samedi 26 novembre 2011

Enuresis in child

Enuresis is a diurnal or nocturnal urinary incontinence affecting mainly children. It is defined as a normal and complete urination, involuntary and unconscious, without injury to the urinary tract in old age, where sphincter control is normally acquired. Urinary continence day and night is usually acquired before the age of five years with " learning of cleanliness. "

The origins of enuresis
Cause of enuresis is often psychological. Thus, education is too rigid, a prominent event as the arrival of  a little brother or sister may be the cause of enuresis in children. may also find its origin in an immature bladder system with deficiency of inhibition of parasympathetic nerve.

Enuresis is a disorder of control of urination and not urinating itself. Enuresis is both a symptom and a disease state. Bedwetting is called "isolated" if it is not associated with daytime voiding disorders. enuresis called "primary" When the troubles were not preceded by a period of continence and enuresis  called "secondary" if the trouble has been preceded by a period of continence greater than six months without any treatment. Estimated 80of enuresis cases as part of primary enuresis. The most frequent enuresis is the nocturnal enuresis primary monosymptomatic which alone accounts for 60 to 85% of the urinary leakages in child.

The daily management
bedwetting can be "managed" by applying simple rules and involving the child in their set up. thus, it is possible to educate the child to control his bladder:
- reducing fluid intake before bedtime
- asking him to empty his bladder before going to bed
- By encouraging the child to be independent at night, getting up to go to the bathroom when he feels the need
- asking him to help in changing his sheets (this will allow him to participate in his management)
these simple rules can greatly advance the child's conscience of urination.

What are the treatments?

Behavioral therapy
as we have previously set it, conscience plays an important role in the treatment of enuresis. and alarm devices have been developed to awaken the child from the first drops. This type of device is worn on the body of the child and therefore requires motivation and acceptance on his part.

during the dialogue with the child and his environment it is possible to identify the origin of enuresis like a state associated with affective disorders it will be highly recommended to go through psychotherapy.

Enuresis, whose origin is generally psychological has few drug solutions that can treat it. However, some products can be used from time to time or when other non-drug techniques have not yielded results. Thus, treatments exist to compensate for inadequate secretion of antidiuretic hormone or to address underlying causes such as diabetes or urinary tract infections.

Motivation therapies
Psychology is essential in the management of enuresis; and the development of a therapy by the motivation of the child may be a solution. First of all the surroundings of the child must be vigilant to create a favorable environmentfor the child. Simple dialogues with the child and a dédramatization of these disorders can only improve and accelerate the realization of the child. Thus, small "games" such as keeping a calendar or the child will draw a sun or a cloud (depending on the leak or not) allow the child to become aware of his progress. A small reward can sometimes be associated to maintain the motivation of the child.

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