infantile enuresis
Introduction
Introduction Pediatric enuresis usually refers to the involuntary urination of children when they are asleep. Under normal circumstances, children begin to control urination at 3 to 4 years old. If they have regular bedwetting after 5 to 6 years old, such as twice a week and last for 6 months, they are medically called "enuresis." Nocturnal enuresis is a common disease. In China, the probability of boys suffering from this disease is higher than that of girls. The cause of bedwetting is ruled out. The exact cause of primary nocturnal enuresis is still unclear. The vast majority of children's bedwetting is related to mental factors, genetic, psychological and health habits, environmental factors, sleep conditions, bladder functional capacity.
Cause
Cause
Genetic factor
Nocturnal enuresis is usually hereditary in the family. If both parents have had nocturnal enuresis, their children will have a 3/4 chance to wet the bed. If one of the parents has a bedwetting patient, their child has a 1/2 chance to get sick. This is a terrible case. Please find out in time for parents to treat them promptly.
2. Disease factors
Ascariasis (stimulation of the urethra), urinary tract infection, kidney disease, local inflammation of the urethra, spina bifida, spinal cord injury, ankle dysfunction, epilepsy, brain hypoplasia, too small bladder volume, etc. However, enuresis caused by illness only accounts for a small proportion. Most children's bedwetting is related to mental factors, health habits, and environmental factors.
3. Sleep is very deep
Can't wake up in time to urinate.
4. Other
Some children are not trained in urination, such as long-term use of diapers, parents do not wake up the child at night, hold the child to the toilet to pee, and even some parents help them urinate while the child is lying in bed, causing the child to urinate during sleep. For a long time, it is prone to night bedwetting.
5. Bladder nighttime control ability developmental retardation
With the increase of age, the symptoms of night enuresis may improve, stop bedwetting, but it may take several years to stop nighttime enuresis, and even 1% of people continue to bed after entering puberty.
6. Environmental factors
Suddenly changing the environment, climate change is like cold. In addition, the child drinks too much water before going to sleep, eats watermelon and other fruits with more water content and diuretic effect. Parents who do not have the urine in time when the child has a good night will cause the child to wet the bed.
7. Can not produce enough control of urinary hormone ADH
In addition, there are 20 to 30% of children with nocturnal enuresis in sleep, the body can not produce enough to control the urinary hormone ADH, control of urinary hormone is a hormone naturally produced by the human body and can reduce the amount of urine.
Examine
an examination
Physical examination
The focus of the physical examination is the palpation of the abdomen, the examination of the genitals, and the examination of the nervous system. In addition, the appearance of the lower end of the spine should be observed for the appearance of pits and skin abnormalities. For example, there is an abnormality in urinating in the medical history, and the urination of the child needs to be observed. Most children with enuresis have no abnormal findings during physical examination.
2. Laboratory examination
Urine routine or urine culture examination should be performed to exclude urinary tract infections, chronic kidney disease, etc. Urine specific gravity excludes enuresis caused by vasopressin deficiency. The cause of most enuresis children is not complicated, but there are also a few cases that need Make a detailed examination, the laboratory inspection process for enuresis.
Diagnosis
Differential diagnosis
Differential diagnosis of enuresis in children:
1. Nervous system disorders: Enuresis is also seen in patients with dysplasia of the ankle and meningocele. Generally there is no difficulty in identification, but for some hidden patients, it is often easy to ignore. In addition to showing enuresis, this type of child often has weakness in the lower extremities. X-rays of the ankle and neurological examination often confirm the diagnosis.
2. Urinary tract infection: Urinary tract infection can induce enuresis. If the urinary tract symptoms disappear after treatment, the enuresis will disappear.
3. Urinary incontinence: Urinary incontinence is often caused by organic factors or structural abnormalities of the urinary system, such as phimosis, urethral stricture, and diabetes. Persistent urinary incontinence can be seen in bladder valgus, hypospadias, and ectopic ureteral openings. Ectopic ureteral openings are more common in girls, and their openings may be in the distal urethra and in the vagina.
4. Urinary tract obstruction: The most common site of urinary tract obstruction is the posterior urethral valve, which accounts for 50% of male neonatal urinary tract obstruction, often accompanied by non-inhibitory contraction of bladder detrusor, 25% of which have urinary incontinence . Common clinical symptoms are finer urine flow, urinary leakage from infancy, upper urinary tract dysfunction, urethrography and bladder examination can often make a diagnosis.
Diagnosis: According to reports, primary enuresis is the most common, especially nighttime enuresis is the most common, more common in boys, nighttime incontinence, about half of the bedwetting every night, or even 2 to 3 times per night of enuresis, excessive activity during the day, excitement After fatigue or physical illness, the number of enuresis is often increased, and daytime enuresis is less common. Children with enuresis are often accompanied by night terrors, sleepwalking, hyperactivity or other behavioral disorders.
