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Our brain contacts the bladder. It tells the muscles when they are about to squeeze or relax. It happens, however, that certain malformations or diseases disturb this contact. Then the baby is wet at night.
A healthy adult should not urinate at night unless he drinks too much fluid before going to bed. – When we sleep, we secrete vasopressin – a hormone that causes urine thickening, the kidneys work slower – explains the urologist Dr. Jan Karol Wolski. However, when the bladder is full, pressure increases and pressure on the sphincter muscles. The nerves send a signal to the brain to urinate, and then we wake up. Young children do not have such a developed nervous system yet, and their brains do not associate certain information with possible outcomes. The baby’s brain is told that the bladder is full, but instead of stopping urination and going to the toilet, the baby pisses in the diaper.
Controlling urination
As he grows up, between the ages of two and three, training in cleanliness, i.e. learning to control bowel movements, comes to an end and the child begins to control urination. However, among 4-year-olds, every third child gets wet at night, and at the age of 5-6 every fifth. On average, every tenth 7-year-old has problems with bedwetting. However, among 12-15-year-olds, this problem occurs in about 3%.
If a child who is to go to school, even once a week soaks at night, it is necessary to visit a nephrologist or a pediatric urologist – says Dr. Wolski.
Bed-wetting diagnosis
Soaking may be a symptom of a defect of the urinary system, urinary tract infection, diseases of the nervous system, kidney disease, and diabetes. If the urological consultation does not allow you to find the cause of the “wet bed”, you should go to a neurologist, then to a psychiatrist and psychologist.
An important element of diagnostics is the comparison of the bladder capacity with the child’s age. This is checked by measuring the amount of urine you pass into the potty. It is also necessary to test urine and an ultrasound of the abdominal cavity. And if necessary, the urologist can perform more detailed examinations.
Small bladder capacity
The cause of bedwetting may be insufficient bladder capacity. In children with bedwetting caused by this, very good treatment results are obtained with drugs that reduce bladder sensation and relax the bladder muscles, which gradually increases its capacity.
Vasopressin deficiency
Sometimes, however, the bladder with the correct capacity is not able to hold a large amount of urine. This may be due to insufficient secretion of vasopressin at night, a hormone that concentrates urine. Such patients are given tablets to supplement the deficiencies of this hormone. Taking them does not stop the body producing vasopressin. If enuresis recurs after drug discontinuation, the treatment may be repeated.
Posterior coil valves
In boys, the cause of bedwetting may be the so-called posterior coil valve. One theory is that they may be the remains of the part of the embryo from which girls develop the hymen. Only that in boys they hinder the outflow of urine from the bladder – explains Dr. Wolski. This defect can cause significant damage to the kidneys in utero and leads to their chronic failure.
Check also: Why the baby’s bedwetting must not be underestimated?
Valve incision
Therefore, endoscopic incision of the valves is necessary. It requires approximately three days in hospital. A thin speculum with a surgical tool (miniature knife) is inserted through the urethra and the valves are cut under the control of a special camera. Sometimes the symptoms of posterior urethral valves do not appear until several years old. These are primarily a weakened urine stream and bedwetting. – This defect can be detected in the womb. Meanwhile, if missed, it leads to serious kidney damage, sometimes to the need for a kidney transplant – warns Dr. Wolski.
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