home Audience 4 Urinary incontinence in a 7-year-old boy. Nocturnal enuresis in children. What medications are needed

Urinary incontinence in a 7-year-old boy. Nocturnal enuresis in children. What medications are needed

It occurs much less frequently in school-age children: 20% of children aged five, 10% of children aged six and 3% of children aged 12. Thus, during middle adolescence, parents may want to seek help from a pediatrician to reduce or completely eliminate cases of urinary incontinence, or enuresis.

Urinary incontinence is defined as involuntary urination >2 times per month during the day or night.

Daytime incontinence (daytime enuresis) is usually not diagnosed until age 5 or 6; nocturnal enuresis - up to 7 years. Specialized Russian professional medical associations, as a rule, take the age of 5 years as the cut-off period for making a diagnosis of enuresis (editor's note). Until this time, nocturnal enuresis is usually called nocturnal enuresis. These age limits are set for children who are developing normally and therefore cannot be applied to children with developmental delays. Both nocturnal and daytime enuresis are symptoms, not a diagnosis, and require a search for the underlying causes.

The age at which children begin to hold in urine varies, but >90% of children are holding in their urine throughout the day by age 5 years. Nocturnal urinary retention occurs later. Nocturnal enuresis affects about 30% of children aged 4 years, 10% of children aged 7 years, 3% of children aged 12 years and 1% of children aged 18 years. Approximately 0.5% of the adult population continues to have episodes of nighttime urination. Nocturnal enuresis is more common among boys and in those with a family history.

In primary enuresis, children never develop urinary continence for >6 months. In secondary enuresis, children develop urinary incontinence after a period of voiding control of at least 6 months. Secondary enuresis most likely has an organic cause. Even when there are no organic causes, appropriate treatment of children and education of parents are necessary due to the physical and psychological impact of enuresis.

Pathophysiology of enuresis in children

The function of the bladder is carried out in 2 phases: storage and emptying. Deviations in any phase can cause primary or secondary enuresis.
During the storage phase, the bladder acts as a reservoir for urine. The capacity depends on its size and plasticity and increases as children grow. Plasticity may be reduced due to repeated infections or impaired urine output (obstruction), leading to hypertrophy of the bladder muscles.

During the emptying phase, bladder contraction is synchronized with the opening of the bladder neck and external urinary sphincter. If there is dysfunction in the coordination or sequence of urination, enuresis may develop. There are several causes of dysfunction. One example is bladder irritation, which can lead to irregular bladder contractions and asynchronous voiding sequences, resulting in enuresis. Bladder irritation can result from urinary tract infections or pressure on the bladder (such as a dilated rectum due to constipation).

Causes of enuresis in children

Urinary incontinence in children has different causes and treatment methods than in adults. Although some disorders cause both nocturnal and daytime enuresis, the etiology can vary depending on whether the enuresis is nocturnal or daytime, and primary or secondary. Most cases of primary enuresis are nocturnal and are not associated with an organic disorder. Nocturnal enuresis can be divided into monosymptomatic (occurs only during sleep and there are no other symptoms of urinary tract dysfunction) and non-monosymptomatic (other problems such as daytime enuresis and/or urinary symptoms are present).

Nocturnal enuresis. Organic disorders account for about 30% of cases and are more common in non-monosymptomatic enuresis than in monosymptomatic enuresis. The majority of the remaining cases are of unclear etiology but are believed to be related to a number of factors, including:

delayed maturation;
incomplete toilet training;
functionally small capacity of the bladder (the bladder is actually not small, but contracts when it is not completely filled);
increased urine production at night;
difficulty waking up from sleep;
family history (if one of the parents had nocturnal enuresis, the probability of its development in children is 30%; if both parents have it, the probability increases to 70%.

The development of organic causes of nocturnal enuresis is influenced by:

conditions that increase urine volume;
conditions that increase bladder irritability;
structural abnormalities (for example, an ectopic ureter, which can cause both nocturnal and daytime enuresis);
abnormal sphincter weakness.

Daytime enuresis. Common reasons include:

bladder irritability;
relative weakness of the detrusor muscle (making it difficult to suppress urinary incontinence);
constipation, urethrovaginal reflux or vaginal urination: girls who adopt an incorrect position when urinating (for example, with their legs tightly pushed in) or have excess skin folds may suffer from reflux of urine into the vagina, which subsequently comes out when standing;
structural abnormalities;
abnormal sphincter weakness (eg, spinal cord defect, (spinal cord pressure).

Urinary incontinence (enuresis) is usually not associated with physiological problems. But this problem causes a lot of trouble for both the child and the parents. It is uncomfortable for a child to wake up in a cold and wet bed, he feels embarrassed, especially if he is not sleeping in the room alone. And of course, this is an additional wash.

Enuresis usually occurs in boys and goes away during adolescence. The predisposition to enuresis is transmitted genetically through the father's line. You can consult a doctor, but you should not resort to surgery. In many cases, the problem can be solved by taking a number of preventive measures. Monitor what your child eats and drinks in the evenings, make sure the bedroom is warm enough, and so on.

Here are some factors that may cause a wet bed:

deep dream
liquid, fruit or cold foods before bed
excess consumption of stimulants such as cola and chocolate
food allergy
urinary tract infections
vaginal infections (in girls)
worms (for girls)
cold in the bedroom
weak kidneys or bladder

By ruling out these factors, you can learn what you need to pay serious attention to and take appropriate recommendations. You should not punish your child or express your dissatisfaction with him. It is better to concentrate on positive actions that will help strengthen the child and eliminate the problem.

In order for a child to stay dry throughout the night, the brain must stop a full bladder from emptying, or the brain signal must be strong enough to wake the child from sleep and direct him to the toilet. This is a complex neuro-evolutionary process in which the bladder must send a signal, the brain must receive it, and the child must respond by waking up and heading to the toilet.

There are various theories explaining the causes of bedwetting. Many parents fear that the problem is caused by a medical condition. In fact, no more than 1% of cases are associated with physical illnesses, such as kidney or bladder infections, diabetes, or congenital genitourinary disorders. In these cases, the child also experiences changes in the frequency and volume of urination during the day or experiences discomfort while urinating.

However, most cases of urinary incontinence are caused by delayed maturation of bladder control mechanisms, which is often associated with genetic factors. Such teenagers are physically and psychologically quite normal children.

In some cases, bedwetting is caused by emotional problems. For example, a child experiencing severe stress may develop enuresis, even though he previously always remained dry at night. Bedwetting can also develop in children who experience sexual or physical abuse.

Most school-aged children who suffer from bedwetting have primary enuresis, which means they have had the condition since birth and simply have not learned to control their bladder at night. These children are often predisposed to such problems due to similar disorders in other family members who were able to control their bladder, most likely after middle adolescence.

In most cases, a child will stop urinary incontinence at about the same age as his parent. Interestingly, if one twin develops bedwetting, the other twin will also begin to experience it, but fraternal twins (heterozygous twins with different genetic appearances) generally do not have this problem.

In some cases, parents begin to pressure the child to develop nighttime bladder control before his body is ready. Such parents may mistakenly believe that bedwetting is a deliberate act of protest by the child, so they may force the child to change his behavior. Your teen may feel discouraged and depressed if bedwetting continues. No matter how hard the child tries to change the situation, bedwetting is not under conscious control, and the child may feel frustrated and depressed because he cannot cope with the problem.

Parents of a child who experiences bedwetting need to be supportive and understanding of the situation. They should be sensitive enough to the child's embarrassment and discomfort about the problem. Your teen may be reluctant to stay over at a friend's house or go to summer camp, and may be afraid that friends might find out about his condition. Parents are able to convince the child that the manifestation of such a condition is not his fault and that the problem will be solved over time.

Assessment of enuresis in children

Evaluation should always include investigation for constipation (which may be a contributing factor to both nocturnal and daytime enuresis).

Anamnesis. The medical history includes the nature of the onset of symptoms (ie, primary, secondary), the timing of their onset (eg, at night, during the day, after urination only), and whether the symptoms are continuous (ie, constant leakage) or intermittent . Recording a urination schedule (urination diary), including time, frequency, and volume of urine, may be helpful. Important associated symptoms include polydipsia, dysuria, urgency, frequency, leakage, and tension. Posture during urination and urine pressure should be noted. Children with bedwetting can use certain movements to prevent leakage, such as crossing their legs or squatting (sometimes placing a hand or heel against their perineum). In some children, such manipulations increase the risk of developing urinary tract infections. As with a voiding diary, a stool diary can help identify constipation.

A review of systems should reveal symptoms that suggest a cause, incl. stool frequency and consistency (constipation); fever, abdominal pain, urinary dysfunction and hematuria; perianal itching and vaginitis (pinworm infestation); polyuria and polydipsia; snoring or breathing pauses during sleep (sleep apnea). Children should be assessed for the possibility of sexual abuse, which, although a rare cause, is too important to miss.

The life history should reveal known possible causes, incl. history of perinatal strokes or birth defects (eg, spina bifida), neurological disorders, kidney disease, and urinary tract infections. Any current or previous treatment for urinary incontinence and how it was actually prescribed should be noted, as well as a list of medications the patient is receiving.
The developmental history should include developmental delay or other abnormalities associated with voiding dysfunction.

A family history of bedwetting and any urological disorders should be noted.

In the social history, it is necessary to note any stress that arose in the period of time close to the onset of symptoms, incl. difficulties at school, with friends or at home; Although enuresis is not a psychological disorder, brief periods of leaking urine can occur during times of stress.

