture;
- X-ray of the pelvic organs;
- Cystoscopy;
- Assessment of the reservoir function of the bladder.
Based on the results of the diagnosis, the doctor determines the tactics of treating nocturnal enuresis.
Treatment
There are many ways to improve your teen's health:
- Drug therapy;
- Psychotherapy;
- Physiotherapy methods;
- Acupuncture;
- Diet therapy;
- Laser therapy;
- Regular methods of ordering measured sleep and nutrition.
Psychotherapy cannot be the only method for treating urinary incontinence, although in many cases of neurotic forms of pathology it is very effective.
Medicines are prescribed depending on the cause of enuresis:
- Nootropic drugs (Semax, Piracetam, Glycine, Phenibut, Instenon) for the treatment of the neurotic form of the disease;
- Antibiotics for treating infections of the genitourinary system;
- Tranquilizers (Radedarm, Eunoktom) to stabilize the depth of sleep, Melipramine, Sydnocarb, Amitriptyline with resistance to previous drugs;
- Adiurecrin for inhibiting the process of urination.
In order to prevent nocturnal enuresis, fluid intake is limited during the day. 7 hours before bedtime, the use of liquid food and drinks is limited; just before bedtime, the teenager eats a salted piece of rye bread.
Physiotherapy procedures include electrophoresis, magnetotherapy, nitrogen, salt, pine baths, circular shower, galvanization. Good results are obtained with the use of physiotherapy exercises that strengthen the muscles of the pelvis and the sphincter of the bladder, and courses of therapeutic massage.
It is recommended that the child's relatives create a positive atmosphere in the family, exclude traumatic situations.
Other treatments
In addition, the following directions in the treatment of enuresis can be distinguished:
- Effective treatment of bedwetting with bedwetting alarm
- Treatment of bedwetting with a conventional alarm clock
- Special exercises for enuresis
- Popular drugs for bedwetting
Enuresis and the army
Young men diagnosed with enuresis do not serve in the army, they can neither do military service nor contract service. If the goal is to get a respite from the army, it is necessary to record all hospitalizations and dispensary events in the child's medical record from an early age. In the case when, for some reason, military service is necessary, enuresis should be cured completely.
Recommendations for parents of a teenager
Family support is very important for a child with urinary incontinence. Parents can do a lot to ease the psychological state of their teenager.
How to help a teenager:
- You can't humiliate him, hang offensive labels;
- A positive attitude of family members will help stabilize the child's condition;
- It is forbidden with a teenager to discuss his problem;
- In case of secondary enuresis, it is advisable to analyze whether the child has a psychotrauma, to help resolve the situation;
- Before going to bed, it is advisable to create a calm atmosphere, do not watch TV, do not play computer games;
- It is advisable to limit the intake of liquids, juicy vegetables and fruits after 19.00;
- A visit to the toilet before going to bed to urinate is mandatory, you can try to wake the child up during the night;
- The bed of a child with bedwetting should be firm.
Since bedwetting is of a polytheological nature, the methods of influence on the body must be combined and combined. In this case, under the guidance of a doctor, it will be possible to eliminate pathological urination in a teenager.
Author of the article: Lebedev Andrey Sergeevich | Urologist
Education: Diploma in the specialty "Andrology" received after completing residency at the Department of Endoscopic Urology of the Russian Medical Academy of Postgraduate Education in the urological center of the Central Clinical Hospital No. 1 of JSC Russian Railways (2007). Postgraduate studies were completed here by 2010.
