What do you know about nocturnal enuresis?

  Concept: Normal children are able to control urination at the age of 2-3 years, but if they still urinate at random after the age of 5 years, it is called enuresis, and most of them occur at night when they are asleep, so it is also called nocturnal enuresis.  Classification: Enuresis can be divided into two categories: primary enuresis and secondary enuresis. 1. Primary enuresis is mostly accompanied by family history, more males than females (2:1-3:1), no organic lesion, and is mostly caused by delayed ability to control urination. Primary enuresis occurs more often at night and occasionally during daytime naps, ranging from 1-2 times a week to once a night or even several times a night. Symptoms can be aggravated by poor health, fatigue, excessive excitement and stress, and mood swings, etc. Sometimes they may reduce or disappear spontaneously, or they may recur. About 50% of children with polydipsia will gradually reduce the number of episodes and heal themselves within 3-4 years, but some children continue to urinate until adolescence, which often causes serious psychological burden and affects normal life and study. Children with polyuria must first exclude systemic and local diseases that can cause secondary enuresis.2. Secondary enuresis is mostly caused by systemic or urological diseases such as diabetes mellitus and urogenital disorders, while other diseases such as mental retardation, trauma, urinary tract malformation, infection, especially cystitis, urethritis and perineal inflammation, can also cause secondary enuresis. The symptoms can disappear after the primary disease is treated.  Treatment: The treatment of primary enuresis should first obtain the cooperation of the parents and the child, and the doctor should guide the aggravating arrangement of a suitable living system and insist on urination training, and should never scold, sarcasm or punish the child when enuresis occurs, otherwise it will increase the psychological burden of the child. The child should be trained to gradually extend the time of urination and to make sure that each urination is completed; the intake of water should be controlled after dinner, and defecation before bedtime should not be excessively excited; parents can wake the child up before the time of frequent urination after sleeping, so that he or she can get used to urinating when waking up, and if necessary, an alarm can also be taken to assist in urination. The effect of medication is 80%, commonly used is desmopressin, an antidiuretic to reduce urination, 0.1-02ug each time, good oral before bedtime, the course of treatment is 3-6 months, also can apply promethazine medication.