Enuresis in adolescents - why young people suffer from this disease

Bedwetting is not as common in teenagers as it is in younger children, but it still happens. Statistics say that 4% of children aged 12-18 years suffer from this disease.

The overwhelming majority of patients are boys. Teenagers have an extremely negative attitude towards this disease; it often causes psychological problems.

It is difficult to cure enuresis in adolescence. But, if you take the disease seriously, it is possible.

Parents should try a comprehensive approach to treatment, but take any action only after medical consultation.

Effective treatment of enuresis with a urinary (bedwetting) alarm clock

An enuresis, or urinary, alarm clock is a device whose operation is based on the following principle: the first drop of urine falls on a miniature sensor attached to underwear.
It is transmitted to an alarm clock or to a bracelet attached to the child’s hand, including a light, vibration or sound signal. To turn it off, you need to wake up, get out of bed, and urinate. Thus, children form a reflex that connects the urge to urinate with the need to wake up. Important terms:

• the child must be over 7 years old;
• he understands and recognizes the need to use a bedwetting alarm.

The mechanism of action of the device has not been fully studied, but the proven effectiveness of the method ranges from 91 to 99%. The course of treatment takes several weeks, another 2-3 weeks are required to consolidate the skill, after which the pathology does not return.

The method using a regular alarm clock, when the child is forcibly woken up a little earlier than he usually wets the bed, is approximately 50-80% effective. Here, just as in the previous method, a conditioned reflex is developed that associates urination with the ringing of the alarm clock. The use of this method is impossible without the participation of the child’s family members and without his conscious attitude.

The necessary conditions:

• The started course of therapy cannot be interrupted; it is carried out under the supervision of a physician;
• The parent helping to wake up should sleep with the child in the same room and help him wake up when the alarm goes off;
• A pronounced effect occurs after 6-8 weeks, after which the course is continued until the child wakes up in a dry bed for 2 weeks in a row.

Every 3-5 days, the alarm clock is set 15-20 minutes ahead until the wake-up time is reached around 7 am. If a time shift leads to failure, you should return to your previous steps.

Treatment prognosis and consequences

Incontinence in children has a relatively favorable prognosis. If you follow all medical recommendations, the problem can be solved within a period of 2 weeks to a year, depending on the form of the pathology.

The consequences of voluntary urination disorder include:

• skin irritation, diaper rash, dermatitis;
• inflammatory diseases of the lower excretory tract (urethritis, cystitis);
• in older children: psychoemotional disorders including depression;
• violation of social adaptation.

Urinary incontinence can lead to serious psycho-emotional disorders

Causes

Until a certain age, urination in babies is not regulated due to the fact that from the moment of birth they adapt to new conditions, form all life processes and skills to meet their physiological needs. If by the age of 4 these processes have not returned to normal, then parents need to ask themselves the question of the causes of the pathology.

According to the famous pediatrician Komarovsky E.O., enuresis does not mean the presence of serious pathologies in the body, so its treatment can quickly help get rid of involuntary urination during sleep, if it is properly organized. The main thing is that parents must remember the need for a gentle attitude towards the child, even if the treatment is delayed.

To choose the right treatment for enuresis in children, you should know the causes of its occurrence.

There are 7 main causes of the disease:

1. heredity;
2. immaturity of the central nervous system and underdevelopment of the bladder;
3. psychological aspect, for example, quarrels in the family, problems at school, change of environment;
4. the baby’s nervous system is delayed in development;
5. disruption of the production of a hormone that is responsible for the amount of urine produced in the human body;
6. diseases of the genitourinary system, for example, narrowing of the foreskin in boys and the urethra in girls;
7. urinary tract infections.

Enuresis and the army

Urinary incontinence can be a reason for a conscript to refuse to serve. But this diagnosis must be confirmed by doctors and recorded in the conclusion of the medical commission.

