Enuresis is the most important and common urination disorder of childhood. If the child cannot wake up and urinates in his bed due to the need to empty himself, which occurs when the functional capacity of the urinary bladder is full during sleep, it is called "enuresis".
Enuresis is one of the most common problems of childhood. It is an important problem that affects the child, his family and his environment. It reduces the child's self-confidence, can cause embarrassment and psychological problems.
DIAGNOSIS OF BEDWETTING
Enuresis occurs after the age at which urinary control is expected (5 years old), during the day or night, by voluntary movements into bed or clothes. It is defined as involuntary or recurring urinary incontinence (at least twice a week). Enuresis may be primary or secondary depending on its onset and course. In some children, sleep urination continues from birth without any dry periods, and this is called primary enuresis; In some, toilet training has been achieved for a while (at least 6 months) and then they suddenly start urinating in their sleep at any age. This is called the secondary type (secondary enuresis).
TYPES
Enuresis can be nocturnal and diurnal. Urination while sleeping at night is called nocturnal enuresis, while urination while awake during the day is called diurnal enuresis. If there are no other complaints in children who urinate only during sleep, day or night, this is called monosymptomatic sleep urination (monosymptomatic enuresis nocturna). Expressions such as bedwetting or bedwetting during sleep should not be used for nocturnal enuresis as they are accusatory definitions, and the term “sleep urination” should be preferred instead.
REASONS FOR BEDWETTING
First of all, a doctor should be consulted to investigate whether there are organic causes, congenital disorders or a disease such as inflammation of the urinary tract. If no disease is found as a result of the investigation, the following may be the reason for the child wetting the bed:
- Premature or too stressful toilet training is the most common cause of enuresis.
- Excessive cleanliness. It shows the child's reaction to the pressured toilet training of a meticulous, organized mother.
- No toilet training at all can also lead to enuresis. can open. The mother's overprotectiveness, her child's dependence on her for a long time, and her subconscious desire also make the child babyish.
- The birth of a new sibling may cause the child to imitate his sibling and wet the bed in order to gain attention again.
- Anxiety caused by life events such as death in the family, separation, discord, illness, school failure may be reflected in children's behavior in the form of enuresis.
STATISTICS
Approximately 15% of five-year-old children Enuresis nocturna is observed. Rates such as 5%-15% are reported from various countries. It is more common in boys. The frequency of Enuresis nocturna, which can also resolve on its own, decreases with age and continues at a rate of 1% in adulthood. In addition, the rate of comorbid conditions in enuresis is found to be quite high.
FAMILY ATTITUDE
The attitude of parents is very important when it comes to the child wetting the bed and incontinence. The family may feel anger and shame, punish the child, and compare him with his siblings. On the contrary, some families support the child without knowing it, such as tying a diaper on the child, kissing and petting him while changing his diaper. It should be known that both attitudes are harmful, that is, neither punishment nor rewarding with affectionate behavior would be right.
First of all, the child needs support. It is not right to scold, shame or punish.
Getting up to go to the toilet at night can solve the problem. Especially the child should be woken up 1.5 hours after sleep. Because bedwetting mostly occurs during this period of sleep. The child is woken up and urinated. There is not much difference in terms of training between urinating in a semi-asleep state and urinating while sleeping in bed.
BED WETTING TREATMENT
There are different treatment methods. These are behavior modification (motivation therapy, conditioning-alarm therapy, bladder retention training), hypnotherapy and drug therapy (anticholinergics, tricyclic antidepressants, vasopressin) methods.
Hypnotherapy and/or psychotherapy can be applied to children with enuresis. Due to the detection and elimination of the main cause, as well as the strengthening of the ego, the secondary gain is the absence of other possible symptoms and possible other psychological problems. It is important to develop the ability to cope with cosomatic situations.
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