Bedwetting in women, men and children

Various disorders of urination are quite common phenomena, characteristic both for children and adults. Especially common is bedwetting: it is a complex problem that affects, inter alia, the psychological state of a person.

In medical circles, bedwetting is called enuresis. A patient who suffers from such a disorder does not feel the urge to urinate during a night's sleep. Until the age of three, such a lack of control over the urinary process can be considered the norm: a baby before the age of 3 can not yet correctly and timely respond to an urge, since its nervous system is at the formation stage. However, signs of nighttime urinary incontinence in a child after 4-5 years old, or even in adults, cannot be physiological and indicate the presence of pathology. [1]

Epidemiology

According to statistics, adults rarely suffer from bedwetting. More often it is diagnosed in childhood:

• in six-year-olds, in 15% of cases;
• in eight-year-old children - in 12% of cases;
• in preterm children - in 7% of cases;
• in twelve-year-old children - in 3% of cases.

About 16% of children recover when they reach adolescence. The frequency of spontaneous relapses in many patients remains quite high. [2]

Boys suffer from bedwetting about 1.8 times more often than girls. [3]

Causes of the bedwetting

The occurrence of bedwetting in adulthood and childhood is often associated with the following reasons:

• age-related unpreparedness of the central nervous system and urinary system (usually everything comes back to normal by about 5 years);
• delayed maturation of NS (sometimes neuropsychiatric disorders, behavioral disorders, etc. Become delaying factors);
• psychological, stressful factors (relocation, loss of loved ones, family turmoil);
• adverse heredity;
• disturbed production of antidiuretic hormone;
• pathologies and infections of the genitourinary tract (cystitis, prostatitis, etc.).

Less common causes are:

• epileptic seizures at night;
• nocturnal apnea, incomplete obstruction of the upper respiratory tract;
• endocrine pathologies (insufficient or excessive thyroid function, diabetes);
• taking certain medications. [4]

Bedwetting and Alcohol

Large amounts of ethyl alcohol are an unbearable burden for the body. Severe intoxication can cause uncontrolled emptying of the urinary organ: more often this happens in patients with chronic alcoholism.

Ethanol has the ability to quickly enter the bloodstream, absorbed in the digestive tract. Alcohol is retained in tissues for a long time, being divided into acetaldehyde and acetic acid. The first component of the decay is the strongest toxic substance, leading to the death of nerve cells in the brain. As a result, the function of the nervous system is completely upset, the transmission of signals responsible for many vital functions is blocked.

Night urinary incontinence after drinking alcohol can also be explained by the fact that ethanol has diuretic properties. In addition, the need for a quick disposal of them becomes a natural response of the body to toxic substances. The work of the renal mechanism is accelerated, urinary fluid begins to be produced in a larger volume.

With prolonged use of alcoholic beverages, the tone of the muscles responsible for retaining fluid in the bladder decreases. Over time, atrophic processes develop, leading already to chronic incontinence even after refusing alcohol.

Nighttime urinary incontinence after taking a drink is usually manifested after falling asleep, against the background of a complete loss of consciousness, muscle relaxation. At the initial stage, the problem may be episodic in nature, but subsequently incontinence is noted more and more often, including during the day. [5]

Adenoid Nocturnal Incontinence

Quite often (especially in childhood) bedwetting is combined with other diseases or conditions - for example, with allergic processes, hyperactivity syndrome, adenoiditis. It would seem that can bind children's enuresis and adenoids? However, an indirect link exists.

Pronounced adenoid growths interfere with the normal respiratory process, especially at night. It is difficult for the child to breathe freely, he snores and sleeps restlessly. Such disorders in some children provoke an increase in pressure. In response, a protective reaction of the body is triggered, which stimulates the production of hormones aimed at stabilizing this pressure. At the same time, there is an active removal of excess fluid from the tissues, and the bladder is filled faster than usual.

It is necessary to solve this problem: first of all, measures must be taken to facilitate nasal breathing in the child. Treatment is prescribed by a pediatrician after consultation with a pediatric ENT specialist and an allergist.

Risk factors

Indirect causes and predisposing factors for the development of bedwetting are as follows:

• digestive disorders, frequent and prolonged constipation;
• helminthic infestations;
• excess weight;
• hereditary predisposition (the presence of a similar problem in one of the parents);
• complex births that could cause the development of neurological problems in the baby;
• difficult psychological and emotional family environment;
• living in unsatisfactory sanitary conditions;
• alcohol abuse.

