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A child who suffers from enuresis is unable to perceive and control urination correctly and consequently manifests an involuntary loss of urine that occurs during sleep.
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The classification also includes a distinction between
To be classified as such, the enuresis disorder must occur with repeated and prolonged frequency: 2 or more times a week and for at least 3 months.
A distinction that must also be made is between
The psychological aspect also plays an important role, particularly in secondary forms.
By way of summary and example, the following causes of the disorder can be identified
Nocturnal enuresis can be considered a normal phenomenon up to 5 years of age: a period when children may not yet have reached complete autonomy and mastery of urinary continence.
In the case of persistence beyond this age, a medical check-up is necessary to exclude other underlying problems and to allow the most appropriate therapy to be set up.
In addition to the objective examination, through which the doctor has the opportunity to assess the lumbosacral region, the genital area and the abdominal area of the child, simple laboratory tests of urine and blood can be prescribed, capable of diagnosing pathologies such as infections, diabetes, endocrine deficiencies.
An ultrasound scan of the urinary apparatus, to rule out anatomical abnormalities or incomplete bladder emptying, also completes the normal diagnostic pathway.
Only when, following the ultrasound, an anatomical and/or functional problem is hypothesised, can more specific investigations be prescribed, such as urodynamic examinations (invasive and non-invasive), which can assess urinary function and the presence of any abnormalities (uroflowmetry, cystometry, bladder residual study, etc.).
Nocturnal enuresis is a problem that in childhood in the majority of cases is not determined by particular pathological problems and that tends to resolve itself during childhood: only a very small percentage of patients remain enuretic even after adolescence.
The psychological-emotional aspect of this disorder must never be overlooked, as nocturnal enuresis can have negative effects on self-esteem; it can trigger depression and discouragement in the young patients affected and in their families.
If, for example, the child suffering from it is diagnosed with diabetes, it will be necessary to act on this with an appropriate therapy, just as, on the other hand, it may happen that constipation is detected, which, by reducing the bladder space, will require a different diet, etc.
New technologies, then, provide further precious help, as some latest-generation devices (nocturnal alarm for enuresis), equipped with special sensors, allow the detection of urine leakage in the sheets or underwear, emitting an acoustic signal that wakes the subject to go to the bathroom.
These devices are particularly useful because they also implement a psychological conditioning process at an unconscious level.
If, on the other hand, the specialist needs to prescribe a pharmacological therapy against enuresis, various drugs may be indicated, the most commonly used in children being
An understanding attitude towards children suffering from nocturnal enuresis is essential as, especially in the primary form, there is no voluntariness of the act.
A reproach to a child for wetting the bed, for example, can be associated by him with the event in a traumatic way, leading to embarrassment and mortification that can make the psychological and emotional burden linked to enuresis even more important.
It is good to remind oneself or one’s children, positively and calmly, that this is a well-defined pathology and that, as such, there is the possibility of tracing the triggering causes and finding a solution.
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