Enuresis: Practice Essentials, Background, Pathophysiology
Enuresis is a pathological condition when a person, due to certain neurological reasons, is unable to control the process of urination by his own efforts. This ability of control is either not yet acquired, if we talk about enuresis in children, or lost for some reason. Urination disorder is possible at very different ages, and this significantly reduces the quality of life, as well as affects physiological and psychological comfort.
In 5% of all cases, enuresis is observed in adolescents, and in adulthood this figure decreases to 1%. The disease is treated by both a pediatrician and a neurologist or urologist.
Causes and provoking factors
Today there is no exact data on what can cause enuresis. And although a lot of research is conducted every year, and different hypotheses are put forward, none of them has been confirmed.
The most common theories explaining the development of such a problem of urination are the following:
- Delay in the development of the nervous system. This may be due to the presence of organic pathology of the brain or functional problems.
- Heredity. It is assumed that if adults had enuresis, then it is highly likely that their children will also be diagnosed with this pathology.
- Hormonal disorders, namely problems with the production of vasopressin. Normally, the amount of this hormone increases at night, which allows you to reduce the amount of urine released by the body. However, with minimal vasopressin production in a dream, there is a high probability of nocturnal enuresis.
- Psychogenic factors, including fears, bullying by peers, low self-esteem, problems with parents. However, there is also the opposite effect – in children with enuresis, the mental state deteriorates greatly, but it returns to normal after getting rid of the disease.
The main symptom is the inability to retain urine. This negatively affects the mental state of a person with such a diagnosis. He becomes shy, withdrawn, he develops complexes. For some, on the contrary, it can cause excessive aggression and resentment against the whole world for injustice.
Enuresis in women usually manifests itself during pregnancy, especially after half term. The provoking factors are coughing, sneezing, any sudden or unexpected movement.
Enuresis in men is a consequence of alcoholism, problems with the prostate gland or after a stroke. Also, this condition is noted in people whose age exceeds 70-80 years.