Doctors should also ask about the impact of bedwetting on the child because this also influences treatment decisions.

Medical checkup. The examination begins with an assessment of vital signs for fever, signs of weight loss (diabetes mellitus), and hypertension (renal disorders). Examination of the head and neck should include enlarged tonsils, mouth breathing, or growth retardation (sleep apnea). When examining the abdomen, any masses consistent with stool or a full bladder should be noted.

In girls, genital examination should note any labial adhesions, scars, or lesions suggestive of sexual abuse. An ectopic ureter is often difficult to diagnose, but should be looked for. In boys, examination should check for irritation of the urethra or any changes on the glans penis or around the rectum. Regardless of gender, the presence of perianal abrasions may indicate pinworm infestation.

The spine should be examined to identify any midline defects (eg, deep sacral dimple, sacral tuft). A complete neurological evaluation is important and should specifically focus on lower extremity strength and sensation, deep tendon reflexes, sacral reflexes (eg, anal), and in boys, the cremasteric reflex to identify possible spinal dysraphism. Rectal examinations may be useful to detect constipation or decreased rectal tone.

Red flags. Findings of particular concern:

signs or problem of sexual abuse;
excessive thirst, polyuria and weight loss;
prolonged primary daytime enuresis (after 6 years);
any neurological symptoms, especially in the lower extremities;
physical signs of spinal cord damage.

Interpretation of results. Typically, primary nocturnal enuresis occurs in children with an otherwise normal history and investigations and probably represents delayed maturation. A small percentage of children have a treatable disorder; sometimes symptoms suggest possible causes. In children who have been evaluated for nocturnal enuresis, it is important to determine whether daytime symptoms of urgency, frequency, changes in posture or performance, and urinary incontinence are present.

In daytime enuresis, impaired urination is suggested by intermittent enuresis, which is preceded by a sense of urgency to urinate, episodes of gambling, or a combination of both. Postvoid incontinence may also be part of the history.

Enuresis caused by urinary tract infections is accompanied by typical symptoms (eg, urgency, frequency, pain when urinating); however, other causes of enuresis may lead to the development of a secondary urinary tract infection.

Constipation should be considered in the absence of other symptoms in children who have hard stools and difficulty bowel movements (sometimes stool is palpable on examination).

Sleep apnea should be considered if there is a history of excessive daytime sleepiness and sleep disturbance; parents may report a history of snoring or breathing pauses. Rectal itching (especially at night), vaginitis, urethritis, or combinations thereof may be a sign of pinworm infestation. Excessive thirst, daytime and nocturnal enuresis, and weight loss indicate a possible organic cause (eg, diabetes mellitus). Stress or sexual abuse may be difficult to identify but should be taken into account

Survey. The diagnosis often becomes obvious after a history and examination of the child. Urine analysis and culture are indicated regardless of gender. Further evaluation is indicated when history, physical examination, or both suggest an organic cause. Ultrasound of the kidneys and bladder is often performed to confirm the normal structure of the urinary tract. Uroflowmetry can detect intermittent urination in patients with impaired urination.

Treatment of enuresis in children

The most important part of treatment is explaining to family members the causes and clinical course of enuresis. Education helps reduce the negative psychological impact of enuresis and leads to increased adherence to treatment.

Treatment should be directed to any identified cause; however, often the cause cannot be found. In these cases, the following procedures may be helpful.

Nocturnal enuresis. The most effective long-term strategy is bedwetting signaling. Although this approach is labor intensive, success can be greater than 70% if children are motivated to stop bedwetting and the family is able to adhere to the technique. Treatment may take up to 4 months of nighttime activities until symptoms disappear completely. An alarm is triggered when wetting occurs. Although children initially have episodes of leaking urine, over time they learn to associate the sensation of a full bladder with an alarm and then wake up to urinate before an episode of uncontrollable nighttime urination. These alarms are readily available online without a prescription. The alarm should not be used in children with complex nocturnal enuresis or children with reduced bladder capacity (as evidenced by a voiding diary). These children should be treated in the same way as children with daytime enuresis. This is necessary to avoid punitive approaches because this undermines treatment and only leads to low self-esteem.

Drugs such as desmopressin (DDAVP) and imipramine may reduce nocturnal wetting episodes. However, results are not sustained in most patients when treatment is stopped; parents and children should be made aware of this to help reduce frustration. DDAVP is preferred over imipramine due to rare cases of sudden infant death with the latter.

Daytime enuresis. It is important to prescribe treatment for the cause of constipation. Information from a voiding diary can help identify children with reduced functional bladder capacity, frequency, urgency, or infrequent voiding, which may be associated with urinary incontinence.

General measures include:

exercises to control urinary urgency. Children are sent to the bathroom as soon as they feel the urge to urinate. They then hold the urine in for as long as they can and begin urinating only when they can no longer hold it in, and then alternate between holding in and starting to urinate again. This exercise strengthens the sphincter and gives children confidence that they can urinate in the bathroom before it happens accidentally;
gradual prolongation of urination intervals (if detrusor instability or dysfunctional urination is suspected);
behavioral changes (eg, urinary retention) through positive continence and scheduled voiding (void timing). Children are reminded to urinate by a watch that vibrates or beeps (preferably, parents remind them);
Using proper urination techniques to prevent urine retention in the vagina. In girls suffering from vaginal filling with urine, treatment consists of stimulating urination while sitting facing the wall on the toilet or with knees wide apart, which will widen the vestibule and allow direct flow of urine into the toilet.

For labia fusion, conjugated estrogen or triamcinolone 0.5% cream can also be used.

Drug treatment is sometimes helpful but is generally not first-line treatment. Anticholinergic drugs (oxybutynin and tolterodine) may benefit patients with daytime enuresis due to voiding dysfunction. Medications for nocturnal enuresis may be useful in reducing nighttime episodes of leaking and sometimes promoting dryness during nighttime events such as the transition to sleep.

How to deal with enuresis in children

Reassure your child that bedwetting symptoms will subside with age. However, until the natural process of maturation occurs, there are several ways to help your child.

Strengthening the bladder. The muscle that relaxes during the act of urination is called the urethral sphincter. The sphincter can relax voluntarily or involuntarily, and there is a simple exercise that can help strengthen it. This is a Kegel exercise, named after the doctor who demonstrated its effectiveness. Exercise is beneficial for everyone and helps cope with incontinence. If you teach this exercise to young children, they are more likely to avoid problems in the future.

Explain to your child what a sphincter is and tell him that by tensing this muscle, you can stop the stream of urine and then start it again. Daily exercise, whether while urinating or just because, significantly improves bladder control. At first, the child should do the exercise 10 times a day. If your child wets the bed, let him increase the number of repetitions to 50 times a day. Each muscle contraction must be held for 5 seconds. You can imagine that this muscle is an elevator that rises inside the body through floors, reaching the fifth floor, and then descends again to the first. Let your child try this exercise at night before bed.

Strengthening the kidneys. Enuresis may be associated with kidney weakness. A child with weak kidneys often catches colds, has cold hands and feet, a pale complexion, increased fatigue and poor appetite. To strengthen the kidneys, you need to provide warmth to your baby, especially in the kidney and bladder areas. Here are some ways to do this:

Cloth. Keep your baby's lower back and belly warm. He needs to wear warm cotton underwear. A long wool vest or sweater will provide additional protection from the cold.
Don't drink at night. Your child can drink as much fluid as he wants in the first half of the day, but do not encourage drinking after 5 pm.
Psychological help. Sometimes enuresis is associated with emotional and psychological reasons. For example, a 4-5 year old child may start wetting the bed after the birth of a second child in the family. In this way, he tries to return to infancy and receive additional attention from his parents. The cause may also be problems at school or at home, when the child is stressed and hides fear or resentment. For boys in such cases, a good relationship with their father is very important. Consulting a psychologist may also be helpful.
Warming up. Certain areas of the body can be warmed using a lit moxa stick (a kind of cigar made from Chinese mugwort). When used correctly, heat penetrates without burning. This is a simple and effective method that tones the kidneys and bladder.

“Moxa” heating technique. You may be able to find moxa sticks at pharmacies or stores offering Chinese remedies.

Remove the outer paper wrapper from the stick. The procedure should be carried out in a well-ventilated room, but not in a draft. Light the tip of the stick and wait for a red glow to appear. Sometimes you have to blow on a stick to achieve the desired result.
Place your child on the bed and place an ashtray nearby for easy disposal of ashes.
On the stomach, you need to warm up an area in the shape of an isosceles triangle, the apex of which is above the pubic bone, and the base is under the navel. The heating zone is as wide as the child’s palm. The corresponding triangle on the back is located above the sacrum.
Open the area to be warmed. Hold the stick in your hand like a pencil, 3-5 cm from the surface of the skin, making circular movements with the burning end over a small area of the selected area. Don't touch your skin! To avoid burns, the burning end should be at least 2.5 cm from the surface of the skin. From time to time, shake the ashes into the ashtray.
When your child tells you that this area is getting warmer, move on to the next small area. This way you need to warm up the entire area. The skin may turn pink, but not red!
To stop the stick from smoldering, insert it into a special case, lower it into the sand, or hold the burning end under running water.

Never perform a moxa stick treatment unless your patient can clearly tell when the skin will become hot. These patients include: small children who cannot yet speak, those who are sleeping or unconscious, as well as those who are taking painkillers. Warming up can be carried out for many months, especially during the cold season. Do not use this method if your child has an infection.

