What is enuresis? You should know the pathological symptoms.

Enuresis is a disease that occurs in children over 3 years old. It is also a urinary system disease. It causes involuntary urination, especially at night. If you have this phenomenon, you should check whether there are neurological symptoms, phimosis, or urethral stenosis.

1. Symptoms and Signs

1. Medical history

Understand the daytime and nighttime urination situation, age, enuresis situation (degree and relationship with sleep), family history of urinary tract infection and enuresis, etc. Patients can be divided into 3 groups: ① Asymptomatic nocturnal enuresis. No further testing is required. ② If there is infection or obvious neuropathy, further examination is required. ③ There are no infection or neurological symptoms, nor other urination abnormalities, so anatomical problems should be ruled out.

2. Physical examination to check for phimosis, prepuce is too long, urethral stenosis; pay attention to the presence of hair or lipoma in the lumbar sacral region, in order to detect occult sacral bifida and incomplete closure of the spinal canal.

2. Pathological Causes

There are many reasons that may lead to the occurrence of enuresis, and it may even be the result of multiple factors working together.

1. Genetic factors

Enuresis has a clear genetic tendency, and the genetic gene is located on chromosome 22q11. Statistics show that the incidence of enuresis in offspring of parents with enuresis, unilateral enuresis, and no enuresis are 77%, 44%, and 15%, respectively.

2. Developmental Delay

If the development of the brain's arousal center is delayed, the urination pattern that was completed by low-level central reflexes in infancy will be maintained, and such children often have other developmental delays. Children's thalamus and pituitary glands are underdeveloped, and the secretion of antidiuretic hormone decreases at night, resulting in increased urine volume at night. This mismatch between the reduced functional bladder capacity and the urine volume at night is an important cause of enuresis.

3. Urodynamic factors Urodynamic examination during sleep revealed 1

/3 to 1/2 of the children have extremely active bladders, with frequent and large-amplitude spontaneous contractions. This unstable bladder can further reduce the functional bladder capacity of the children.

4. Secondary to urinary tract infection or obstruction such as posterior urethral valve disease and annular stenosis.

5. Abnormal neurological function.

6. Psychological factors.

3. Preventive Care

Children should be given a good schedule and hygiene habits from an early age. They should learn the rules of nighttime urination, wake up at regular times or use alarm clocks so that they can gradually form time-dependent conditioned reflexes and develop the ability to take care of themselves. In addition, a good living environment should be provided to avoid enuresis caused by adverse environmental stimulation. When children face setbacks and accidents, parents should be good at guidance and help them eliminate psychological tension. When children suffer from enuresis, they should not be blamed or physically punished. Instead, the causes should be found and symptomatic treatment should be given.

When training children to urinate, they must first understand that they will feel the urge to urinate and will feel uncomfortable after wetting their urine. Children's urination training should be coordinated with their developmental level, and parents should be guided to pay attention to children's response to urination training. If children refuse, parents should not intervene forcibly and should appropriately postpone the training time.