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ENURESIS NOCTURNA (NACHT BODEM NAT)


Involuntary bedwetting at night is defined as Enuresis Nocturna in children over the age of 5 who do not have congenital or acquired central nervous system problems. It is one of the most common urinary system problems of childhood.

Bedwetting is divided into two groups as Simple and Complicated. In simple bedwetting, there are no symptoms other than incontinence to bed at night. In complicated bedwetting, symptoms such as sudden urgency during the daytime, frequent urination, daytime urinary incontinence and chronic constipation are the threshold, apart from nocturnal urinary incontinence.

If no nighttime urine control has been achieved since birth, this Primary Enuresis is defined as Secondary Enuresis if it starts again after a dry period longer than 6 months.



Why Do Kids Soot?

Genetic factors, waking disorders, hormonal factors and bladder (urinary bladder) related factors are responsible for simple bedwetting, which is more common. While the incidence of this problem is 77% in a child who has bedwetting problems in both parents during childhood, this frequency is 46% in a child whose single parent has bedwetting.



-Waking Disorders: Families of children with bedwetting problems often mention that their child has difficulty waking up. However, studies have shown that the sleep depth of these children is not different from other children. Most of these children wake up after urinating. However, the main problem in these children is that they do not perceive that their bladder is full. This is a developmental delay and this condition improves with age.

- Low bladder capacity: The urinary bladder capacity, which should normally increase at night, was found to be low in children who wet the bed. In addition, some of these children were found to have involuntary contractions in the urinary bladder muscle.

- Increased amount of urine at night: Insufficient production of the hormone called Antidiuretic hormone (ADH), which is responsible for regulating urine production, can cause bedwetting.

Urinary tract infections: These children may also have problems such as frequent urination and burning while urinating.

-Diabetes: It should definitely be investigated, especially in the secondary type.

Diabetes without diabetes: In this disease, called Diabetes Insiputus, there is a deficiency of the hormone that controls urine production.

-Anatomical problems of the urinary tract

-Hyperthyroidism

-Sleep apnea syndrome

-Psychological reasons

-Genetic causes



What are the Treatment Methods:
1. Supportive Treatment:

Liquid intake should be restricted two hours before going to bed in the evening.

If there is a constipation problem, it should be resolved

It should be ensured that he goes to the toilet regularly every 2-3 hours during the day. It should be ensured that he sits in the appropriate position on the toilet and his feet are on the ground. If necessary, steps should be placed under their feet.

Must go to the toilet before going to sleep. Wake up to urinate 2 hours after sleeping.

· Cloth should never be tied

The child should actively participate in changing, cleaning and changing the sheets after urinary incontinence.

· Punishment should not be given

Wet and dry nights can be noted on the calendar to increase motivation.



2.Alarm Treatment:

It is an effective treatment especially in children with waking problems. When the child leaks urine, the alarm will sound and he will get used to waking up at that time. It is a method that requires the harmony of the family and should be applied for at least 6-8 weeks to decide on its success. If a response is obtained, treatment should be continued for 6 months.



3. Drug Treatment:

Some drugs can be used to reduce the amount of urine at night. It should definitely be used under the supervision of a doctor and following the rules of use.

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