Pathogenesis

A newly born baby cannot control certain processes - in particular, such as bowel movements and urination. As they grow older, the mechanism of arbitrary urination is established, and the child begins to visit the toilet on his own, including at night: usually this happens at about 4 years old, sometimes at five. If night incontinence continues in an older child, then they talk about pathology.

Bedwetting is a serious problem - for both children and adults. It is important to understand that we are talking about a disease, and not about the lack of education, stubbornness or personality traits of a person. Incontinence must be treated: specialists such as urologists, neuropathologists, psychotherapists, therapists and pediatricians help in this. [6]

The causes of the problem can be many. In childhood, primary incontinence is more likely to occur - this is a pathology associated with imperfection of the nervous system. In such a situation, the baby does not feel the fullness of the bladder and urinary urges, which ultimately leads to an “accident” during a night's rest.

Secondary incontinence is more often diagnosed in adolescents and adult patients. It is formed against the background of other congenital or acquired pathologies and often manifests itself not only at night, but also in the daytime. [7]

Of great importance in pathogenesis is the delay in the maturation of the nervous system in the delayed staging of urinary regulation skills. According to experts, the imperfection of the central nervous system provokes a disorder in the regulatory functions of many systems in the body. In particular, bladder contractions may not be controlled during sleep. Since bedwetting is a multifactorial pathology, organic and psychogenic disorders, which are often combined with each other, play a significant role in its development.

The problem is also often caused by a number of other painful conditions - for example, diabetes, neoliguric renal failure, genitourinary infections, constipation, neurogenic bladder, urinary tract defects, apnea, or snoring. [8]

Independent studies have shown that reduced urinary fluid formation during nighttime rests is due to increased production of vasopressin. Therefore, some patients with bedwetting are successfully treated with Desmopressin. However, there is evidence of cases of impaired renal sensitivity to these hormones, which requires a fundamentally different therapeutic approach. [9]

Symptoms of the bedwetting

The main symptom of bedwetting is obvious - this is an involuntary emptying of the bladder during a night's rest.

If the problem occurs against the background of other pathologies, then other first signs may be detected:

• with neurological disorders, hyperactivity, neurosis, tics, depression, stuttering can be noted;
• with infectious and inflammatory lesions of the genitourinary tract, an increase or other change in diuresis, pain during urination, abdominal pain, high body temperature is noted.

Sleep incontinence during normal daytime urethra is called monosympathetic enuresis. Polysympathetic pathology is said to be if the patient combines nighttime incontinence with other urinary disorders - this may be urgency, pollakiuria, daytime enuresis, etc. All these symptoms indicate the presence of overactive bladder syndrome.

If episodes of incontinence occur in a patient less than three times a week, then they speak of periodic pathology. If wet nights occur more often than this indicator, then doctors diagnose stable nighttime urinary incontinence.

Bedwetting in children

One of the factors in the occurrence of nighttime urinary incontinence in children is heredity, the other is the instability of the psychological state. Sudden incontinence can occur after a strong fright, stressful situation, etc. Typically, the problem occurs in the phase of deep sleep, with sleepwalking or in the presence of night phobias.

The atmosphere within the family - regular scandals, misunderstanding between parents, divorce, the appearance of a second child, change of residence - often affects the formation of bedwetting.

Another common factor is urological problems. Typical symptoms are frequent urinary urges, disturbances in the urination process, etc. The source of the problem should be sought in the state of the genitourinary organs.

If during pregnancy fetal hypoxia was recorded, or there was a birth injury, then subsequently this may affect the health of the child’s brain. Neurological pathologies are often manifested by bedwetting.

It turns out that there are many reasons for the appearance of a similar problem in children. Therefore, each child must be carefully examined, with the exception of not only urological, but also neurological and somatic factors. [10]

Teen urinary incontinence

When referring to bedwetting, they often mean young children. However, this problem can manifest itself in adolescence. Here is a list of the root causes of the problem:

• overactive bladder syndrome;
• inflammatory processes in the genitourinary system;
• hereditary predisposition;
• features of nervous regulation, etc.

Psychological factors have an indirect effect on the formation of nighttime urinary incontinence:

• excessive custody (an overly tutored teenager continues to feel like a baby, and therefore behaves accordingly);
• lack of attention (unconsciously, a teenager performs actions that, in one way or another, draw attention to himself);
• stresses, traumatic situations (urinary incontinence can be a kind of reaction to quarrels of parents, loss of loved ones, etc.).