Why don't they serve with enuresis? The army is a place where the conscript is subject to severe physical and emotional challenges, so even healthy young people who have not previously suffered from this disorder can develop it. Guys with urinary incontinence may experience exacerbations, and there is a high likelihood of more frequent episodes even during the daytime.

But if a young man suffers from enuresis and has never sought treatment, then he can be drafted into the army.

Types of disease

Bedwetting can be caused by the child’s sound sleep
. According to the modern classification, the disease is usually divided into 2 forms:

• Primary. It manifests itself only as bedwetting in children; it usually occurs very early, when the baby still has poor bladder control at this point.
• Secondary. It can appear both at night and during the day. It is characterized by constant relapses; after some time after effective therapy, urinary incontinence occurs again.

Traditional medicine is a storehouse of healing methods for all kinds of diseases, so you should not neglect effective home recipes that came from time immemorial. They have been tested in practice by many generations of people and contain only natural ingredients:

• For children under 10 years old, brew a tablespoon of dill in a glass of boiling water and leave for an hour. Drink half a glass in the morning on an empty stomach.
• Cook lingonberry compote with the addition of 2 tablespoons of rosehip, let it sit. The infusion can be drunk several times a day; it has a calming effect on the nervous system.
• Pour 2 tablespoons of rose hips into one liter of boiling water and leave. Instead of tea, drink throughout the day. Rosehip strengthens nerve cells well.
• Bring lingonberry berries and leaves, St. John's wort in an arbitrary small amount to a boil in ½ liter of water. Leave for 30 minutes, strain, cool and take throughout the day.
• Brew 30 g of crushed plantain leaf in 350 ml of hot water, let it brew, take 10 g 4 times a day.
• Chop the herbs of mint, St. John's wort, birch leaves, chamomile flowers in equal parts and mix. Pour 50g of the mixture into 1 liter of hot water in a thermos and leave for 8 hours. Take 100 g half an hour before meals. To ensure that your child drinks the infusion with pleasure, you can add honey to it. After 3 months you need to take a break for 2 weeks, then continue taking the drug.
• A collection of knotweed, yarrow, St. John's wort, and blackberry leaves will relieve the symptoms of enuresis. All ingredients must be crushed and mixed in equal parts. Pour 300 ml of boiling water over the finished 10g mixture and leave in a thermos for 2 hours. The infusion should be taken 5 times a day before meals.

Folk remedies will have the desired effect if taken under the supervision of a physician. Herbal remedies are an addition to the main treatment and should not be a complete replacement for it. In addition, herbal remedies can have a good effect in preventing enuresis.

To make such a diagnosis, the child must undergo a comprehensive examination. A competent specialist will not only prescribe medication, if necessary, but also introduce you to the physiotherapy procedure, recommend a massage, and send you for a consultation with a child psychotherapist.

There is also the practice of treatment with folk remedies. But it is worth remembering that only if the baby wets the bed at night more than 3 times a month and has reached the age of 5, we can talk about a disease such as enuresis.

It is very important not to confuse normality with pathology. That is why only highly specialized specialists are able to assess the case and prescribe or deny the need for treatment.

Parents, for their part, can only help understand the causes of enuresis in children.

According to research data, it is known that 15-20% of 5-year-old children suffer from bedwetting, 7-12% of children suffer from bedwetting at an older age.

Among teenagers 12-15 years old, this figure is set at 3%. If we talk about gender, boys have this disease 2 times more often than girls. Among the 18-year-old population, up to 1% of people suffer from enuresis.

Types of disease

Bedwetting may be caused by the child's sound sleep

All parents are faced with the problem of bedwetting in children, but not everyone knows that you really need to start worrying when it happens after 5 years. The disease means the bladder is unable to hold its contents. When a person sleeps, the muscles relax, so involuntary urination occurs.