Seeking help for bedwetting in children

If your child has primary enuresis, you may want to discuss the problem with your pediatrician to better understand the problem and make sure it is normal.

If a child develops enuresis after previously remaining dry at night, he or she should be seen by a pediatrician. This may serve as a signal that the condition is associated with illness or psychological stress in the child.

In some cases, especially if the child is experiencing emotional stress due to bedwetting, the pediatrician may perform a physical examination, take a urine test, and review the child's entire developmental history. Your doctor may also recommend one or more of the treatments described below.

Drug treatment

Because primary enuresis usually goes away on its own as the child gets older, some doctors worry that drug dependence may involve more risks (due to side effects) than benefits.

If doctors do prescribe medications, most often they opt for imipramine. This is a tricyclic antidepressant taken before bed; approximately half of the children perceive it well. Other children taking the drug may not have any response or may experience a relapse after some noticeable improvement.

Ask your pediatrician about the side effects of imipramine. Some children taking the drug experience drowsiness, dry mouth, weight gain, sometimes dizziness, difficulty concentrating, or trouble sleeping. In rare cases and when taking the drug in large doses, heart rhythm disturbances may occur.

Sometimes doctors prescribe a drug called DDAVP (desmopressin). It is an antidiuretic hormone that reduces the amount of urine excreted by the kidneys. DDAVP is inhaled through the nose before bed and helps some children avoid bedwetting. This is a fairly expensive treatment that is best used on special occasions, such as staying overnight with friends or grandparents, or during a summer camp.

Use herbs to improve the tone of the urinary system and reduce the child's anxiety, which often occurs with bladder control problems. For optimal results, use the following remedies for several months. There are several Chinese recipes to improve kidney function. Since these special recipes take into account your child's body type and symptoms, you will have to consult a Chinese medicine specialist.

Tonic to strengthen the bladder muscle. This is an effective remedy that strengthens the muscle reflex and increases the tone of the bladder.

1 tablespoon St. John's wort tincture
1 tablespoon kava-kava tincture
1 tablespoon mitchella tincture
1 tablespoon of snakeweed tincture

Mix all ingredients in a dark glass bottle. For children from 5 to 9 years old, give 1/2 teaspoon, for children over 9 years old - 1 teaspoon 2 times a day.

Infusion for the treatment of urinary tract. For irritation and inflammation of the urinary tract, you can give your child an infusion of marshmallow and licorice roots every day. (If your child has adrenal problems or high blood pressure, substitute burdock root for the licorice).

1/2 tablespoon marshmallow root
1/2 tablespoon licorice or burdock root
1/2 liter cold water

Place the roots in a glass jar. Add water, cover and leave for 1 hour. Strain. Give 1/4 to 1 cup 3 times daily for 4 weeks.

Psychotherapeutic assistance

If bedwetting is caused by stress or causes emotional distress, psychological interventions to address bedwetting may be helpful. Hypnosis can sometimes help children gain more control over bedwetting. Proponents of the use of hypnosis as a treatment for bedwetting claim that they have achieved a cure in 75-80% of cases. Although it is known that hypnosis is quite safe, and most often effective, the mechanism of its action has not yet been studied.

Fortunately, bedwetting will decrease each year as the child's body matures; Most children stop bedwetting before they reach adolescence.

Daytime and nighttime urinary incontinence in children can occur for various reasons of a pathological or physiological nature. The deviation is not uncommon and often manifests itself even at 6 or 7 years of age, sometimes older. Enuresis is characterized by a frequent urge to urinate that occurs during the day or at night. If violated, the baby suffers from constant discomfort. It is best to consult a doctor to find out what the sources of the childhood disorder are and whether special treatment is required.

Control of urination in children should occur by the age of 4, otherwise the presence of enuresis can be stated.

Features of enuresis in childhood

What types are there?

Urinary incontinence in girls and boys is diagnosed only after the age of 4, when the child is already able to control the process of urination. Cases of daytime or nighttime enuresis that occur earlier should not be regarded as a pathology, since the child’s body cannot yet control and stop the release of urine in a timely manner. It is customary to divide urinary incontinence into several types, which are presented in the table.

Classification	View	Peculiarities
With the flow	Isolated	There is no daytime enuresis and child incontinence occurs only at night
With the flow	Combined	Pathology worries you at any time of the day
Based on the presence of clinical manifestations	Monosymptomatic	Apart from uncontrolled urine output, no other symptoms occur
Based on the presence of clinical manifestations	Polysymptomatic	Characterized by additional manifestations associated with urological, psychological or other disorders
By etiology	Primary	Occurs in early childhood and is not associated with stress factors
	Primary	There is no period without nocturnal enuresis
	Secondary	Manifests itself in psychological disorders, against the background of various diseases

Sometimes imperative urinary incontinence is recorded in children 8 years of age and older, in which the disorder is periodic in nature, and urine leaks slightly when the desire to urinate arises.
What are the reasons for the deviation?
From early childhood, children are taught to go to the potty and control the urge to urinate. But sometimes parents find a few drops on the baby’s panties or a puddle on the floor. The problem does not always indicate a disease. We can talk about pathological incontinence only when it becomes systemic. In this case, the following causes of enuresis in girls and boys are distinguished:

Enuresis in children develops against the background of genetic disorders, diabetes, worms, and stress.
Genetic predisposition and hereditary factor. When deviated, more or less vasopressin is produced. The likelihood of developing childhood pathology increases by 80% if both parents suffer from enuresis.
Reduced functional bladder capacity. If the volume of the internal organ is insufficient, the urine produced at night is not able to be retained, so daytime leakage is observed.
Abnormalities in the urinary system. Congenital diseases or acquired inflammatory processes in the kidneys or bladder can contribute to the development of enuresis.
Neurological disorders. With delays in the development of the nervous system, the baby’s late control over the urinary process is noted. Epilepsy and disorders in the brain of an infectious or organic nature can often contribute to the development of urinary incontinence.
Psychiatric diseases. Children with schizophrenia or intellectual disabilities often suffer from daytime enuresis.
The influence of psychological factors. Regular physical and emotional stress, stress, and depression become the source of urinary incontinence in a child 3 years of age and older.
Chronic constipation.
Diabetes mellitus of various types.
Helminthiasis.

What causes neurotic enuresis?
Childhood neuroses, nervous breakdowns and other disorders of a similar nature often provoke urinary problems. Daytime urinary incontinence is often observed in children who have lost a loved one, whose parents are divorcing, and other negative moments in life. Increased stress, leading to overwork of the body, can affect neurotic enuresis in girls and boys.
When treating such a disorder, it is first of all necessary to rid the child of negative influences. Psychologists and psychotherapists can help you cope with daytime incontinence.
Additional symptoms

Enuresis in children is often accompanied by indigestion, insomnia, and irritability.
Pathological daytime urinary incontinence in children will be accompanied by other signs. So, with a urinary tract infection, the baby may complain of painful urine output, and parents may notice unusual discharge from the genitals. Additionally, the following symptoms appear:
the occurrence of irritation on the epidermis of the external genitalia;
broken stool;
general weakness and fatigue;
constantly anxious state;
disturbing sleep (if manifested);
isolation and shyness;
development of various phobias.

How to diagnose a disorder?
Parents can detect symptoms of urinary incontinence in children on their own, but it is worth seeking medical help to determine the cause of the deviation. The doctor will examine the little patient and question him for the presence of pathological signs and pain. It is important to clarify exactly when enuresis manifests itself, whether the child has been exposed to stress, and whether the parents suffer from such a disorder. After collecting anamnesis, the doctor will prescribe laboratory and instrumental procedures:
general and bacteriological urine analysis;
blood test for sugar and vasopressin levels;
ultrasound diagnostics of urinary organs;
uroflowmetry;
cystoscopic examination;
excretory urography;
cystourethrography;
electroencephalography.

Effective treatment of urinary incontinence in children

What medications are needed?

For childhood enuresis, the doctor may prescribe antidepressants, drugs that affect the functioning of the bladder.
Daytime urinary incontinence in children requires timely detection and conservative treatment. The doctor may prescribe tablets for enuresis and other medicine that normalizes the urinary process. It is strictly forbidden to treat yourself and use any drug without a doctor’s prescription. The table shows the most used medications that can be used to cure the problem of urine retention in children.

Is it possible to treat with folk remedies?
It is possible to use unconventional methods for treating enuresis in children, but you should first consult a doctor.
For enuresis in children, you can additionally use traditional medicine recipes.
If you try to get rid of the problem yourself using natural ingredients, you can worsen the situation. At home, you can prepare herbal decoctions and tinctures that help eliminate daytime enuresis in boys and girls. They are most often treated with the following folk remedies:
Dill seeds. Use 1 tbsp. l. main component and 250 ml of boiling water. Allow the medicine to stand for 60 minutes, then take it orally according to the following scheme: for children under 10 years old, half a glass, for older patients, 250 ml. Therapy lasts 10 days, and the infusion is drunk before eating.
St. John's wort. A decoction is prepared from the herb using 2 tbsp. l. product and 200 ml of boiled water. Place the product on the fire for 10 minutes, then consume a whole glass orally before going to bed.
Honey. Every day eat 1 tsp. a beekeeping product that helps retain fluid well and calms the nervous system.

The child’s inability to control the process of urination is initially considered a minor nuisance for many parents. But when they realize that their child has already grown beyond the age to “wet his pants”, and the problem remains, they begin to seriously worry about the health of their child. Urinary incontinence in children or enuresis is a condition in which involuntary emptying of the bladder occurs at night or while awake. According to medical indicators, about 15% of children aged 5 to 10 years suffer from urinary incontinence. The causes of this condition can be hidden both in the physiological immaturity of the bladder, and manifest themselves against the background of internal diseases or as a result of psychotraumatic factors.