Often, bedwetting is combined with daytime enuresis. Such a complex problem requires a special approach to treatment, with a mandatory visit to a psychologist.

Adult Bedwetting

The causes of nocturnal enuresis in adulthood are completely different than in children. Violation may indicate a change in hormonal function, an upset in the functioning of the kidneys, diseases of the internal organs, nervous system, or may be the result of taking certain medications. In general, the causes of the problem in adults are divided into the following categories:

• neurological (due to past injuries, strokes, etc.);
• urogenital (overactive bladder, urgent or stress incontinence).

Nighttime urinary incontinence in women is especially often manifested during hormonal adjustment - in particular, during menopause. It is also noted that female incontinence occurs more often than male incontinence. Other factors in the appearance of this problem in women can be difficult childbirth, abortion, neurological disorders.

But bedwetting in men more often belongs to the urgent type - that is, it is associated with urinary neurogenicity. There are several reasons for this problem:

• traumatic damage to the spine;
• head injury (head injury);
• suffered a stroke.

In most cases, urgent incontinence affects older men who have these additional painful symptoms:

• frequent uncontrolled urination;
• leakage of urinary fluid (incontinence).

Bedwetting in older people is not always related to neurogenic bladder. The problem can be triggered by an infectious lesion of the urinary system (inflammation of the prostate, cystitis, etc.), tumor processes of various origins (including an adenoma or cancer of the prostate gland).

Stress enuresis is often caused by urethral or urinary bladder failure, which causes increased mobility of the urethra, or sphincter insufficiency.

If the problem is associated with excessive filling of the bladder, then incontinence is more often due to impaired urethral patency or improper contraction of the urea. There are less common causes:

• stricture narrowing of the urethra;
• taking anti-allergic and diuretic medicines;
• diabetes;
• multiple sclerosis.

In some cases, doctors diagnose idiopathic bedwetting. This term means that it was not possible to establish the root cause of the violation.

Forms

What types of bedwetting do experts usually talk about?

• Imperative (it is also urgent, imperative) incontinence is manifested by the inability to retain urine at the peak point of the urinary urge. Such a malfunction is usually caused by increased activity of the muscles of the urinary bladder walls due to pathologies of the brain or spinal cord, hormonal disorders, inflammatory or other damaging processes in the bladder.
• Stress incontinence at night can occur at the time of coughing, sneezing - that is, with a sudden increase in pressure in the abdominal cavity. The problem is due to sphincter disturbance due to hormonal, anatomical or nervous disorders.
• Unconscious (also known as reflex) incontinence is explained by incorrect conduct of a nerve signal to the bladder: a person does not feel the urge to go to the toilet even with a full bladder. As a result, this leads to reflex emptying of the organ.
• Continuous urination in the form of leaks is explained by a disorder of nerve conduction, or incomplete adjunction of the sphincters. Sometimes the muscles of the bladder lose their ability to contract adequately: as a result, too much fluid accumulates in the body, which begins to leak.
• Direct bedwetting is any kind of involuntary urination that occurs during a night's sleep in adult patients, or in children older than 5 years of age. Such a pathology can be primary (occur from birth), or secondary (appear already against the background of a properly formed urinary reflex).

Complications and consequences

Experts say there is a definite connection between bedwetting in boys and further problems with potency in an adult male. For girls, urinary incontinence in childhood can eventually turn into frequent infections of the genitourinary system, in particular cystitis.

Many children with enuresis have a significantly worse quality of life: personality formation is impaired, severe neurosis develops. Self-doubt, low self-esteem can transform into a disorder, cause social disorientation. According to the personal data of patients who had a chance to face night urinary incontinence, the violation had an extremely negative effect on their lives.

Urinary incontinence is a psychological stress both for the patients themselves and for their environment. It becomes difficult for a person to communicate with friends and colleagues, it is difficult to go on a trip or even go on a visit. For a child suffering from enuresis, a trip to a children's camp or on an excursion becomes a problem. Strangers, and sometimes close people, are often very cruel to the sick, resorting not only to ridicule, but also to punishments. Patients (especially children) are under a prevailing sense of shame, fear, which over time develops into an inferiority complex, depressive states develop.

Diagnostics of the bedwetting

Any diagnostic measures begin with collecting patient complaints. The doctor clarifies the possible causes of the violation, the degree and frequency of bedwetting, listens to related complaints. In addition, it is advisable to interview the patient's relatives about similar painful signs in order to exclude the hereditary origin of the disease.