If “trouble” happened to a small child, then there is nothing to worry about. Parents of those children who have crossed the five-year mark and continue to wet the bed should sound the alarm

There are primary and secondary enuresis. The primary form of urinary incontinence most often develops according to a family scenario, when the teenager’s direct relatives suffered from this pathology. Sleep characteristics, the type of response of the central nervous system to psychological stress, and the production of antidiuretic hormone by the pituitary gland are inherited. The combination of 2-3 unfavorable influence factors leads to the fact that from the moment of birth the child almost never wakes up in a dry bed.

The secondary form is formed when the urinary control reflex was formed at one time, but for some reason disintegrated. Most often, negative factors are diseases of the genitourinary system and endocrine disorders (diabetes mellitus).

Causes of bedwetting in adolescents:

• Infections of the urinary system, when the kidneys and bladder are affected (cystitis, pyelonephritis, pyelitis, nephritis).
• Congenital absence of a conditioned reflex to control urination.
• Genetic predisposition inherited from direct relatives.
• Injuries of the lumbar spine, pelvic organs.
• Prolonged stressful situation, teenage crisis.
• Hormonal changes in the body.

The psychological factor significantly influences bedwetting. These could be conflicts with peers, teachers and parents, excessive workload at school, moving to a new place of residence, sleep disturbances, character traits, and lack of self-confidence.

What is urinary incontinence in a child?

Urinary incontinence in a child (the medical name is incontinence) is a persistent disorder of controlled urination, that is, the inability to hold urine in the bladder, resulting in its spontaneous leakage during daytime wakefulness or night sleep. Incontinence is not an independent disease; this disorder accompanies various pathologies and is combined with other manifestations.

Incontinence affects about 10% of all children under ten years of age, and the most common form of the disorder is enuresis, that is, urine leaks at night, during sleep. Statistics say that approximately 20% of five-year-old children have the problem of bedwetting, and involuntary loss of urine during the day is observed in 8% of children of the same age.

Now medicine does not classify enuresis before the age of five as a pathological condition, but defines it as a stage in a child’s development when he is just learning to control his body. Over the years, the issue resolves itself. However, approximately 5% of children still suffer from the unpleasant phenomenon by the age of 12.

Incontinence (especially nighttime) before the age of five is not considered a pathological condition.

Boys are more susceptible to the disorder than girls. One tenth of boys under 14 years of age experience enuresis. Little girls learn to control urination and potty training faster than boys - this is due to the functional characteristics of their nervous system.

Teenage incontinence is not a very common phenomenon. It usually appears against the background of severe stress or mechanical trauma, while in children it is often due to organic reasons.

Classification of the disorder

Pediatric urologists separately consider urinary incontinence and incontinence. In the first case, the child is unable to control the flow of urine, because he simply does not feel any urge to urinate; in the second, the baby feels the need to go to the toilet, but cannot prevent the process of urination, unable to hold urine.

There are daytime, nocturnal or permanent (mixed) types of incontinence. If uncontrolled urination occurs in a child over 3.5–4 years old during sleep (at night or during the day) at least 2 times a month, and no mental abnormalities or urogenital diseases have been identified, then we are talking about enuresis.

Enuresis is a form of urinary incontinence where uncontrolled urination occurs during sleep

The nature of the disorder can be:

• Primary or persistent. In this case, the natural process of formation and consolidation of the voluntary urination reflex is delayed. The disorder usually accompanies neuropsychiatric diseases or pathologies of the urinary organs.
• Secondary, or acquired. Such a disorder is said to exist if the skill of voluntary urine retention disappears after a “dry” period, that is, spontaneous urine output was not previously observed (except for physiological incontinence at an early age) or it was absent for more than six months. The secondary disorder may be traumatic or psychogenic in nature.