By the age of four, children develop control over urination, which is why doctors do not consider urinary incontinence a disease until this age. In cases where a child is 5–7 years old and urinates periodically or regularly, the doctor makes a diagnosis of enuresis, the causes of which can be very different.

Urinary incontinence in a child: causes

Urinary incontinence in children - causes and treatment differ significantly from adults, since the epidemiology of this condition is often based on organic and neurological factors. Uncontrolled urination in children can occur both during the day and at night, so when making a diagnosis, the doctor makes a diagnosis of nocturnal or daytime enuresis. Many parents, faced with urinary incontinence in a child, are sure that the cause is some infectious disease, but this is not always the case, since in 70% of cases, childhood enuresis is psychological in nature. Among the main reasons that can provoke urinary incontinence in a child are:

bladder immaturity;
delay in child development;
frequent or recurrent stressful situations;
feeling of fear;
sound sleep, difficulty waking up;
heredity;
congenital pathologies of the urinary system;
congenital pathologies of the spinal cord;
kidney infections;
immaturity of the nervous system;
epilepsy;
attacks of apnea during sleep;
endocrine diseases;
side effects of certain medications.

Quite often, urinary incontinence in children occurs against a background of stress, when the child experiences severe fear of something or suffers due to problems at school, kindergarten, divorce or quarrels between parents. In such cases, we can say that the child has stress urinary incontinence, which does not require special drug therapy, but without consulting a psychotherapist and eliminating the factors that cause such a symptom in the child, it is difficult and almost impossible to solve the problem.

Often children are not able to control the process of urination during active games, coughing, sneezing or laughing. Usually during this period, children feel a strong urge to urinate, but do not have time to run to the toilet. In such cases, it is difficult to identify the cause, since it may be associated both with weak bladder muscles and with the fact that children are in no hurry to go to the toilet at the first urge, and with any relaxation of the pelvic muscles, they do not have time to run to the toilet. In each case, the cause of urinary incontinence must be considered individually, taking into account the child’s body.

Types of enuresis in children

Daytime enuresis - manifests itself in connection with disturbances in the functioning of the cerebral cortex during wakefulness. This disorder is typical for those children who are often overworked, suffer from emotional exhaustion, or have a history of urological infectious diseases. In such children, urination most often occurs during some activity, as well as urinary incontinence when coughing or laughing, when there are no signal urges and the child cannot control the process itself.

Nocturnal enuresis. It is considered most common among children and is characterized by a lack of control over the urge to urinate at night. Most often, boys suffer from nocturnal enuresis. The reasons for this condition are most often associated with psycho-emotional disorders: resentment, fear, quarrels with peers, troubles at school and other traumatic circumstances that negatively affect the child’s psyche. If only bedwetting is noted, it is often called monosymptomatic.

In the urological practice of doctors, it is not uncommon to encounter neurotic enuresis, which is associated with various fears of the child. Such children may stutter, be withdrawn, and have changeable moods. This type of enuresis is treated by a psychologist, but the parents of such a child also need professional advice from a specialist.

How to treat urinary incontinence in a child

Before treating urinary incontinence in a child, the underlying cause must be identified. Usually the child does not need hospitalization, so treatment is carried out on an outpatient basis. The only exception is if the cause of this condition is associated with infectious diseases of the kidneys or bladder, then the child requires hospital treatment.

To solve the problem of urinary incontinence in a child, it is often necessary to consult several specialists: a pediatrician, a pediatric urologist, a nephrologist, a psychologist, who can more accurately determine the cause and prescribe the necessary therapeutic measures to eliminate it. A child who suffers from urinary incontinence may be prescribed medication, massage, physiotherapy, folk remedies or sessions with a psychologist. Only an integrated approach to solving the problem will allow you to get rid of an unpleasant symptom, thereby restoring confidence to the child and peace of mind to the parents.

Drug treatment of enuresis in children includes taking medications that reduce the volume of urine and normalize the functioning of the bladder. Any medicine must be prescribed by a doctor. Most often, a specialist prescribes Adiuretin-SD nasal drops, Driptan tablets, antidepressants (Novopasit, Persen) and others. It is also recommended to take vitamin complexes and multivitamins: Multitabs, AEvit, Pikovit. During treatment, the child is recommended to visit a psychologist who can determine whether the cause of urinary incontinence is related to the child’s psychological trauma. To cure urinary incontinence in a child, you can use traditional medicine, but only after consulting a doctor.

Good results can be obtained by taking herbal decoctions of St. John's wort, blueberries, and lingonberries. Traditional medicine in the treatment of urinary incontinence in children can only act as an auxiliary therapy to the main treatment. Often the child does not need medical therapy at all. It is enough to normalize his sleep and wakefulness patterns, reduce fluid intake or periodically remind him of possible urges to go to the toilet.

Parents who are faced with the problem of urinary incontinence in a child often blame him, try to scold and shame him in the presence of other children, thereby further aggravating the situation and making a huge mistake. The fact that a child is not able to control the process of urination is often their own fault, since they often create an environment that negatively affects the child’s psychological state.

In order to solve the problem of urinary incontinence in children, adults need to adhere to the following recommendations:

You should never punish or scold a child for waking up wet.
There is no need to put a diaper on your child at 4-5 years of age.
Limit fluid intake before bed.
Be sure to take your child to the toilet before bed.
Remind your child during the day to go to the toilet.
The child should go to bed no later than 21.00.
There is no need to wake the child during sleep to empty the bladder.
Praise your child for dry nights or days.
If you suspect any infectious disease, you should immediately consult a doctor.
There is no need to self-medicate.
Give your child more attention.
There is no need to involve children in family conflicts or scandals.

Children are more susceptible to all sorts of diseases and disorders in the functioning of organs and systems than adults. Enuresis, or urinary incontinence, is one of the disorders of the body that occurs most often in children aged 3.5 - 7 years.

Boys suffer from this about three times more often than girls. This problem can occur both at night and during the day. But in babies, as a rule, involuntary urination occurs at night. This type of urinary incontinence is more difficult to treat, but it is still possible to even treat enuresis in children with folk remedies.

Adults should be aware that children at different ages learn to empty their bladder on their own. At approximately two years and six months, 50% can control this process during the day; after four years, 89% are able to do this. But at night, control is possible later.

69% of children have developed this skill by the age of 3.5, but only by the age of 10 is it fully functional in 89% of children. Therefore, only after five years are people talking about enuresis as a pathology.

Causes of enuresis

Urinary incontinence can occur in children under the following circumstances:

the presence of acquired or congenital mental illnesses that occur in severe form;
disorders of the spinal cord or brain;
completely unfinished development of the genitourinary system;
severe psychological or physical trauma received;
surgical operations;
long-term use of diapers;
disturbance of water-salt balance in the body;
damage due to birth trauma of the brain centers that are responsible for the urinary system.

The famous pediatrician, Dr. Komarovsky, many times drew the attention of parents to the fact that enuresis cannot be classified as a disease. He claims that this is just one of the steps in the development of the child’s body’s control over physiological processes. That is why this problem is dealt with by doctors from different fields: psychologists, nephrologists, pediatricians, pediatric neurologists, endocrinologists, physiotherapists and specialists who specialize in homeopathy.

Main forms of enuresis

Simple form. It manifests itself in relatively infrequent, but at the same time regular cases of enuresis - from 2 to 4 times over 7 days. The child sleeps soundly, and involuntary urination occurs until two in the morning. Children are indifferent to this problem, and the cause, as a rule, is a hereditary predisposition.
Neurotic form. This type of enuresis is wavy in nature and does not occur very often (during critical age periods - 3, 5, 7 years). Children have an extremely negative attitude towards what is happening to them. In the face of “trouble,” children’s fears, crying for no reason, tics, nervousness, and emotional agitation are observed. Children have restless sleep.
Endocrinopathic form. It occurs at night and is combined with some pathological processes: fever, obesity, diabetes.
Epileptic enuresis occurs in children diagnosed with epilepsy. When urinating, a large amount of urine comes out.
Neuropathic enuresis. This type occurs both during the day and at night against a background of severe nervousness, which appears due to frequent colds, minor changes in the peripheral or central nervous system. In this case, sleep disturbances very often occur.
Dysplastic nocturnal enuresis occurs in both adults and children. The frequency of manifestation is directly related to the amount of liquid that the baby drinks during the day. Children treat what is happening either indifferently or adequately, without showing any special emotions.

What should parents know?

Many parents are of the opinion that it is better not to focus the child’s attention on the problem that has arisen in order to avoid mental trauma. This position is not entirely correct, since avoiding the problem cannot solve it, but only aggravates it.

How can the closest people help a child and what should they not do?

How is enuresis treated in children at home?

Parents are interested in a natural question: “How to treat enuresis in children?” Traditional medicine offers a large number of recipes, so loved ones must be patient and, through trial and error, find exactly the one that will help their baby.

What's prohibited?

The baby does not need to be given fruits, juices and sweet drinks after 17.00. It is necessary to reduce the consumption of vegetable oil. Watermelons, grapes, celery, and asparagus should be removed from the diet. When the problem goes away, the child can eat these foods.