Some specialists suggest that patients fill out a so-called “questionnaire” list of issues related to urinary incontinence. The standard “questionnaire” includes the following items:

• How long does the patient show signs of incontinence?
• Are there any changes in the amount of urine output?
• Are bedwetting cases becoming more common?
• What does the patient associate with the appearance of enuresis episodes (physical exertion, coughing, running, laughing or sneezing, carrying heavy objects, changing body position, the sound of a splash of water, stress, hypothermia, etc.)?
• Are there any other problems with urination?
• How often do you have to restrain urination?
• Does urinary fluid leak (with or without urges)?
• Does the patient wake up to go to the toilet at night?
• Does nighttime urinary incontinence affect the quality of everyday life?

In addition, the doctor often initiates the patient maintaining a special diary. In it, the patient should make notes daily on the amount of fluid drunk, on the frequency and volume of urination, on the quality of the urge, on episodes of urinary incontinence (night and day). [11]

Women suffering from bedwetting are additionally given a vaginal examination - primarily to exclude background diseases. Pathologies such as atrophy of the vaginal mucosa, prolapse of the pelvic organs, etc. Can directly affect the appearance of a problem.

Also, during the examination, a cough test is performed (when coughing, urinary fluid from the urethra is noted).

Urine tests are always prescribed for any diseases associated with the urinary system. To collect a general analysis, you need:

• Before collecting biomaterial, thoroughly flush (wash) the external genitalia;
• to collect urine at the first morning visit to the toilet (collected from the middle portion of the stream).

Instrumental diagnostics usually consists of MRI, ultrasound of the pelvic organs. In addition, an urodynamic diagnosis is prescribed to help determine the type of incontinence. [12]

Differential diagnosis

Differential diagnosis, first of all, is carried out with nocturnal epileptic seizures. In addition, bedtime incontinence is often a symptom of sleep apnea syndrome with incomplete obstruction of the upper respiratory tract. Some endocrine diseases (diabetes, hypothyroidism, endemic goiter) are often combined with genitourinary disorders. Presumably, nighttime incontinence amid endocrine problems occurs as a result of impaired bladder autonomic innervation. Increased excitability of the urinary organ is observed in allergic processes. An exception is food allergies.

Bedwetting is detected after hypothermia, as well as with cold allergies, cryotrauma. To exclude certain diseases and conditions, a thorough examination of the whole organism, in particular the pelvic area, is carried out. [13]

Treatment of the bedwetting

Although in some patients (especially children), bedwetting over time goes away even without any treatment, there can be no clear guarantee on this. That is why treatment is prescribed in any case if there is episodic but persistent incontinence.

The treatment regimen is determined depending on the etiological factor of a particular case of the disease. In general, therapeutic methods may be as follows:

• medication (with the use of drugs);
• non-pharmacological (psychotherapeutic, physiotherapeutic, etc.);
• regimen, etc.

Many practice the technique of nightly “wake-ups”. This technique consists in awakening a patient with bedwetting every hour after midnight. After about a week, the frequency of “wake-up” is reduced, choosing the most optimal mode. If the episodes are repeated, then the cycle is repeated.

Diet therapy also plays a significant role in healing. The diet is changed, starting with the restriction of liquids (drinks and liquid dishes). There is also a specific Krasnogorsky diet, which helps increase the osmotic pressure of the blood and retain moisture in the tissues, which generally causes a decrease in urine volume. [14]

All regime activities are as follows:

• Extremely limited fluid intake in the afternoon. After dinner, drinking is generally canceled.
• The bed for a night’s sleep should not be too soft.
• If the patient sleeps too deeply, then it is advisable to turn it several times in a dream.
• The patient should be protected from stress, psycho-emotional overstrain, overwork, as well as hypothermia.
• During the day, you should avoid foods and dishes with caffeine, carbonated drinks, juicy fruits and berries are also excluded.

Medications Your Doctor May Prescribe

If bedwetting is associated with infectious processes in the urinary tract, then the patient is prescribed a full course of antibiotic therapy under the control of urine counts (microflora sensitivity to antibacterial and uroseptic drugs is also taken into account).

If necessary, prescribe tranquilizers with sleeping pills - to stabilize the depth of sleep (Eunoktin, Ramedorm). If resistance to these drugs develops against the background of a neurosis-like form of the disease, then stimulants (Sydnocarb) or timoleptics (Milepramin, Amitriptyline) are used shortly before sleep.