Depending on the mechanism of development of the disorder, the following types are distinguished:

• Imperative (urgent), when the child is unable to control the bladder at the maximum point of urge. This phenomenon is usually observed in babies with a neurogenic bladder with increased excitability of the detrusor (the muscle that is needed to expel urine).
• A reflex form that arises due to miscoordination of the centers of the spinal cord and brain, which regulate the functionality of all internal organs. With this disorder, uncontrolled release of urine in drops or small portions is observed.
• The stress type of the disorder is caused by poor development of the pelvic muscles and urethral sphincter. In this case, the child urinates due to a sudden change in intra-abdominal pressure when lifting heavy objects, laughing, sudden movements, coughing, sneezing.
• Paradoxical ischuria, or incontinence with a full bladder. This type of pathology occurs when urinary outflow is impaired due to obstruction (blockage) of the urinary tract under the bladder or is associated with a neurogenic bladder of the hyporeflex or arereflex type. The bladder overflows, overstretches, bladder pressure exceeds intraurethral pressure, and involuntary drip of urine occurs.

Urinary incontinence can occur for various reasons

Total incontinence is rare and is a constant drip of urine. This type of pathology occurs against the background of severe insufficiency of the urethral sphincter, with ectopia, that is, incorrect location of the ureters (urethral or cervical) or with cystic spasms caused by neurogenic disorders.

Urologists distinguish between vesical and extravesical incontinence. In the first case, urine is excreted naturally - through the urethra, in the second - through other pathological channels. Such unnatural flow of urine is observed with malformations of the genitourinary organs:

• non-fusion of the urachus (vesico-umbilical fistula);
• exstrophy of the bladder - underdevelopment, in which the mucous membrane of its posterior wall is turned outward;
• ectopia of the mouth of the ureters, that is, their atypical extravesical or intravesical location;
• epispadias (splitting of the upper wall of the urethra);
• hypospadias, that is, a displacement of the location of the urethral outlet.

Video: doctor about urinary incontinence in children

Treatment of enuresis with plowed clover

The use of herbal remedies helps to gently and gently get rid of the problem of nocturnal enuresis. It is important to remember that before treatment you should check the child’s reaction to the drug mixture so as not to cause an allergy attack. To do this, apply a minimal amount of herbal infusion to the wrist, behind the ear, and on the elbow. Redness of the skin indicates that the drug should not be used.

Arable clover is a common plant; its other names are: cat's clover, rabbit's clover, porridge, cat's ears.

It is valued for its rich composition, which includes:

• Essential oils;
• Tanning compounds;
• Mineral salts;
• Quercetin;
• Organic acids;
• Vitamins C, E.

You can collect clover yourself, or you can purchase a ready-made pharmacy collection. The drug Trifolium arvense was created based on cultivated clover. For enuresis, use tea from this plant - 1 tbsp. l. clover herbs are poured into a glass of boiling water and drunk with sugar, like regular tea. The infusion is very effective and helps quickly.

Which specialist should I contact?

The doctor who deals with the primary diagnosis and treatment of all childhood diseases is a pediatrician. Despite the fact that the disease is associated with the urinary organs, it is worth starting with a visit to this particular specialist. A qualified doctor must identify the specialist who will be needed for a more accurate diagnosis and refer the parents and child for a full examination.

Considering that enuresis is a disease that can be caused by a number of different factors, it is appropriate to undergo examination by several specialists:

• the neurologist prescribes electroencephalography, which should reveal the state of the nervous system;
• the psychologist finds out whether there have been stressful situations, how the child is developing, uses special techniques to identify the emotional background in the family, and gives recommendations to parents;
• The urologist prescribes an ultrasound of the child’s kidneys and bladder, a urine test, and then drug treatment.

Each specialist works in turn, looking for the causes of the disease in their area.

Diagnostics

A teenage child is not always able to bring his problem to public attention and decide to visit a doctor.

His problems are first dealt with by a pediatrician who, if necessary, refers the patient to such specialists as:

• Pediatric urologist,
• Endocrinologist,
• Neurologist,
• Psychiatrist.

