Enuresis after 5 years
Tips to reduce the risk of bedwetting
During the day
- Make the child drink at least 1 liter of fluids between 8 and 18 to regulate diuresis and improve bladder distension
- Have you pee every 2-3 hours to avoid over distension and promote proper emptying of the bladder
- If the child has "urgency" you must ask him to take a deep breath and then throw out the air for a count of 10 before peeing, in order to allow proper relaxation of the detrusor muscle of the bladder.
- Check that the child discharges regularly and does not coexist constipation
In the evening
- At dinner, limit foods rich in calcium (milk and dairy products) or too salty to reduce hypercalciuria and / or hypenatruria (increased elimination of calcium and sodium in the urine) which lead to increased urine production overnight
- Choose mineral waters with low calcium content (<25 mg / L) to avoid hypercalciuria and thus limit urine production during the night
- Always pee before going to bed
- If the parents go to bed much later than the child, they can give him a second pee to "make room" for the urine produced during the night.
READ ALSO THE INSIGHT ON NIGHT ENURESI
What is nocturnal enuresis
The term "bedwetting" describes the loss of urine during sleep; the child pisses in bed while sleeping and is generally not awakened by the wet.
This nocturnal incontinence, when it occurs, albeit with involuntary urination which is completely normal except for the place and time considered inappropriate and socially unacceptable, in a child over the age of five in whom bladder control should have matured even at night, must be considered a disorder to be treated, but it is unfortunately very underestimated.
Bedwetting is a real problem. Parents don't talk about it, partly out of shame, partly because they consider it a completely normal fact, having often experienced episodes as children. The family pediatrician, in turn, thinks that if the parent does not talk about it, it is because the problem does not exist. A real vicious circle. With this project we want to accurately measure the size of the problem, and help to urge family and parent pediatricians to bring out nocturnal enuresis and to deal with it.
Nocturnal enuresis, causes and treatments
In fact, nocturnal enuresis represents a complex event in which they come into play
- hereditary aspects (there is a clear family character in two out of three cases),
- genetic (affects two boys for each girl),
- biochemical and hormonal mechanisms (partial deficiency of antidiuretic hormone or vasopressin or ADH),
- hyperactivity of the bladder,
- depth of sleep and awakening problems.
Treatment must therefore be modulated according to the prevalence of one or more factors over the others. The treatment can be behavioral, with the adoption of habits that may seem trivial and obvious, but in practice very important (see the rules above) to improve bladder function and regulate diuresis, associated with drugs such as desmopressin, analogue of antidiuretic hormone, and anticholinergics, to control bladder overactivity. Also useful is the use of a sensor placed on the panties which, in contact with the drops of urine, emits an acoustic signal and wakes up the child who completes his urination in the bathroom. It helps the establishment of a conditioned reflex which determines, after a few times, an autonomous awakening when the urination stimulus appears.
It is important to set up a medical treatment of enuresis, which contrary to what many may still think does not have a psychological origin, because it is a disorder that reduces self-esteem and increases the risk of incontinence in adulthood, especially in women after 50 years old.
- bedwetting after age 5
- 3-5 children years