Amitriptyline is standardly taken in a dosage of 12.5 to 25 mg up to three times a day (tablet form of release of 10, 25 or 50 mg). During taking the medicine, side effects such as increased intraocular pressure, increased heart rate, mydriasis, and constipation may occur.

If incontinence has no connection with inflammatory processes, then it is optimal to prescribe imipramine. It is used to treat adults and children over six years of age (dosage from 0.01 to 0.05 g per day). Some experts practice such a therapeutic scheme: an hour before a night’s sleep, the patient is given 25 mg of the drug, but if they do not achieve the desired effect, then after 4 weeks the dosage is doubled. Further, the amount of the drug is gradually reduced and canceled. Possible side effects during treatment: dizziness, increased sweating, dry mouth, disturbance of accommodation. [15]

If we are talking about neurotic enuresis, then the patient is prescribed tranquilizers:

• Hydroxyzine in tablets of 0.01-0.025 g, or in syrup (5 ml corresponds to 0.01 g);
• Medazepam in tablets of 0.01 g or in capsules of 0.005 or 0.001 g;
• Trimethosine tablets 0.3 g each;
• Meprobamate in tablets of 0.2 g, a course lasting 1 month. [16]

Considering that the appearance of a problem in children in many cases is associated with imperfection of the child’s nervous system, nootropic drugs are used for treatment, such as Glitsesed, Nootropil, Phenibut, Instenon, etc. Such drugs are prescribed for long-term use - within 1-2 months, in combination with other types of therapy.

If bedwetting is caused by unstable urinary bladder function, neurogenic disorders, or detrusor idiopathic disorders, then the patient may be prescribed oxybutynin g / x in the form of tablets of 0.005 g (it can be used in children over five years of age).

The most successfully used are Desmopressin, an artificial analogue of the hormone Vasopressin, a regulator of excretion and absorption of free fluid in the body. The most common such drug called Adiuretin SD, which is available in drops. The drug is dripped into the nose (in the area of the nasal septum) 2-3 drops per day for a week. After reaching nights without “accidents”, treatment is continued for another 3 months, after which the drops are canceled. If a positive effect is not observed, the dosage is increased by one drop per week, until the result is achieved. Children over eight years old are dripped up to 12 drops per day. [17]

Vitamins

Despite the fact that a deficiency of vitamins in the body does not directly affect the appearance of nighttime urinary incontinence, the introduction of vitamin preparations into the body often helps to cope with this violation. So, in 2018, scientists conducted a study in which they offered certain doses of vitamins to children with enuresis. After a thorough analysis of the results, the following conclusions were made:

• supplements containing vitamin D and fish oil help prevent childhood bedwetting (from 7 to 15 years);
• optimal dosages for children are 1000 IU / day of vitamin D and 1000 mg / day of fish oil.

In some cases, the dosage may increase, which should be monitored by the attending pediatrician. It is allowed to take fish oil, both in pure form, and in capsules or chewable pastilles, which is not of fundamental importance.

Physiotherapeutic treatment

Among the additional treatment methods, physiotherapy, represented by such procedures, is quite common:

• acupuncture (reflexology, which provokes the appearance in the body of bioelectric currents that positively affect the work of the bladder);
• magnetotherapy (the method is based on the influence of low-frequency magnetic fields with a variable or constant effect on a painful area in the body);
• laser treatment (involves exposure to a concentrated beam of light on the body);
• music treatment (specific musical psychotherapeutic method), etc.

The effectiveness of such techniques depends on the characteristics of the body, on the causes of nighttime urinary incontinence, as well as on the age and presence of other diseases in the patient. Physiotherapy is always prescribed in combination with medication and other types of treatment.

Alternative treatment

Alternative healers offer their own, sometimes extraordinary methods of correction of urinary function. For example, during bedwetting, it is recommended to carry out the following procedure: for a short period of time, immerse the patient's feet in very cold (literally ice) water, then carefully wipe them with a soft towel and quickly warm them.

In addition, for patients with enuresis, other methods are recommended to retain fluid in the body to prevent its elimination. For example, before going to bed, the patient is allowed to eat a piece of salted herring, or brown bread with salt. The most important condition is that such a “dinner” should not be washed down with any liquid.

Instead of salt, some experts advise using honey - about 1 tsp each. Daily before going to bed for a long time. How exactly honey works in this case is unknown. However, many patients report a significant improvement in well-being and relief of painful symptoms associated with bedwetting.

Herbal treatment

To eliminate night urinary incontinence, infusions and decoctions based on St. John's wort and dill are successfully used.