To accurately assess the health status of a teenager, a full examination is prescribed:

• General blood and urine analysis;
• Ultrasound of the bladder, kidneys;
• Bacterial culture of urine;
• X-ray of the pelvic organs;
• Cystoscopy;
• Assessment of bladder reservoir function.

Based on the diagnostic results, the doctor determines the treatment tactics for nocturnal enuresis.

Treatment of enuresis with honey water

Honey is a universal remedy used in the treatment of bedwetting. In this case, the property of honey to retain fluid in the body is used. To prevent nocturnal enuresis, the child should drink honey water before falling asleep. It is prepared very simply - add a teaspoon of honey to 1/2 cup of water. The course of treatment is short - only 3 days. You can divide 100 ml into 3 doses, taking 30 ml three times a day.

A longer course of treatment using honey is 3 months. Honey is added to the infusion of a mixture of medicinal herbs (chamomile, centaury, mint, knotweed, St. John's wort, birch leaf). To prepare a medicinal drink, pour 15 g of a mixture of herbs with boiling water, leave for 10-12 hours, and filter. Add honey to 1/2 cup of the decoction and repeat the intake 3-4 times per day.

How to treat enuresis?

There is no single prescription for the treatment of bedwetting in children, since the prescription depends on the causes of its occurrence. Each specific case requires an individual approach. Methods of drug treatment are prescribed based on the results of diagnosing the condition of the bladder muscles, the content of the hormone vasopressin, which regulates fluid levels, as well as the condition of its receptors:

1. Minirin - produced on the basis of vasopressin in the form of nasal drops, instilled before bedtime;
2. Driptan – with increased bladder tone;
3. Minirin in combination with Proserin - for hypotension of the bladder in the form of injections;
4. Nootropil, Persen in tablet form, B vitamins - treat nocturnal enuresis of neurotic origin.

All medications are used only after examination, identification of the causes and prescription by a specialist with strict adherence to the rules of administration and dosage. Alternatively, patients may be referred to a homeopathic physician who will prescribe alternative remedies:

1. Pulsatilla – in the presence of infectious diseases of the urinary tract, also for emotionally excitable children;
2. Gelsemium – for symptoms of relaxation of the bladder muscles as a result of stressful situations;
3. preparations containing Phosphorus are prescribed to children who drink a lot of cold water;
4. Sepia – for urinary incontinence when coughing, laughing at any time, also in the first 3 hours after falling asleep.

Modern homeopathic medicines can guarantee a cure for enuresis, provided that the diagnosis is correct. Alternative methods may be prescribed if medications do not have the desired effect and bedwetting in children cannot be cured.

Diseases of nervous origin are often treated using traditional medicine. Persen is considered one of the safest sedatives

Causes of urine leakage when laughing

The main causes of urine leakage when laughing:

• Pressure incontinence. Due to complications in childbirth or being overweight, the pelvic muscles become stretched and the muscle fibers cannot support the bladder. It moves down and presses on the vagina, thereby preventing the urethral sphincter from contracting. Urine leakage occurs with additional pressure (laughing, coughing, sneezing).
• An irresistible urge. In this case, an involuntary contraction of the bladder muscles occurs, which, in turn, causes the urge to urinate. Urine leakage occurs even before the woman has time to approach the toilet.
• Overactive bladder;
• Increased intra-abdominal pressure;
• Climax;
• Gynecological operations of any nature;
• Hormonal changes;
• Constant hard physical labor.

As medical statistics show, in women, stress leakage of urine most often occurs due to the presence of several reasons.

Special exercises for enuresis

There are simple and effective exercises to get rid of enuresis. They are used according to gender: for women, Kegel exercises are used, stimulating the pelvic floor muscles and bladder sphincter, while men train the perineal muscles.