Herbs help

Dill seed. Brew one tablespoon with a glass of boiling water, then let it brew for 60 - 80 minutes. Take in the morning on an empty stomach. Children aged 10-15 years should drink the entire glass, children under 10 years old should drink half a glass. Treatment should be continued for 10 days. In case of advanced enuresis, you must also take a break for 10 days, and then repeat taking dill seed.
The collection method gives a good effect, which includes the following crushed ingredients in equal proportions: knotweed, yarrow and St. John's wort, blackberry leaves, immortelle flowers. To prepare the infusion, you need to take 10 grams of the collection, pour it into a thermos and pour 320 ml of boiling water, leave for 3 hours, then strain. Give children 25 minutes before meals, half a glass up to 5 times a day. The last dose should be one and a half hours before bedtime.
St. John's wort and centaury, taken in equal proportions, are brewed and drunk like tea.
Powder obtained from psyllium seeds, should be given to children 3 to 4 times a day, two grams (at the tip of a knife).
Dry lingonberry leaves, take half a glass, pour ½ liter of boiling water, boil for about 6 minutes, leave for 45 minutes, strain. For a month, give children a glass of decoction 3 times a day before meals. A child taking it will urinate frequently during the day, but will be guaranteed a restful sleep at night.

Other methods

Honey will help. At night, the child should be given a teaspoon of honey, which has a calming effect on the body and also retains fluid. This reduces the load on the kidneys and controls the child’s urination.
We use aromatherapy using sage or coriander or lavender essential oil. This normalizes the state of the nervous system and relieves the baby of enuresis. To do this, take 35 ml of water and dissolve 4 - 5 drops of essential oil in it, and then spray it in the room where the child sleeps at night. Aromatherapy is carried out for 21-22 days in a row.
Compress on the lower abdomen. For the procedure, you need to soak a towel in hot ginger water, which is obtained from ginger juice squeezed into boiling water.
Massage of the reflex areas of the skin located on the soles of the feet has proven itself to be excellent. The child can do the massage independently. You just need to buy him a massage mat on which he will happily stomp. Or you can offer to play by rolling small balls with your feet.
Among the methods of traditional medicine, there are also healers who offer special spells and prayers to get rid of enuresis.

Parents need to remember that traditional medicine recipes can be used after consultation with a pediatrician and only if the child does not suffer from allergic reactions to honey and medicinal herbs.

Prevention of urinary incontinence in children

To protect children from such troubles as enuresis, parents should remember that

it is necessary to eliminate diapers in a timely manner;
you should monitor the amount of liquid that the child drinks throughout the day;
children need to be taught sanitary and hygienic skills;
if necessary, consult a doctor promptly for treatment of genitourinary tract infections;
You should avoid wearing tight panties;
It is necessary to prevent situations that traumatize the child’s psyche.

To summarize, it should be noted that love and understanding of loved ones are the key to a successful fight against childhood enuresis.

Video: Doctor Komarovsky on the treatment of enuresis in children

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Bedwetting or daytime urinary incontinence is a common, unpleasant and very traumatic problem. The child’s psyche can suffer significantly due to such “surprises.” The parents’ task is to quickly help the child cope with enuresis without aggravating the situation, without scolding him for a wet bed. Folk remedies that have been tested by time and many generations of now adults will come to the rescue.

Symptoms and signs

Bedwetting can have many causes, both congenital and acquired. Underdevelopment of the bladder, overwork, hypothermia, infectious diseases, psychological and neurological problems. Not the least of the causes of enuresis is lack of normal nutrition.

Usually the baby pees either closer to midnight or in the morning. In the first case, the bladder relaxes excessively when falling asleep, in the second, it is quite strong and, as it fills, does not expand to the full extent necessary, as a result, there is an uncontrolled release of fluid naturally out. Quite rarely, enuresis occurs during the daytime, during the midday nap.

Most often, children suffering from enuresis sleep much more soundly than others. And usually they don’t remember in the morning what happened at night. You can wake them up in the middle of the night, although this is quite problematic, and put them on the potty, but the result will be unchanged - the baby will not pee until he is back in his bed.

When are traditional methods not enough?

If incontinence is caused by tumor processes and dysfunctions of the central nervous system.
If enuresis is a consequence of more serious causes associated with inflammation of the bladder and kidney diseases.
If the inability to control the bladder is hereditary.

The children's doctor in this program will talk about childhood enuresis, as well as if the cause of “wet panties” is neurological in nature.

Effective folk remedies

A cotton swab on the back. Take a small piece of cotton wool, wet it with warm water and run it along the child’s spine from top to bottom (from the base of the neck to the tailbone) several times. Then put a dry T-shirt on him and send him to bed. Such an incredible and inexplicable, from a medical point of view, method works very well. In most children, enuresis disappears within the first 2-3 days. The method is effective for incontinence caused by nervous shock and stress.

Dill seeds. Brew a tablespoon of dry dill seeds in a glass of boiling water. Leave for at least 2-3 hours, then give children half a glass in the morning before breakfast on an empty stomach, and children over 10 years old – a whole glass.

Lingonberry leaves and berries. Brew dried lingonberry leaves (about 50 grams) in half a liter jar of boiling water. Then you should boil the liquid for 10-15 minutes. Infuse, cool and strain. It is advisable to give this drink to your child in the morning on an empty stomach, and then half an hour before meals each time. The total number of daily doses is no more than 4. A single dose depends on age. Children are usually given half a glass, older children – a whole glass. As a result, during the day the child will visit the toilet somewhat more often than usual, and at night his bed will remain dry.

Lingonberries are great for making fruit drinks, which should be given 2-3 times a day, but not before bedtime.

Honey therapy. If the baby pees at night, then before going to bed he can be given a teaspoon of honey, of course, if the child does not have allergies. This bee product soothes, relaxes the nervous system and retains moisture. Gradually, the evening dose of honey should be reduced as the child recovers.

Parsley root. Chop the dried parsley root and make a decoction. Let it sit for about an hour. The child is given this drink 2-3 tablespoons per day with the last dose at least five hours before going to bed.

Hardening. Fill the bathtub or basin with enough cold water to submerge just the child's feet up to the ankles. Let the baby trample in cold water until he starts to freeze. Then place him on a massage mat or a regular hard bathroom mat and let him walk on it until his feet are warm. It is better to carry out the procedure in the morning.

Physiotherapy. Try to make gymnastics a mandatory exercise in your baby’s daily routine. Add to it exercises related to strengthening the muscles of the perineum - walking on the buttocks. While sitting on the floor, ask your baby to move forward, pushing only with his buttocks. First forward and then back.

Warm compresses with ginger water. Grate the ginger, squeeze the juice out of the resulting mass through cheesecloth and mix with a glass of boiled water, which has cooled to 60-70 degrees. Gently dip the edge of a towel into it and apply it to the lower abdomen, in the area of the bladder, until the skin in this area turns red. Such warming with ginger juice perfectly relaxes a tense bladder and is no less effective at strengthening an overly relaxed organ.

Bread and salt. Half an hour before bedtime, let your baby eat a small piece of bread sprinkled with salt. In the same way, children are given small pieces of salted herring.

Plantain leaves. 20 grams of dry plantain leaves should be brewed in a glass of boiling water, let it brew thoroughly, strain and give the resulting liquid to the child 2-3 times a day.

Onion-honey mixture. Grate one onion and mix the resulting pulp with a tablespoon of flower honey and half a green apple, grated on a fine grater. Give the mixture to your child for about two weeks, a tablespoon before each meal on an empty stomach. The mixture cannot be stored; it must be prepared anew before each use.

Lavrushka. Boil three large bay leaves and simmer for half an hour in a liter of water. Cool, let it brew well and let the child drink the resulting decoction 2-3 times a day, half a glass, for a week.

Thyme and yarrow. Take equal parts of dried pharmaceutical herbs and brew as tea. Give your child food 2-3 times a day, one tablespoon at a time. Children over 8 years old can be given a quarter glass.

When is specialist help needed?

If bedwetting is accompanied by frequent daytime trips to the toilet and complaints of painful urination.
If the child complains of pain in the lower abdomen, side or pulling sensation in the lower back.
If enuresis begins to recur in a child over 10 years of age.

What can't you do?

Some parents and healers advise using elements of hypnosis to treat childhood enuresis. In the stage of paradoxical sleep (when the baby has not yet fallen asleep, but is no longer awake, his eyes are stuck together), the child is given certain verbal suggestions and instructions. Experts categorically do not recommend that untrained people use any tools from the arsenal of psychotherapy. At best, this will have no effect; at worst, it will negatively affect the baby’s psyche and nervous system.
You should not begin treatment for incontinence without consulting your doctor. The cause of enuresis must be found, because incontinence can be a manifestation of serious and dangerous diseases of the urinary tract, disturbances in the production of the antidiuretic hormone, and delayed development of the central nervous system.
Enuresis cannot be ignored and taken lightly. Yes, yes, there are also parents who claim that bedwetting is an age-related and temporary phenomenon that will go away on its own. If you do not provide the child with timely medical care, enuresis threatens to result in severe hysteria, mental disorders, prolonged depression and the formation of a persistent inferiority complex in the child. And if you “overlook” the beginning inflammation in the urinary tract, the infection can develop into a chronic form, become complicated, and then you will have to be treated for the rest of your life.

Adviсe

The country's leading pediatrician, Dr. Komarovsky, will tell us everything in detail about such a delicate topic as childhood enorezia, the causes of its occurrence and how to deal with it.

Urinary incontinence is not uncommon in childhood; boys are more likely to suffer from it. Treatment of enuresis in children with folk remedies is very popular. It is used together with traditional methods, as well as for prevention purposes.

