Incontinence during sleep, also known as "Nocturnal Enuresis", is a very common condition, it appears at the same rate all over the world and its incidence decreases with increasing age. 16% of 5-year-olds leak at night. We encounter it at a rate of 3% in adolescence and 0.5-1% in advanced ages. It appears more in boys than girls. It is the second most common chronic childhood disease after allergic diseases in children. Separation of parents is the third most important cause of depression after domestic violence in children aged 8-18. It seriously affects children's school success. Nocturnal urinary incontinence is not usually psychological, but it creates serious psychological problems. Children who have urinary incontinence at night have a serious sense of shame and isolate themselves from social environments. In these times when appearance is very important, their self-confidence decreases due to these diseases and causes significant problems in their development. Despite this, 50% of the patients still do not get help from the doctor even under today's conditions.
Why do children leak urine at night
Even though the reason for urinary incontinence at night is not fully understood, 82% of families think that their children leak urine at night due to laziness and inability to wake up.
Actually, 3 factors are important in urinary incontinence at night.
The problem of waking up: The sleep is not really heavy here, on the contrary, these children do not get enough quality sleep during their sleep, so they know that their urine comes from. they cannot notice. In other words, they are not in a deep sleep during their entire sleep, but only during the time they miss. During this period, they cannot give the necessary response to bladder contractions and sound.
Producing more urine than normal at night (Nocturnal Polyuria).
The bladder is smaller than normal or excessive contractions.
There is a genetic basis for urinary incontinence at night. It is known that 2/3 of the families of children who leak urine at night have a mother, father or sibling who leak urine.
p>Some behavioral problems and attention deficit hyper-activity.
Sleep apnea
The doctor first takes a detailed history and performs a physical examination. It is very important whether there are daytime complaints in the history. Daytime urinary incontinence, rushing to the toilet by squeezing, urinating thin and straining, inability to urinate, urinating less than 4 times more than 7 times a day, and whether the child has a dry period for 6 months are questioned. Weight loss, growth and development retardation, vomiting, nausea, desire to drink too much water, snoring and suffocation symptoms are important and if any, the doctor should be told. Evaluation and treatment planning of children who only wet the bed at night and children whose bedwetting is accompanied by the above-mentioned complaints are completely different.
Tools Used in Diagnosis
In children who do not have daytime complaints While only a simple complete urinalysis is performed, other tests are also required in children with daytime complaints.
Treatment
These children should seek help from a doctor as soon as possible after the age of 5.
If no treatment is applied, % every year 15 of them return to normal on their own.
First of all, we have some simple suggestions.
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Review of nutrition and fluid intake habits.
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It is recommended to drink a glass of water at least 6 times a day.
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Caffeinated and carbonated drinks should be reduced at night.
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The bladder should be emptied before going to bed at night.
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If there is constipation, the amount of fiber intake should be increased.
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Regular going to the toilet should be made a habit and it should be ensured that she reaches the toilet quickly.
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When the child leaks urine, constructive attitudes should be taken and the child's active participation should be ensured while the bed and laundry are cleaned.
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Wet and dry nights should be marked on the calendar.
In cases such as some behavioral problems and attention deficit hyper-activity, enuresis should not be treated as just a psychological problem. It should be continued on a treatment protocol in which the urologist and child psychiatrist take a common stance. Pediatric urology doctor should be consulted.
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