Infant bed wetting is a normal phenomenon, but parents should be vigilant when preschool children aged 5 or 6 wet their beds. Here I sorted out the reasons for children's bed wetting for your reference. I hope you can gain something in the process of reading!
Physiological factors
Due to the delayed development of bladder function and the inability to safely exercise the ability of independent control, there is no inhibitory contraction in the urine storage period, resulting in small bladder volume, high sensitivity and poor compliance; The perception ability of bladder filling and systole is not high, and the stimulation intensity of cerebral cortex is lower than the threshold of sleep awakening; Bladder baroreceptor function is abnormal and can not provide early warning information, so that it urinates before waking up.
The closing function of urethra is not complete, that is, the unstable urethra causes enuresis; Urethral malformations such as congenital stricture. About 30-40% of enuresis patients have a family history, which is considered to be polygenic, and the probability of occurrence varies due to different races and regions. In general, the incidence of children with two parent enuresis is 77%, that of children with single parent enuresis is 44%, and that of children without both parents is only 15%.
Mental factors
Bed wetting and mental, psychological and behavioral abnormalities, sudden mental stimulation, such as fear, shock, rage, sadness, strong psychological depression and behavioral abnormalities, and confusion of consciousness can cause enuresis. These factors will become the cause of children's growth and adult persistent refractory enuresis.
Pathological factors
The diseases causing enuresis come from multiple systems, including organic, inflammatory, metabolic and traumatic diseases. The common ones are:
Nervous system diseases: epilepsy, encephalopathy, brain tumor, cerebrovascular disease, multiple cerebrospinal sclerosis, spinal cord inflammation and tumor, hemorrhage, meningocele, lumbosacral fissure, etc.
Urinary system diseases: malformation (urethral stricture, urethral orifice stricture, hypospadias, urethral valve, bladder neck obstruction, male prepuce, phimosis, etc.), inflammation (nephritis, pyelonephritis, cystitis, urethritis, glans), stone, renal function injury, etc.
Other diseases: such as chronic diarrhea, abdominal pain, trachea and lung diseases that cannot be cured after a long cough; Metabolic related ectopic pituitary posterior lobe, pituitary and renal diabetes insipidus, diabetes, etc. Severe anemia, hypercalcemia and hypokalemia related to blood; Masturbation related to bad habits, inertia; Others include sleep apnea, allergies, etc.
Children should not be scolded and treated with determination. 1. Parents give high care and care to children. It is forbidden to drink water after dinner, urinate before going to bed, and wake up the children at night to urinate 1 ~ 2 times.
2. Drug ① imipramine: as a central stimulant, it can reduce the depth of sleep. It takes 25 ~ 50mg orally every night for 3 ~ 4 months. In case of recurrence after drug withdrawal, it can be administered again. ② Parasympathetic blocker: prubencin or oxybutynin (Ditropan). Oral administration before falling asleep can relax detrusor and inhibit bladder contraction. ③ Ephedrine 25mg orally before going to bed. It can increase the contractile force of bladder neck and posterior urethra.
3. Bladder training in the daytime, ask the children to prolong the urination interval as far as possible, gradually from once every 1 / 2 ~ 1 hour to once every 3 ~ 4 hours, so as to expand the bladder capacity.
4. Conditioned reflex training uses a set of enuresis alarm device to train children to wake up before enuresis. Put an electronic pad under the child and connect it with an electric bell. Once the electronic pad is wet, connect the energy circuit to make the electric bell find a sound and wake the child up to urinate; If the effect is poor, imipramine can be added to reduce the depth of sleep. Generally, after 1 ~ 2 months of training, 70 ~ 80% of primary enuresis can be cured.
1. Take the child to the doctor
If a child who never wet the bed suddenly starts to wet the bed, parents should take the child to see a doctor and make the necessary examination. Suddenly, bed wetting should be alert to risks such as urinary tract infection, diabetes and nervous system diseases. Sleep apnea may also be the culprit in children's bed wetting.
2. Have a good talk with your children
A number of studies have found that many bed wetting children feel that things they should be able to control are "out of control", so their self-esteem is frustrated, remorse and sad. At this time, parents should talk to their children to help and encourage them to improve their self-confidence.
3. Do not punish
It is not intentional for a child to wet the bed. It is useless to punish the child.
4. Pay attention to children's constipation
Constipation will compress the bladder, making it difficult for the bladder to store urine normally and enhance the sense of urination. If the child has difficulty defecating and dry stool, it is best to take the child to see a pediatrician.
5. Give children a warning
This is the best solution to the problem of children's bed wetting, with an effective rate of 75%. Dr. Hubert S. warner of pediatric urology at nemes children's Hospital in Florida suggested that once a child is found to wet the bed, wake him up immediately, and then teach the child to change the sheets, take a shower and go back to bed. When children realize that they have to do this every time they wet the bed, they will naturally wake up and pee.
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