Advantages of treating enuresis in children with folk remedies

There are many time-tested recipes suitable for use at home for urinary incontinence (incontinence) in a child. Parents will have to be patient, since choosing exactly the method that will help the baby may not be possible right away.

If a child has enuresis, it is necessary to bring him to an appointment with a pediatrician so that a specialist can prescribe an examination, identify the cause and select an effective treatment. But even doctors themselves often advise turning to traditional methods to eliminate pathology.

Herbal medicine uses only natural ingredients, which is good for the child’s body, but treatment can take a long time.

To treat enuresis, plants are used that have a positive effect on the nervous and cardiovascular systems. They are equally useful for both men and boys, and women and girls.

Useful plants for enuresis

Various herbs and folk remedies for enuresis are relatively safe and give a minimum of adverse reactions. Medicinal mixtures include plants that have soothing and anti-inflammatory properties.

The herbal mixtures include the following components:

In addition, in folk recipes to combat enuresis in boys, licorice, chamomile, blackberry, knotweed, rose hips, flaxseed, and dill are used. Various decoctions and tinctures are prepared from them, and although the treatment of urinary incontinence with folk remedies takes a long time, the first results will not be long in coming.

Recipes for popular folk remedies for enuresis

Alternative medicine offers many treatment options for urinary incontinence in children. To remove such an unpleasant symptom as incontinence, the following methods are used.

Bearberry tincture

The crushed leaves of the plant are brewed in boiling water at the rate of: 2 teaspoons of dry extract per 1 glass of water. Next, the infusion needs to stand for about 30 minutes, and only then can it be strained. Take herbs three times a day, 15 ml.

Oxalis infusion

For cooking, you only need the leaves of this plant. They have a therapeutic effect. Oxalis - 20 grams of crushed leaves - is steamed with two glasses of boiling water and left for 1 hour. After the tea leaves have settled, filter the tincture and consume one tablespoon 3 times a day.

The plant is poisonous!

It is important to strictly follow the recipe to avoid poisoning. Treatment of enuresis with folk remedies will be safe only if you follow all the recommendations described in the recipes!

Rosehip infusion

This traditional medicine is effective for disorders of the urinary system. It is used by both adults and young people. Due to its natural composition, the tincture is also recommended for the treatment of enuresis in children.

To prepare, you need to grind the rosehip roots into powder and pour boiling water at the rate of 1 tablespoon per glass. You need to infuse the product for at least 8 hours, then strain and take 100 ml three times a day before meals. The course of treatment takes a month. The infusion can also be taken in a smaller dosage for prevention.

Millet infusion

The grains must be cleaned and washed thoroughly. Pour boiled warm water over the millet and let stand for 3-5 hours, then shake well and strain. For each dose it is necessary to prepare a fresh portion. This remedy is so effective that already on the 2-3rd day the child will wake up if he feels the urge to urinate.

Shepherd's purse juice

To prepare the product, the plant herbs are passed through a meat grinder. Freshly squeezed juice is diluted with water. For fifty drops you need to take about 100 ml of liquid. Enuresis can be cured with such remedies in 1-2 months.

Decoction of lingonberries and St. John's wort

For enuresis in children, pour boiling water over the grass and berries and boil for 8-10 minutes. For half a liter of water you need to take one tablespoon of plant leaves, as well as a handful of berries. You need to take the product after it has completely cooled down 3-4 times a day, half a glass.

Dill seed infusion

For most people, this plant is just a seasoning, but its seeds have medicinal properties. To treat enuresis, you need to brew one tablespoon of seeds in a glass of boiling water and let it brew. Drink the product after meals, a tablespoon 3 times a day.

Parsley tinctures

There are two options for recipes with this plant for the treatment of urinary incontinence in children. In the first case, brew a teaspoon of roots in a glass of boiling water and leave for 30 minutes. In the second, an infusion is prepared from seeds in the same proportions, but left to ferment overnight.

Also, decoctions and tinctures for enuresis in children are prepared from blackberry leaves, yarrow herbs, St. John's wort, centaury, sage, nettle and thyme.

Other treatments for enuresis in children

No less effective alternative methods of treatment for urinary incontinence in children include

compresses;
massage;
applying essential oils to the skin.

For therapeutic purposes, it is recommended to chew violet root throughout the day. This method is relevant for older children. You can put valerian root under your child’s pillow: its aroma soothes and makes the baby sleep soundly, but the child wakes up on his own when he has the urge to urinate.

Retains urine, has a beneficial effect on kidney function and soothes bee honey. It is enough to give your child 1 teaspoon of this product at night.

Another method of therapy is compresses. They are applied to the lower abdomen. Compresses have a relaxing and calming effect. The most effective against enuresis is ginger hot water, but aromatic essential oils also have a beneficial effect on children's sleep. At night, sage, coriander or lavender extract is sprayed in the room where the baby sleeps.

Massage can also help get rid of enuresis. To prevent the child from urinating in his sleep, rub the soles of his feet, focusing on the reflex zones. If your baby doesn't sleep well at night, and when he wakes up the sheet under him is wet, you need to change the bedtime process.

It is important to follow the rules:

goes to bed at the same time;
limit TV viewing in the evening;
before going to bed, take short walks in the fresh air;
try not to scold the child for incontinence, treat the problem with understanding.

Only by feeling the support of the parents will the child be able to cope with the problem, and traditional medicine methods will help him with this.

Prevention of enuresis in children

Hygiene skills will help prevent urinary incontinence in children. After 2 years, diapers should be abandoned, and the child should be taught natural ways to empty the bladder. In addition, you need to limit your fluid intake before bed.

It is important to teach your child to observe the rules of personal hygiene from an early age and to buy him underwear made from natural fabrics. It is important to pay special attention to the child’s health: promptly diagnose and treat infectious diseases, including the urinary system. Advanced pathologies can be complicated by enuresis.

To prevent incontinence, it is recommended to drink decoctions of medicinal herbs once every six months. The composition of medicinal preparations for prevention is selected individually: the components can cause allergies, so it is important to consult a doctor before taking it.

How to cure enuresis in children/

Treatment of nocturnal enuresis in a boy by suggestion

The boy was already 3 years old, and at night he still wet the bed. One evening, his grandmother, putting him to bed, said: “Now we will close your pussy with this key, and at night we will give the key to grandfather so that he keeps it, and in the morning, when you wake up, we will open it for you.” She showed the child the key, twirled it around the grandson’s tummy and gave the key to the grandfather. In the morning, when the grandson woke up, the grandfather was already standing next to the key, turned it around the child’s tummy and sent him to the toilet. That night the bed was dry. They did this for 8 days, until the grandson said that now he would close and open the lock himself. This is how we managed to get rid of enuresis (newspaper “Vestnik ZOZH” 2011, No. 14, p. 21)

Children's enuresis - treatment with aspen

1 tbsp. l. bark, aspen twigs, pour 1 cup of boiling water, boil for 10 minutes. Take 1/2 cup 3 times a day. A woman gave this remedy to her 7-year-old son. He drank a weak infusion of spring aspen bark instead of tea, but without sugar. Gradually, the boy's nocturnal enuresis went away. (HLS 2007, No. 10, p. 30)

Enuresis - traditional treatment

Treatment of enuresis with bird cherry

The recipe is similar to the previous one, but instead of aspen bark and twigs, bird cherry bark is used. The drink is not as bitter as the previous one, so children drink it more willingly. (HLS 2011, No. 8, p. 39)

How to cure nocturnal enuresis in a boy

The boy was already 6 years old, but every morning, if his parents did not wake him up in the middle of the night to go to the toilet, the bed would turn out to be wet. A relative managed to cure enuresis in a child using a simple method. Before going to bed, she dipped a cotton wool in water, squeezed it out so that it wouldn’t drip, and ran this wet cotton wool along the child’s spine from the cervical vertebrae to the tailbone, back and forth 5-7 times. At this time, she read the “Our Father” prayer. She asked the parents not to wake the boy up at night. In the morning the bed was dry. Six months after the nervous breakdown, the child had a relapse. The method with cotton wool was repeated. 6 years have passed since then, the boy is doing well. (HLS 2009, No. 18, p. 9)

The same recipe was recommended to the mother of a boy suffering from enuresis by a kindergarten teacher. The child's urinary incontinence went away very quickly and forever. (HLS 2004, No. 14, p. 25)

Treatment of childhood enuresis with viburnum roots

It was time for the boy to go to school, but every night he wet his bed. His parents were worried and treated him with various means, but all in vain. One day a gypsy woman came to them and suggested a folk remedy for enuresis. Wash 15 pieces of viburnum roots, 8-10 cm long, and add 2 liters of cold water. Bring to a boil and simmer over low heat for 40-50 minutes, leave, strain. Drink half a glass warm, adding a little honey, 3-4 times a day. The boy managed to cure enuresis with the help of this drink (HLS 2008, No. 19, p. 30)

Birch buds

1 tbsp. l. crushed birch buds, pour 1.5 cups of boiling water, cook for 5 minutes over low heat under the lid, leave for 1 hour, wrap well, strain, squeeze. Take half a glass 2-3 times a day 20 minutes before meals. The course of treatment for enuresis is 2-3 weeks. (HLS 2007, No. 4, p. 28; 2006, No. 9, pp. 28-29)

Treatment of enuresis in a child with sugar, honey and sweets

A woman managed to cure a 10-year-old boy living next door from enuresis in such an unusual way: in the morning on an empty stomach the child should eat 1 teaspoon of granulated sugar, on the second morning - 2 teaspoons, etc. On the 10th morning you need to eat 10 tsp and start reducing one spoon at a time: at 11 am – 9 spoons, etc. You can’t drink sugar. The course of treatment is 1 cycle. (HLS 2007, No. 13, pp. 35-36)

There are many other examples confirming this method: children can be cured of nocturnal enuresis with the help of sugar, honey, and caramels. These are the examples:

In the evening, when the child is ready for bed, give him one caramel to suck. You need to suck, not chew. In this case, the child should sit in bed and not lie down. This should be done every evening for 2-3 weeks. The effect of treatment will definitely come. (2006, no. 5, p. 29)

To cure nocturnal enuresis in children, you need to give them honey before going to bed, do not wash down the honey with anything, and immediately go to bed. Children under three years old – 1 tsp. honey, from three to five - a dessert spoon, after five - a tablespoon. (2006, no. 17, p. 33).