Sequence of performing Kegel exercises:

• Squeeze the pelvic muscles responsible for holding the stream of urine and hold in this position for 5 seconds.
• Rest for 10 seconds.
• Repeat 3-4 times.
• Squeeze your muscles for 10 seconds.
• Relax for 10 seconds, repeat 3-4 times.
• Squeeze your pelvic floor muscles for 30 seconds.
• Repeat 2 times.
• Repeat the entire cycle 2 times a day.

Men are recommended to interrupt urination 3-4 times during urination. With each “training” the urinary retention time increases. Pronounced results appear after a month of regular exercise.

Treatment for urine leakage when laughing

If urine leakage occurs when laughing, you need to contact our urology and oncology medical center for immediate treatment of this ailment. Sometimes it is enough to change your lifestyle for this problem to leave your body forever. Urine leakage when laughing can only be treated comprehensively .

Initially, treatment is aimed at eliminating the underlying causes of involuntary urination.

If the problem of urine leakage is caused by weakening of the pelvic floor muscles, then special physical exercises are prescribed that are aimed at strengthening the abdominal muscles, urethra and perineum. The selection of a treatment method is carried out only by a highly qualified urologist or gynecologist. The doctor makes the decision and method of treatment only after studying the tests performed and the entire medical history.

In our medical center for urology and oncology, there is a whole range of medical measures that help you forever forget about such a common problem as urine leakage when laughing. Physical exercises are prescribed to all women familiar with this problem. Performing these exercises strengthens the muscles that are involved in the process of urination.

Losing excess weight is guaranteed to help cope with urine leakage . Experienced doctors will help you identify all types of foods that irritate the bladder lining. Excluding them from the diet, abstaining from alcohol and smoking will help cope with the problem. Then you need to change your urination habits (scheduled urination, bladder training, stimulated urination). To treat urine leakage when laughing, you may be prescribed medications to suppress the involuntary contraction. Anticholinergics are the most commonly prescribed drugs, which relax the bladder and increase its capacity.

Special medical devices are commonly used that are inserted into the vagina to create pressure that will help support the urethra and thereby retain fluid in the bladder. If conservative treatment is ineffective, surgical intervention is resorted to. Today, there are a huge number of surgical operations aimed at treating urinary incontinence during laughter.

The purpose of surgical operations is to restore the anatomically normal position of the organs of the urinary system

The main operations of our medical center for urology and oncology:

1. Transurethral resection;
2. Sectional nephrolithotomy;
3. Brachytherapy (local radiation therapy);
4. Perineal prostatectomy;
5. Laparoscopic prostatectomy.

In our medical center for urology and oncology, urine leakage during laughter is treated using modern and completely safe treatment methods for the body , which return patients to normal everyday life in the shortest possible time. Our medical center for urology and oncology has a narrow specialization in the treatment of diseases of the genitourinary system. Taking into account our many years of experience and high skill, we confidently speak about successful results in the treatment of urological diseases.

Enuresis tablets

Therapy with medications is the last chance to get rid of the problem if other methods have proven ineffective.

Enuresis must be treated if the patient is over 5 years old. Children under five years of age may normally experience bedwetting.

Medicines for enuresis are prescribed by the attending physician. It is impossible to choose an effective drug on your own, since the causes of incontinence can be varied.

During treatment you should adhere to the following recommendations:

• treat the child with medications in combination with psychotherapeutic techniques;
• Under no circumstances should you scold him for a wet bed, but, on the contrary, support the baby and say that he will soon recover;
• improve family relationships and eliminate quarrels;
• talk with the child, find out why he does not get up to go to the potty at night, maybe he is afraid to wake up his parents.

Drug therapy helps to get rid of the unpleasant manifestations of enuresis if other methods have failed. In 30% of cases, the problem disappears forever within 2-3 months; the remaining patients require a little more time to recover.

