How is it treated?

Treatment of neurosis-like incontinence is carried out together with a neuropathologist:

• make a less deep sleep: take a warm bath, and a cool shower before bed, tonic drugs in small doses at night (ephedrine, atropine, belladonna, for example - bellataminal, theophoodrin);
• mobilizing psychotherapy: explain to the child that urinary incontinence is not good, if he does not want to be cured - no one will help him;
• elaboration of the reflex: to awaken the child at the same time, it is necessary to exaggerate, that is, to lead at night to the toilet completely awake, so that the child does everything consciously;
• be sure to consult a neurologist in terms of prescribing nootropic drugs for the night (nootropil, encephabol) and, in severe cases, antidepressants (amitriptyline, etc.);
• psychiatrist consultation;
• reflexology;
• physiotherapy: paraffin applications on the urinary bladder area for trophic improvement, daily for 12-15 days; electrophoresis on the area of the bladder with atropine;
• LFK for strengthening the muscles of the pelvic floor;
• drugs that improve microcirculation: vitamins B ₆, B ₁₂, B ₂;
• adiurekrin - increases the reabsorption in the tubules of sodium and water, therefore, less urine is formed and the baby peeds less. Constantly preparations on the basis of vasopressin can not be given, but in complex therapy in children older than 5 years - the effect is good;
• enuresol: powder, given before bedtime (constituents: belladonna extract, ephedrine, vitamin B _: etc.).

"Spinal bladder" - a serious pathology associated with spinal cord injury, which is difficult to correct, for example, with expressed spinal hernias or transverse myelitis. Obligatory consultation of a neurologist and urologist.

Treatment of enuresis in children:

1. Find out a detailed obstetric anamnesis for determining the "nature" of enuresis: neurosis or neurosis-like condition.
2. Assign laboratory-instrumental methods of research:
   • analysis of rhythm and volume of urination on Saturday and Sunday;
   • trial according to Zimnitskiy;
   • several urinalysis (3-5) of the common and Nechiporenko;
   • Ultrasound of the urinary system to identify gross urological defects.
3. If there are changes in the examination, according to clause 2, X-ray-uricologic examination (cystography, urography) is performed to reveal nephrologic and urological pathology.
4. If there are no changes in the survey presented in paragraph 2 - conduct EEG and EchoEG, myography, prescribe a consultation and treatment of a nephrologist (with neurosis-like conditions) and a psychiatrist (with neurosis). In the absence of effect for 6-12 months. X-ray examination is also shown.

All of the above conditions can lead to the development of neurogenic dysfunction of the bladder.

Medical measures for any kind of enuresis:

• adequate psychotherapy (different in neurosis and neurosis-like state);
• calm situation, without overloads and stresses (reduce the time for watching TV programs, exclude quarrels, etc.);
• diet: dinner for 3 hours before bedtime with the exception of diuretics (exclude apples, cucumbers, dairy products, coffee);
• for the last hour before bedtime 3 times (every 20 minutes) to recommend the child to go to the toilet;
• sleep on your back in a warm bed;
• Exercise therapy, swimming, bicycle to strengthen the muscles of the back, abdomen, perineum;
• continue treatment for 3-6 months. After cessation of enuresis. It is better to treat out-patient or in a sanatorium.

In the vast majority of cases, if there are no gross developmental defects or traumas of the spinal cord and brain, correct reflexes are formed in children by the age of 9-11 and enuresis stops. However, without timely treatment, an infection of the urinary system (pyelonephritis) or neurosis (if it was not present) may occur, requiring treatment by a psychiatrist.

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