If you want to cure a child from bedwetting, give him half a glass of water 2-3 days before bedtime, stirring 1 tsp in it. honey (2002, no. 3, p. 19).

Enuresis in a girl and a wasp's nest

A girl under 7 years old suffered from nocturnal enuresis. They managed to cure it this way: in the attic they found a large wasp nest, 15-20 cm in diameter. They removed the dust from it, put it in an enamel pan, poured 3 liters of water and boiled it for 1 hour. This decoction was given to the girl instead of water 4-5 times a day. When the broth was over, the nest was filled with water again, but it had already been boiled for 3 hours. After the girl drank the second portion of the decoction, her nocturnal enuresis went away. (HLS 2007, No. 18, p. 33)

Treatment of cystitis and enuresis in a child with parsley

The boy suffered from cystitis and enuresis for a long time. I took a lot of medications that didn’t help, but simple parsley helped.

Parsley roots should be washed, chopped and dried. 2 tbsp. l. roots, pour 1 liter of boiling water, boil for 2-3 minutes. Leave for 40 minutes. Give this decoction to the child instead of water. The boy drank about half a liter per day, i.e. the portion was enough for 2 days. It only took a month for the child to sleep peacefully. The cystitis also went away. (2005, no. 10, p. 30)

Parsley also helps - young children with urinary incontinence are given a decoction of the leaves; it is also useful to eat as much fresh parsley as possible in the summer. (HLS 2005, No. 11, p. 28)

Belarusian folk remedy for enuresis

Take a pig's bladder (not a wild boar's), soak it in salt water for several days, changing the water. Then soak in water and baking soda. Then lightly boil the bubble, grind it through a meat grinder, add minced meat, make cutlets, and freeze. In the morning, fry 1-2 cutlets and eat on an empty stomach. Eat a piece of bread. The course of treatment is 9 days.. (HLS 2001, No. 5, pp. 18-19)

Children's enuresis - treatment with thyme

Brewing thyme and drinking it like tea is a very effective folk remedy for enuresis. A woman took in a foster child from an orphanage. The boy was 12 years old and suffered from enuresis. She began to give the child thyme tea, and after three months the illness went away. True, the woman woke him up during treatment 3 times a night at the same time. (HLS 2001, No. 16, p. 2)

Treatment with goat milk

The boy suffered from enuresis from birth. He was treated by a neurologist and in children's sanatoriums, but nothing helped. A nurse I knew advised the child to drink fresh goat milk; by that time he was already in the 5th grade. They began to take milk from a neighbor, morning and evening. At first the boy did not want to drink, but then he got used to it and began to ask for it himself. They gave me milk for a year, and everything just went away. (HLS 2000, No. 15, p. 19)

Enuresis in adolescent and adult men

It often happens that nocturnal enuresis in boys does not go away for a long time, and even as teenagers and adult men they continue to wake up in a wet bed 1-7 times a week. In this case, the folk remedies given above can help: aspen or bird cherry bark, dill seeds, parsley decoctions. Enuresis alarms are very effective in treating nocturnal enuresis in adolescents.

Clay treatment

This recipe helps with enuresis in children and adolescents, as well as involuntary loss of urine in the elderly.

Somehow she came across a book where it was written that even cancer can be cured with clay. I started making clay compresses for my son - I put hot clay on napkins, I put one napkin with clay on the bladder area, the other on the lumbar area. When the clay cooled, I used two more napkins with fresh hot clay. I changed the napkins until the 20 minutes were up. After the fifth procedure, the teenager’s pants became drier, and he did not wet the bed. A total of 10 procedures were required to completely cure enuresis in a teenager. (HLS 2008, No. 20, pp. 9-10)

Enuresis in men - herbal treatment

Traditional healers considered tea made from a mixture of St. John's wort and centaury, taken in equal proportions, to be the most reliable remedy for urinary incontinence. The man had the urge to go to the toilet every 30 minutes, after he started drinking tea from these herbs, the time increased to 1.5-2 hours.
Here is another recipe for enuresis: pour 100 g of galangal root with 500 ml of vodka, leave for 7 days. Take 1 tbsp. l. 2 times a day. (HLS 2009, No. 4, p. 32)

Enuresis in adult men

This method can be used to treat both children and adults, and pre-conscription conscripts were treated in the same way. A young man under 17 years old had nocturnal enuresis, neither pills nor procedures helped. And this folk remedy helped cure the disease.

A few minutes after the child has gone to bed, you need to approach him with a piece of herring and feed him. After that, say with him: “I won’t pee in bed today.” Do this procedure every evening. The course of treatment is 10-15 days. (HLS 2005, No. 6, p. 32)

Enuresis in men - treatment with horsetail

This recipe helped the author of the letter get rid of enuresis, and it was also tested on relatives and friends. You need to put 2 tbsp in a half-liter jar. l. horsetail, pour boiling water, leave for 1-2 hours. Drink warm 20 minutes before meals. Daily norm – 500 ml. The course of treatment is 7 days. (HLS 2005, No. 7, p. 31)

Enuresis in older men

Treatment of urinary incontinence with herbs

In old age, enuresis in men has some different causes than in adolescents and young men. This is due to age-related changes in the genitourinary system, muscle atrophy, and problems with the prostate gland. In men, with age, the size of the prostate increases, the lumen of the urethra narrows, frequent urination is replaced by difficulty, the bladder does not empty completely, it stretches, and the muscle “shrinks out.” In the last stage of this process, urine drips or involuntarily oozes from an overfilled bladder.

If enuresis is accompanied by inflammation of the mucous membrane of the bladder (this often happens with prostatitis in men), then for treatment it is necessary to choose folk remedies that, along with the treatment of enuresis, relieve this inflammation. We must remember that bacteria that cause inflammation die in an acidic environment; teas from rose hips, or a mixture of centaury and St. John's wort, or from corn silk, an infusion of marshmallow roots (6 g per glass of cold water, leave for 10 hours) will help create an acidic environment in the body ), decoctions of viburnum bark, an infusion of berries and lingonberry leaves in half with St. John's wort, an infusion of dill seeds are widely known remedies for enuresis

The following recipe will help with bedwetting:

Take 2 parts of parsley seeds, 2 parts of horsetail, and 1 part each of heather, hop cones, lovage root, bean leaves. 1 tbsp. l. Brew the mixture with 1 cup of boiling water and drink throughout the day.
(HLS 2013, No. 10, p. 33)

Urinary incontinence in men after removal of prostate adenoma

An elderly man had his prostate adenoma removed, after which he suffered from urinary incontinence for several years. He did not agree to a repeat operation to correct the bladder neck and turned to the newspaper “Vestnik ZOZH” for advice.

Doctor med answered him. Sciences Kartavenko V.V., who advised the patient to cope with enuresis using gymnastics aimed at strengthening the rectus abdominis and long back muscles. Strengthening these muscles helps strengthen the bladder walls.

To strengthen the rectus abdominis muscles, you need to lie on your back, fix your legs and lift your upper body. To strengthen your back, you need to do the same, but just lie on your stomach (HLS 2011, No. 21, p. 14)

Walking on the buttocks treats frequent urination and adenoma in men

Frequent urination in old age occurs in a large number of men. There is an easy way to get rid of this problem - walking on your buttocks.

The man got up to go to the toilet every 30 minutes at night because he had an adenoma. After I included walking on my buttocks in my exercises, I only get up 1-2 times at night.

In addition to enuresis, this exercise - walking on the buttocks - eliminates constipation, treats prolapse of internal organs, hemorrhoids, and strengthens the abdominal and back muscles. (HLS 2002, No. 16 p. 7)

Greetings to all readers! My name is Svetlana. Graduated from Samara State Medical University with honors.

When a family is faced with the problem of enuresis in children, parents often ignore the prescribed treatment, without at all trying to understand the true causes of its occurrence. Urinary incontinence is caused by a number of factors, so it is necessary to use complex therapy, which will be discussed below.

To make such a diagnosis, the child must undergo a comprehensive examination. A competent specialist will not only prescribe medication, if necessary, but also introduce you to the physiotherapy procedure, recommend a massage, and send you for a consultation with a child psychotherapist.

There is also the practice of treatment with folk remedies. But it is worth remembering that only if the baby wets the bed at night more than 3 times a month and has reached the age of 5, we can talk about a disease such as enuresis.

It is very important not to confuse normality with pathology. That is why only highly specialized specialists are able to assess the case and prescribe or deny the need for treatment. Parents, for their part, can only help understand the causes of enuresis in children. According to research data, it is known that 15-20% of 5-year-old children suffer from bedwetting, 7-12% of children suffer from bedwetting at an older age.