There are many groups of medications. Drug treatment can be carried out with the following medications:

• tranquilizers or antidepressants - if the cause of childhood incontinence is hyperactivity or other disorders of the child’s psycho-emotional state;
• antibiotics – in the presence of pathogenic microorganisms in the urine;
• nootropic drugs - affecting the nervous system;
• antispasmodics – to normalize bladder regulation (decreased tone);
• hormonal drugs are effective for enuresis caused by a shrinkage of the bladder.

Synthetic analogs of antidiuretic hormone are most effective for urinary incontinence. Drugs in this group eliminate hormonal imbalances that lead to enuresis. They contain an analogue of the hormone vasopressin, which is responsible for nighttime urine production.

When treated with hormonal drugs, the volume of urine at night and the number of urinations decrease. Tablets for enuresis of this group:

• Minirin. It is the best remedy for children against nocturnal enuresis. The tablets have a pronounced antidiuretic effect. They are prescribed for polyuria, primary nocturnal enuresis, neurogenic bladder and other pathologies. The drug is contraindicated in anuria, edema syndrome, polydipsia, taking diuretics, renal failure, fibrosis of the bladder, predisposition to blood clots, during pregnancy and children under 1 year. Side effects of this drug in the form of nausea, dizziness and headache occur in case of heavy fluid intake. The course of treatment can last up to 3 months.
• Adiuretin SD. Available in the form of drops and tablets. Indications, contraindications and side effects are similar to those of Minirin.
• Desmopressin. Available in the form of nasal drops and spray. The indications and side effects are the same.

The active ingredient of all products is desmopressin.

These are drugs that have an antispasmodic effect, normalize bladder contractions and increase its volume by reducing receptor sensitivity. Medicines in this group are effective for neurogenic bladder.

List of popular remedies for enuresis in children:

• Atropine. Available in the form of an injection solution. Contraindicated in case of individual intolerance. It should be used with caution in case of reflux esophagitis, intestinal atony, cerebral palsy and Down's disease. Can be used by children from 3 months. Adverse reactions - tachycardia, dry mouth, urinary retention, dizziness.
• Driptan. Reviews about the drug are positive. It helps with nocturnal enuresis and urinary incontinence caused by bladder dysfunction. Driptan tablets have antispasmodic and myotropic effects. They should not be taken for ulcerative colitis, intestinal atony, bleeding, obstructive uropathy and for children under 5 years of age.
• Spasmex. The tablets control the excretion of urine from the body. Contraindicated in renal failure, heart disease, urinary retention, galactose intolerance and children under 14 years of age. You need to drink 1/2 tablet up to 3 times a day. The course of treatment is from 3 to 6 months.
• Detrusitol. These are tablets from the group of m-anticholinergic drugs. Indicated for overactive bladder and bedwetting. The drug should be used with caution in children under 18 years of age. Side effects include dry mouth, tachycardia, weakness, blurred vision, headache and dizziness.

For secondary enuresis, nootropic drugs that improve metabolic and bioenergetic processes in nerve cells are effective.

Enuresis is treated with the following medications:

• Pantogam. Improves brain function, reduces muscle tension in the bladder. You need to take 3 tablets per day. The course of treatment is 20-40 days.
• Picamilon. This is an effective remedy for bedwetting. Suitable for children aged 3 years and older. It has the following side effects: headache, itching, allergies, tachycardia, excitability, irritation.
• Pantocalcin. Tablets are effective for urinary disorders such as enuresis, pollakiuria, daytime urinary incontinence and urgency. Contraindicated in acute renal failure.
• Cortexin. This is an injection solution that is used for newborns from the first days of life. It has no adverse reactions or contraindications.

Improve metabolic processes in the nervous system and accelerate the transmission of nerve impulses Glycine, Piracetamine, Taufon and folic acid. Also, these drugs stimulate blood circulation and have a calming effect. They cause the child to wake up at night with the urge to urinate rather than wet the bed.

For psychogenic nocturnal enuresis, the drug Phenibut is also effective. It normalizes mental state. The course of treatment is 7-10 days.

