The enocturnal nuresis it is the nocturnal, involuntary and functionally normal elimination of urine that occurs at an age in which voluntary control of urination can be expected in the child.
The Spanish Society of Outpatient Pediatrics and Primary Care gives us the 10 keys that you should keep in mind if your child suffers from this important health problem, whose early diagnostic and treatment can help these children to Improve your quality of life.
It should be noted that nocturnal enuresis it affects 16% of 5 year olds, 10% of those 6 years old and 7.5% of those 10 years old.
1- The nocturnal enuresis is an anomaly in the control of the bladder sphincter from five years of age.
2- Many cases remit spontaneously.
3- Enuretic children have an awakening disorder, that is, They sleep very deep.
4- Also, most of them have nocturnal bladder contractions or increased urinary volume
5- At the pediatrician's office you must discard existence so much from problems renal or other associated with an increase in urinary volume such as nasal respiratory failure that may occur with apnea pauses.
6- It is ideal that any form of treatment begins only when the child requests it and its implication is admitted given the initial importance of behavioral treatment. This usually happens from the age of eight. It is feasible to try behavioral treatment before moving on to a next therapeutic phase with drugs or audible alarms.
7- The desmopressin treatment selectively activate the water resorption in the renal collecting tubule and therefore reduces urine production. This treatment It acts on two factors that favor bedwetting, namely awakening disorder and increased urinary volume. Your employment is not indicated if the child and family are not in a position to strictly comply with the liquid restriction.
8- In cases with a history of previous day symptoms of overactive bladder (polaquiuria (urinating many times small amounts), incontinence, urinary urgency) or when desmopressin is not effective, you can try Anticholinergic drug treatment.
9- When they are used audible alarms, the child must have sufficient degree of maturity to understand how it acts, what is intended and why you have to get up to urinate when the alarm sounds. The response is usually slow and compliance demands effort and involvement of the child and his family. The alarm is activated when the humidity of the first drops of urine reaches the electrode. At that time the child must wake up and stop urination, disconnect the system, go to the bathroom, urinate and change clothes if it has been wet and reconnect it before going to bed. It is the form of treatment that maintains greater efficiency once its use is suspended.
10- Although it is not a disease, nocturnal enuresis should be treated because negatively influences in the Child's self-esteem
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