One of the most common problems with the urinary system in childhood is bedwetting at night. In medical terms, it is called 'enuresis nocturna'. Enuresis; urination incontinence, 'nocturna'; It is used to mean night. If there is both day and night, the term 'enuresis diurnal' is used.
Although enuresis nocturna is frequently seen in our country and is a serious problem, the mother or father also encountered the same problem in childhood and spontaneously (in older ages) Most of the time, they do not consult a doctor because they know that it can get better.
The child who wets the bed may not be able to concentrate adequately during the day because he cannot sleep soundly at night, and this affects his success in classes. Due to the stressful situation caused by bedwetting, psychological problems such as anxiety and self-confidence problems may arise in the future. Parents also experience the same situation. Of course, washing the laundry, spent detergent, water and electricity, and environmental pollution are another economic aspect of the business.
By definition, bedwetting in children over the age of 5 at night during sleep is defined as enuresis nocturna.
What causes bedwetting?
Awakening disorder.
Low bladder capacity and excessive contraction of bladder muscles at night.
Increased amount of urine at night (Nocturnal polyuria).
Diagnosis
If there is urinary incontinence only at night and there is no complaint during the day, only urinary system ultrasonography and A urinalysis is performed. If these tests are normal, it is considered simple enuresis.
Treatment
Behavioral treatment
The patient diagnosed with enuresis nocturna In the first stage of treatment; doctor, parents, staying in the same house with the child at night; The caregiver, grandparent and child should be discussed together. Treatment is started by making sentences that will motivate the child. It should be explained that peeing in one's pants is not a crime, that one's mother or father also peed in the past, and that although they are heavy sleepers, they are not peeing now.
In behavioral therapy, the patient is made to pee a certain hour after sleeping. Fluid intake is restricted in the evening. If he still pees in his pants, medical treatment support is required.
Medical treatment
Alarm treatment in cases of difficulty in waking up.
Desmopressin.
Bladder. Anticholinergic in those with low capacity.
Alarm therapy: Effective in those with waking problems. Over time, it helps people learn to wake up without leaking urine when their bladder is full. Motivation of the family and the child is important. The child should be taken to the toilet every time the alarm goes off. 10-30% of families cannot complete treatment.
Desmopressin: It reduces urine production and increases its concentration. It is immediately effective when used during temporary absences from home or on school trips. Fluid restriction should be done. Fluid intake should be restricted 1 hour before bedtime.
Anticholinergics: It is used in cases of decreased bladder capacity, increased detrusor activity, or unresponsive to desmopressin if there are symptoms during the day, especially in incontinence that occurs more than twice a night.
Follow-up. A follow-up call is made within 2-4 weeks and the patient's compliance is reviewed.
Read: 0