For bladder infections, antibiotics such as Fosfomycin or Cefixime are prescribed to treat enuresis in children.

Antidepressants affect the biochemical processes of the brain. They reduce the excitability of the bladder, activate nerve impulses transmitted by the central nervous system and have an antidiuretic effect. These tablets include Imipramine and Amitriptyline.

Treatment regimen

Treatment lasts 1-3 months, sometimes the course is longer.

Night form

2 hours before bedtime you need to limit your fluid intake. The child is given medicine 1 hour before. Before going to bed, the baby needs to be seated on the potty so that he defecates. At night you need to hug the baby, kiss, read a fairy tale. The atmosphere should be calm.

Day form

It is necessary to establish a daily routine, protect the child from stress, limit too active games, and avoid overwork and hypothermia. Foods and drinks that have a diuretic effect should be excluded from the diet.

When treating enuresis in children with tablets, you should carefully read the instructions. Most products have age restrictions and severe side effects.

Oksana Belokur, doctor, specially for Nefrologiya.pro

Drug therapy for bedwetting includes many effective drugs:

• Minirin. The main active ingredient of the drug is desmopressin, a synthetic analogue of the hormone vasopressin, normally produced by the pituitary gland. The effect of taking Minirin tablets is felt after 15 minutes and lasts 10 hours.

  Contraindications for use: psychogenic and congenital polydipsia, angina pectoris, tendency to thrombosis, pathologies of the respiratory system, disturbances of consciousness.

  The effectiveness of the product is so great that it is able to eliminate bedwetting in one course, judging by the reviews of patients and their parents. Minirin is available in the form of tablets that need to be dissolved under the tongue, and as a nasal spray.

• Driptan. The drug reduces the frequency of involuntary urge to urinate and is an antispasmodic. The main active ingredient oxybutin regulates the contraction and relaxation of the bladder sphincter. It is used for the neurogenic form of nocturnal enuresis in patients over 5 years of age.

  Contraindicated for gastrointestinal diseases, bleeding tendency, myasthenia gravis. Usually, for the treatment of nocturnal enuresis, 2 tablets per day are sufficient, one of which is taken immediately before bedtime. Although the urge to urinate becomes less frequent, the risk of side effects (headache, weakness, nausea) forces us to look for analogues of the drug.

• Picamilon. The drug belongs to the group of nootropics that normalize blood circulation in the brain and acts as a psychostimulant and tranquilizer. Contraindications are minimal - children under 3 years of age, severe renal failure. It is used as part of complex therapy of urological diseases in adults and children.
• Melipramine. The drug belongs to the group of antidepressants, sedatives, and is used to treat mental disorders, urinary incontinence, and nocturnal enuresis. Melipramine has serious contraindications for use: cardiovascular pathologies, tuberculosis, diabetes mellitus, hypothyroidism, and a tendency to seizures. To treat bedwetting in children, take 2 tablets, one of them an hour before bedtime. Users note the positive effect of using Melipramine. Occasionally, children experienced side effects such as nausea and drowsiness, but these manifestations were insignificant.
• Pantocalcin. The drug belongs to the group of nootropics and is used to treat a wide range of mental disorders and delayed mental and mental development. Contraindications are minimal - pregnancy and individual intolerance. Treatment with Pantocalcin for nocturnal enuresis takes from 2 weeks to several months. The medicine is issued by prescription and taken under the supervision of a doctor.
• Pantogam. The drug belongs to the group of nootropics and is used in children over 3 years of age to treat disorders of intellectual and psychoemotional activity, developmental delays, neurotic disorders, and urination disorders.

  The medicine is safe, has a minimum of contraindications, and positive reviews from the parents of patients. The effect of Pantogam is cumulative and manifests itself after 1.5 months of regular use. Side effects are minimal, most often they are increased drowsiness and sleep disturbances. Therefore, it is not recommended to take Pantogam after 16 hours.