Urinary incontinence (enuresis)

Involuntary excretion of urine from the urethra without the urge to urinate occurs in many diseases of the urinary and reproductive systems of men and women of different ages. Incontinence must be distinguished from incontinence, in which there is an imperative urge and the improbability of holding the stream of urine.

Distinguish between primary and secondary urinary incontinence.

Primary incontinence causes anatomical congenital or acquired damage to the obturator apparatus (sphincters) of the bladder.

With secondary incontinence, there is a functional insufficiency of the sphincters, the slow formation of a conditioned reflex for the regulation of urination, the loss of this reflex as a result of exposure to unfavorable causes of bladder wrinkling. In babies, urinary incontinence is often caused by malformations of the genitourinary system (epispadias, exstrophy of the bladder). Bedwetting, which affects more often boys, is isolated into a separate disease “enuresis nocturnal”.

Secondary urinary incontinence occurs when the innervation of the bladder at the level of the conduction tracts of the spinal cord is disturbed. At the same time, neurogenic disorders of urination develop, which are characterized by the absence of the urge to empty, not often chronic urinary retention; at the same time there are violations of sexual function. Clinical manifestations are persistent and difficult to treat.

Involuntary leakage of urine can manifest itself with stress in women as a result of a birth injury, with heavy physical labor. Its degree can be different: from the release of a few drops to the complete emptying of the bladder during laughter, coughing, sexual intercourse, etc.

With a mild degree of incontinence, the treatment is conservative, electrical stimulation of the muscles of the perineum, physiotherapy exercises, and medications that increase the tone of the closure apparatus of the bladder are used. In severe cases, resort to surgical treatment. Paradoxical urinary incontinence occurs with adenoma, prostate cancer or other diseases, when, against the background of an overflowing, atonic bladder, urine is excreted drop by drop. Manifestations of various forms of urinary incontinence are extremely variable. Treatment is focused on addressing the underlying cause. Prolonged urinary incontinence deforms the personality characteristics of a person, leads to social and sexual maladjustment.

Articles from the forum on the topic ” Incontinence (enuresis) “

I would like to know the signs and symptoms of enuresis in children

Answer #1

non-voluntary urination

Answer #2

Vegetative symptoms are revealed:
– slow heartbeat
– cyanosis of the extremities
– hypothermia.

Neurotic disorders are noted:
– irascibility
– secrecy
– depression shyness.

Answer #3

Urinary incontinence, as a result of a delayed formation of control over urination or the destruction of an already formed function due to organic and infectious diseases or traumatic lesions of the nervous system, is called neurosis-like. The presence of neurosis-like enuresis, caused by an organic lesion of the child’s nervous system even in the period of intrauterine development, does not depend on unrest and other psychological factors, but increases with overwork, physical ailments, and hypothermia.

With the destruction of an already formed function, urinary incontinence does not appear at an early age, but after an injury (for example, concussion) or infection (for example, meningoencephalitis – inflammation of the membranes and brain substance). At the same time, enuresis is, as a rule, monotonous, monotonous in nature. In cases where the rate of onset of compensation is slow or there are additional negative factors that interfere with recovery, neurosis-like urinary incontinence can last for years and sometimes leads to pathological personality formation in adolescence. In such cases, the doctor may recommend long-term sessions with a psychologist against the background of drug treatment.

The function of urination can also be destroyed under the influence of various psychological reasons (due to acute mental trauma). In this case, one speaks of neurotic enuresis. This form of the disease can be both short-term and longer-term. For example, if a child has involuntary urinary incontinence from fear. Usually a neurotic reaction with enuresis lasts for several hours or days and disappears as the mental stress disappears.

In those cases when emotional excitement persists for several weeks and months, and painful manifestations are fixed, they speak of a neurotic state. Its reasons may be:

* family moves from one place of residence to another, where the child is acutely experiencing the loss of friends and buddies and is faced with the need to adapt to a new kindergarten or school;

* death of close relatives or acquaintances;

* the birth of a brother or sister in the family;

* long-term chronic illness of loved ones;

* chronic conflicts in the family;

* divorce of parents or pre-divorce and post-divorce situation;

* death of a pet – cat, dog, parrot

In such cases, the child is having a hard time with internal conflict and his protracted illness.

A clear dependence on the mental state leads to the fact that the neurotic course of enuresis, unlike a neurosis-like disorder, may manifest itself inconsistently – either disappear or intensify depending on the emotional state of the child. Such enuresis can be flickering in nature and last from several weeks to several months. But the force of the child’s experiences is very intense. In these cases, a qualified psycho-correction of his internal conflict is effective.

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