Among teenagers 12-15 years old, this figure is set at 3%. If we talk about gender, then Boys have this disease 2 times more often than girls.. Among the 18-year-old population, up to 1% of people suffer from enuresis.

Types of disease

Bedwetting may be caused by the child's sound sleep

According to modern classification, the disease is usually divided into 2 forms:

Primary. It manifests itself only as bedwetting in children; it usually occurs very early, when the baby still has poor bladder control at this point.
Secondary. It can appear both at night and during the day. It is characterized by constant relapses; after some time after effective therapy, urinary incontinence occurs again.

Causes

To choose the right treatment for enuresis in children, you should know the causes of its occurrence.

There are 7 main causes of the disease:

heredity;
immaturity of the central nervous system and underdevelopment of the bladder;
psychological aspect, for example, quarrels in the family, problems at school, change of environment;
the baby’s nervous system is delayed in development;
disruption of the production of a hormone that is responsible for the amount of urine produced in the human body;
diseases of the genitourinary system, for example, narrowing of the foreskin in boys and the urethra in girls;
urinary tract infections.

The characteristic and distinctive symptoms of this disease are as follows:

urinary incontinence at night;
frequent desire to urinate;
uncontrolled urine output;
low body temperature;
slowing of pulse and heartbeat;
blue extremities;
on the part of the central nervous system – isolation, depression and secrecy.

When performing diagnostics It is worth paying attention to whether additional symptoms accompany the disease or is it isolated.

Treatment of enuresis in boys is different, as they often do not have such symptoms. You need to submit your urine for a bacterial test to determine the presence of a genitourinary tract infection. Children over 6 years of age are prescribed cystography, cystoscopy, and ultrasound of the genitourinary organs - this is how the proper functioning of the system is determined.

It is worth showing the baby to such doctors as: pediatrician, gynecologist or urologist, neurologist. Thanks to a comprehensive examination, the correct diagnosis is determined and therapy is prescribed, which can be medicinal or non-medicinal. Only after a visit to specialists, parents will be able to take advantage of recommendations on how to treat enuresis in children.

Drug therapy involves taking medications such as:

hormones;
psychostimulants;
antidepressants;
andrenomimetics;
caffeine.

25-30% of patients after such therapy completely get rid of the disease in a short period of time, the rest experienced a significant reduction in symptoms. If the problem is emotional in nature, methods such as communicating with a psychologist, turning to hypnosis or folk recipes also produce a positive effect.

Medicines

The table provides an overview of commonly used tablet medications for enuresis in childhood.

Name release form age category	Active substance	Contraindications	Adverse reactions	price, rub.
MINIRIN, tablets, from 5 years	Desmopressin	Heart failure and other conditions requiring diuretics, hyponatremia, moderate or severe renal failure	Hyponatremia, which can cause headache, nausea, vomiting, decreased serum sodium concentration, weight gain, general malaise, abdominal pain, muscle cramps, dizziness, confusion, decreased consciousness, and in severe cases, seizures and coma	1300
PANTOGAM, tablets, from 3 years	Calcium hopantenate	Hypersensitivity to the components of the drug, acute severe kidney disease	Possible allergic reactions, including rhinitis, conjunctivitis, skin rash	500
MELIPRAMINE, tablets, from 6 years	Imipramine	Cardiac arrhythmia, severe kidney and/or liver disease, urinary retention, glaucoma (narrow-angle glaucoma)	Constipation, dry mouth, vomiting, nausea, paralytic ileus, stomatitis, darkening of the mouth, diarrhea, stomach pain. Urinary dysfunction, urinary retention	300
PICAMILON, tablets, from 3 years	N-nicotinoyl-g-aminobutyric acid sodium salt	Renal failure, pregnancy and lactation	Skin rash, itching, dizziness, headache, nausea, irritability, agitation, restlessness	100
PANTOCALCIN, tablets, from 3 years	Calcium salt of hopantenic acid	Kidney diseases, first trimester of pregnancy, breastfeeding period, children under 3 years of age	Allergic reactions are possible (rhinitis, conjunctivitis, rash). Sleep disturbance or drowsiness, noise in the head	500

Parents' reviews of MINIRIN are positive; it is considered effective for primary enuresis in children. During use, it is worth limiting fluid intake, as the drug retains it in the body, putting a strain on the kidneys.

The dosage for adults and children over 5 years of age is 0.2 mg at bedtime. In case of insufficient effect, the dose can be increased to 0.4 mg. The course of treatment is 3 months.

PANTOGAM helps if incontinence is caused by excessive motor excitability or convulsions. The drug has a mild sedative effect and promotes the secretion of hormones in brain neurons, fills cells with vital oxygen, and also stabilizes the functioning of the nervous system.

The daily norm for children from 12 years old and adults is 1.5-3 g, for children from 3-12 years old – 0.75-3 g. The course of treatment is 1-4 months, in some cases up to 6 months. After 3-6 months, a second course of treatment is possible.

MELIPRAMINE increases the tone of the body as a whole, the drug is an antidepressant. The tablets have a wide list of side effects; the drug must be taken strictly as prescribed and under the supervision of a doctor.

You should consider taking MELIPRAMINE only if you have mental disorders that have caused urinary incontinence in children. Dosage: 6-8 years (body weight 20-25 kg) – 25 mg/day, 9-12 years (body weight 25-35 kg) – 25-50 mg/day,
over 12 years old (body weight more than 35 kg) – 50-75 mg/day.

PIKAMILON is known for its nootropic effect; it has a positive effect on brain function and memory. The drug is prescribed only in complex therapy. Children 3-10 years old take 20 mg 2-3 times a day, children 11-15 years old - 50 mg 2 times a day, over 15 years old - 50 mg 3 times a day. The course of treatment lasts 1 month.

If the therapy is long-term and is carried out with the help of PANTOCALCIN, you should not combine its use with other nootropic drugs. It is recommended to take it in the morning or afternoon. Dosage: over 12 years old - 0.5-1 g 2-3 times a day, children 3-12 years old - 0.25-0.5 g (daily dose 25-50 mg/kg) 2-3 times a day day. The course of treatment is from 1 to 3 months.

Traditional medicine

How to treat enuresis at home without the use of medications can be found in the table below, which describes methods for preparing various medicinal plants.

Name	Cooking method	How to use	Duration of treatment
A collection of knotweed, mint, St. John's wort, centaury, birch leaves and chamomile flowers	Mix all ingredients in equal parts and chop. 30 g pour 1 liter of boiling water, leave for 8 hours in a thermos	Take 100 ml of infusion during the day, half an hour before meals.	3 months, then take a break for 2 weeks and continue treatment
A collection of blackberry leaves, knotweed grass, immortelle flowers, yarrow herb and St. John's wort	Mix in equal parts and grind. Pour boiling water (500 ml) over 20 g of powder, leave in a thermos for 2 hours, strain	Take 4-5 times a day, 100 g, 20 minutes before meals. Do not take one hour before bedtime	1 month
Infusion of dill seeds	Brew 1 tablespoon of seeds with a glass of boiling water, leave for 2 hours	Take daily after lunch	1 month
Parsley roots	Pour 10 g of roots with a glass of boiling water and leave for 1 hour, strain	Drink 1 glass daily	14 days
Laurel leaves	Pour 3 medium bay leaves into a glass of water and simmer for 10 minutes, let it brew for 1 hour, strain	Take 100 ml 3 times a day after meals	7 days
St. John's wort herb	Pour 40 g of herb into 200 ml of boiling water, cook for 10 minutes over low heat, strain	Drink 1 glass of decoction daily before bedtime	14 days
Yarrow grass and flowers	Pour 10 g of crushed mixture of herbs and flowers into 1 liter of boiling water. After 10 minutes, turn off and leave for 1.5 hours. Strain	Take 100 ml 3 times a day	14 days
Lingonberry leaves	Pour half a glass of dried lingonberry leaves into 0.5 liters of water, cook for 10 minutes in boiling water, leave for 40 minutes. Strain	1 glass three times a day before meals	1 month

The decoction can be sweetened with honey or sugar. This treatment will not always completely eliminate urinary incontinence in children during the day, but it will allow you to stay dry all night.

Exercises at home

At home, parents are recommended to conduct acupressure courses

Thanks to physical exercise, the muscles of the pelvic floor and the sphincter of the bladder in the part responsible for stopping urination are strengthened.

It is believed that if you exercise in the fresh air, you can achieve a much greater effect in the treatment of nocturnal enuresis in children:

walking on the buttocks (effective in treating enuresis in girls);
squats with knees apart;
exercise "bicycle";
“scissoring legs”, lying on your back (helps with enuresis in boys);
The most effective exercise is when the baby sits on the potty and starts urinating, ask him to pause the process and wait 5 seconds, then continue and stop again for 5 seconds. After that, complete your plan. At first it will be hard for the baby to endure, but over time the muscles will train and the skill will become easier. Smoothly increase the interval from 5 to 20 seconds, then to 1 minute.

find and press two points on the baby’s neck - on each side of the 3rd and 4th vertebrae;
gently massage the point located just above the navel;
also press on the point located on the inside of the shin.

conclusions

The most important principle in the fight against this disease is parental support. The child must see that the people closest to him are confident in his success, and are also ready to accept anyone. There is no need to show concern, because children feel everything and are very vulnerable; they may feel powerless.

It is necessary to demonstrate by your behavior that there is no problem in a wet bed, and together you can come to a good result.