• 1 tbsp. L dill seeds are brewed in 200 ml of boiling water, infused under a lid for 2.5 hours. They are used a little inside to drink the entire volume per day. Treatment is continued daily for 7-10 days.
• 40 g of dry St. John's wort raw material is poured into a thermos and filled with 1 liter of boiling water. Insist for 2.5 hours. Drink throughout the day instead of tea.

The dominant volume of any liquid, including various infusions, should be drunk in the morning. A few hours before going to bed, fluid intake should be stopped.

In many recipes for bedwetting, plantain is present - or rather, plant seeds. It turns out that they do not have to be pre-cooked at all. It is enough just to take ½ g of seeds three times a day, washed down with water. The duration of such treatment is one month. In the absence of seeds, the infusion of plant leaves is allowed: it is drunk in 1 tbsp. L four times a day.

Homeopathy

Among the various methods of alternative treatment for bedwetting, experts most often recommend homeopathy. This type of therapy is actively used in both pediatric and adult practice. However, the independent choice of drugs is not welcome: they are selected by a specialist, taking into account not only symptoms, but also the individual characteristics of the body. For example, with stress incontinence, Gelsemium is recommended for many patients, but the doctor prescribes the dosage individually.

For tearful, moody natures that require increased attention, Pulsatilla is suitable. If nighttime incontinence is associated with any phobias, Argentum nitricum is prescribed.

Incontinence due to family turmoil requires the appointment of Natrium muriaticum or Causticum.

We must not forget that bedwetting can have both functional and organic nature. Only a specialist can figure out the reasons. Therefore, do not self-medicate. It is better to immediately, without wasting time, consult a doctor who will select the most optimal treatment regimen, having previously determined the origin of the problem.

Surgery

Surgery for bedwetting is a serious procedure, with the possible development of complications. The effectiveness of such operations is estimated at approximately 80%.

Most often, surgeons suggest the following interventions:

• suspending (sling) operation;
• vaginal plastic;
• staging of a sphincter implant;
• injection of volume-forming preparations into the periurethral site.

Indications for surgical intervention are:

• acquired stress enuresis;
• combined leakage of urine with a dominant stress component;
• rapid progression of the violation;
• lack of effectiveness from drug treatment.

Each of the operations has its own additional indications and contraindications. Before deciding on such a crucial step, it is necessary to carefully weigh all possible risks, conduct a full diagnostic examination, and consult with a number of medical specialists.

Prevention

Preventive measures to prevent the occurrence of nighttime urinary incontinence are based on the following actions:

• personal hygiene, training in basic tidiness skills;
• control of the volume of drinking fluid according to the average consumption rate;
• timely treatment of infectious urological and other diseases;
• avoidance of moral pressure on a person, the elimination of stress, the fight against phobias.

If the patient has already had cases of bedwetting, it is necessary to take measures to prevent relapse of this problem:

• establish a drinking regime, with the restriction of the use of any drinks in the afternoon and especially in the evening;
• be patient with the patient, avoid ridicule, rudeness, in no case do not punish and do not focus on the problem;
• limit not only drinking liquids, but also the use of liquid foods (soups, smoothies, juicy vegetables and fruits);
• provide access to fresh air in the sleeping room;
• avoid stress, psycho-emotional stressful situations, excessive fatigue;
• avoid hypothermia;
• Do not eat foods and dishes that have a diuretic property (coffee, cocoa, chocolate, watermelon, etc.).

It is recommended that children suffering from bedwetting be awakened approximately 3 hours after going to bed - to go to the toilet and empty the bladder. [18]

Forecast

Bedwetting can disappear on its own, however, this scenario is characteristic only for lungs, non-severe pathologies of the nervous system and spinal cord. Similar childhood problems often go away by about 12-14 years of age. If you start treatment in a timely manner, then recovery will come much earlier.

With the timely and competent provision of medical care, the prognosis of the disease is quite good: after a couple of therapeutic courses, the child is completely cured. [19]

Another question is that if there is a person in the family who suffers from nocturnal incontinence, then this problem affects all its members. Almost all patients, and especially children, begin to face considerable psychological problems. It is a constant feeling of guilt, shame, fear of night sleep. The sleep becomes restless, superficial, and the patient himself becomes quick-tempered, irritable, capricious, insecure. Often patients become isolated, depressed, which further exacerbates the situation. If a person is not provided with the necessary medical care for a long time, then bedwetting can become a problem for life. Therefore, it is very important at the first unpleasant "calls" to visit a doctor and treat the problem.