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Enuresis is a disease that is defined as the persistent loss of urination or uncontrolled and involuntary urination of children during the day and night (the most frequent). It is said that children have enuresis when they exceed five years in the case of girls and six in the case of boys, they still cannot control their urination, that is, they continue to urinate on themselves, during the day and especially at night in the bed while they sleep.
UrologistJuan Carlos Ruiz de la Roja Responds in this interview to the most common doubts of parents about childhood enuresis.
1-Is enuresis hereditary?
Enuresis is a hereditary problem to the point that in 90 percent of cases there is a family inheritance. They can usually be parents, grandparents, and even uncles. If the father and mother have urinated, there is a percentage of approximately 75 percent that the offspring have the problem. And if a father or mother has urinated, about 50 percent of the children they have will suffer from the problem.
2-Why is enuresis more frequent in boys than in girls?
The explanation is very simple. Enuresis stems from a problem, in the delay in both bladder maturation and hormonal maturation, in such a way that these children have a smaller bladder and greater urine output. This with development is disappearing, what happens is that the boy usually takes longer to mature than the girl and that is the reason.
3-From what age is a child considered to have enuresis?
We are talking about a child who has turned five years old, who has to urinate a minimum of four nights throughout a month and, at least, in a minimum period of three months. If our child meets these requirements we can say that he has enuresis and then we should consult a specialist.
4-When should we take the child to the urologist?
We must take our child to the urologist or specialist whenever he is five years old and we are not able to remove the night diaper. We are talking that in 90 percent of cases there may be a medical cause below and it must be diagnosed. For that, you have to go to the consultation and do some medical tests that are very simple and get to know the exact reasons why the child urinates and based on that, give the most appropriate treatment.
5-What are the causes of infantile enuresis? What can cause enuresis in children?
The causes for which a child urinates are 90 percent medical and 10 percent psychological. Among the medical causes, it is mainly due to the fact that these children have an overproduction of nocturnal urine, they produce more than normal because they have a delay in the maturation of their bladder. It means that they have a smaller bladder and so they hold less urine. Among the psychological causes, there may be situations such as the beginning of school, separation of parents or the birth of a brother.
6-What treatments exist for childhood enuresis?
The most appropriate treatments depend on reaching an accurate diagnosis of why our child urinates. If it is a bladder capacity problem, we must treat that, if the problem is that our child has an overproduction of nocturnal urine, the solution will be to try to reduce this overproduction. If you have a mixed question, both will have to be addressed. If it comes from a basic psychological problem we will have to use a treatment by a psychologist.
Within enuresis, the medical part represents 90 percent of the cases. You can see cases, for example, in which it has been discovered that children who are diabetic and who did not know it have a problem of enuresis. In these situations, diabetes must be treated, so it is very important to do medical tests to reach a diagnosis.
If the problem is that the child has an overproduction of nocturnal urine, usually the treatment is with a pill that is put under the tongue and that causes a reduction in the amount of nocturnal urine to prevent leakage. In the event that the child has a smaller bladder, it will also be necessary to do certain exercises and even the possibility of some medical treatment depending on the reason why the growth of the bladder is not adequate in that child.
7-Are there home treatments to treat enuresis?
There are many things that have been done throughout history to treat enuresis, such as the issue of heat. Children were routinely placed warm cloths over their bladder. There are many of these issues that, unfortunately, do not work, so the most important thing is to consult with a specialist and that it is the doctor himself who gives the guidelines since, luckily, there are many. For example reducing the fluid control that one drinks throughout the night, having the child urinate every three hours or reducing the amount of caffeine consumed in the afternoon to reduce nocturnal urine production.
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