[건강톡톡] Every night unbeknownst to me, ‘a mistake when drawing a map on a blanket’… Why is that?

It’s easy to dismiss a map drawing on a blanket as a child’s little mistake while sleeping at night. However, if it does not improve as it grows and repeats itself, enuresis should be suspected. Enuresis is a symptom that occurs frequently in children, and is a symptom of urinating against one’s will during sleep at least twice a week for at least 3 months, although normal urination can be controlled by age 5 or older. Let’s solve your enuresis questions with Haidak experts.

Enuresis mostly occurs in children, but it can also occur in adultsㅣSource: Getty Image Bank

Q. I don’t drink much water at night, and I go to the bathroom before going to bed, but I pee when I sleep. Why?
A. It is normal to store urine in the bladder when you fall asleep and hold it until the next day. Urinating before waking up at night is called enuresis.
Types of enuresis are mainly divided into primary enuresis and secondary enuresis. Primary nocturnal enuresis is a condition where a child has never urinated at night since birth. Secondary enuresis is when enuresis occurs again after a temporary period of urination.
In the case of enuresis, the pituitary gland secretes less antidiuretic hormone (ADH), making more urine than normal people when sleeping at night, so there may be cases of overflow. There are sensitive forms that cause discharge.
– Urology Counseling Doctor Haidak Hyukjun Lee (Purun Urology Clinic)

A. Enuresis is defined as urinary incontinence during sleep in children over 5 years of age. Enuresis is often found in urinary tract infections, constipation, bladder outlet obstruction or external urethral stricture in boys, spinal cord disorders, sleep apnea, diabetes insipidus, diabetes, and attention deficit hyperactivity disorder, so the presence or absence of these diseases must be determined. .
Through a detailed medical examination, the tendency for enuresis is identified, and the urination pattern is analyzed in advance through a urination diary for diagnosis. In the hospital, the presence or absence of spinal cord deformities and perineal abnormalities is seen through physical examination along with urinalysis, blood tests are performed to evaluate antiuretic hormones and renal function, and radiation X-rays, abdominal ultrasound, and urodynamic tests. It tests bladder function.
– Urology Counseling Doctor Hydak Joo-Nam Kim (Neoyu Women’s Urology Clinic)

Q. If the amount of urine during the night is much higher than during the day, is it severe enuresis?
A. The main cause of enuresis is a functional bladder problem. Since the amount of urine at night is higher than during the day, it appears as enuresis along with an overactive bladder. An overactive bladder is caused by the bladder muscles contracting excessively, frequent urination (more than 8 times a day), nocturia (waking up before bed or while sleeping to urinate), urinary urgency which is difficult to hold urine in. back, and a feeling of not feeling refreshed even after urination (residual urination). ), and in severe cases, they complain of ‘urgency urinary incontinence’, where they cannot hold back and urinate when going to the bathroom. From time to time, you may feel a tingling sensation in your lower abdomen.
The exact cause of overactive bladder is not yet known, but it is known to be linked to incorrect urination habits at a young age, frequent cystitis, stress, sensitive personality, obesity, and genetic factors.
Tests for diagnosing overactive bladder mainly include urine tests and bladder function tests (urolith tests or urodynamic tests), and a urine log written by you is also essential for diagnosis. Bladder function tests are performed to evaluate the exact condition of the bladder (volume, contractility, amount of residual urine, etc.).
In the case of enuresis combined with an overactive bladder, unlike general enuresis, it is difficult to expect a cure with drug treatment alone. Therefore, it must be combined with overactive bladder treatment. Overactive bladder treatment includes behavioral therapy, drug therapy, and physical therapy (magnetic field therapy), most of which are classroom-based rehabilitation therapy. In other words, it is a treatment that increases the flexibility of the bladder muscles to make it a more mature bladder, and requires long-term treatment for more than 3 months. Overactive bladder is not a fatal disease, but must be treated because it causes extreme stress in everyday life and can lead to depression in severe cases.
– Urology Counseling Doctor Hydak Choi Ho-seong (Neoyu Women’s Urology Clinic)

Q. When I dream about peeing, I always lie on the futon. Could it be related to enuresis?
A. There are many causes of enuresis. It can be caused by psychological reasons, sleep disorders, abnormal secretion of hormones, bladder dysfunction (overactive bladder), and drugs Effective treatment is only possible when the root cause is identified.
When psychological factors are determined to be the cause, an evaluation of the psychological background is required. If you dream of urinating while sleeping, it seems that you have such a dream because you have to urinate or are bored.
Bedwetting in children is based on drug treatment for several months, and if the treatment is ineffective, treatment with an enuresis alarm can increase the effect of the treatment.
He is already past 5 years old, and if he has suddenly gotten worse recently, it may be a temporary phenomenon, so I think we need to keep an eye on him. When a urine mistake occurs, stabilizing the psychological state through conversation is helpful to overcome it.
– Urology Counseling Doctor Hydak Choi Ho-seong (Neoyu Women’s Urology Clinic)

Q. Can enuresis occur even after becoming an adult?
A. In the case of bedwetting in adults, a diagnosis can be made if there is an average of 2 or more times a year. Causes of enuresis in adults include psychological problems, sleep disorders, abnormal secretion of hormones, bladder dysfunction (overactive bladder), and drug use. You should find out if you urinate often, if you urinate urgently, and if you wake up at night because you need to pass water. If you have one or more of these , you should suspect bladder dysfunction. In addition, the influence of changes in the surrounding environment and psychological effects can also have a significant impact. Adult enuresis is closely related to sleep disorders. If you suffer from a sleep disorder such as chronic insomnia, the incidence of enuresis is more than twice that of people who sleep normally.
– Urology Counseling Doctor Hydak Choi Ho-seong (Neoyu Women’s Urology Clinic)

A. Enuresis needs to be differentiated between waking and urinating at night because of the need to urinate and passing urine without being aware of urinating. Strictly speaking, the latter is enuresis, but if you feel the need to urinate during sleep, it can be caused by various diseases of the lower urinary tract such as prostatitis, enlarged prostate, overactive bladder, bladder bacterial, and interstitial cystitis.
However, enuresis is a very rare phenomenon in adults who are trained to urinate, but it occurs mainly in children when the function of urination is not yet complete, because abnormal nerve function or an emotional state can affect on it. If you are an adult male enuresis, you should first check if there are any diseases that can affect the urination function, and continue taking medicines such as TCA, anticholinergic, and beta-blocker alpha-blocker to see if the symptoms are relieved.
– Urology Counseling Doctor Hydak Lee Woo-seung (Eurojin Urology Clinic (Wonju Branch))

A. Wetting the bed can happen even as an adult. The exact cause of enuresis is unknown, but delaying treatment can worsen the symptoms. In addition to visiting a urologist, the following lifestyle adjustments are also required.
– First of all, reduce salt and water intake at lunch.
-Don’t eat a lot of soup or water at lunch, and avoid eating fruit after dinner.
– You must urinate before going to bed.
It seems that it would be useful to try lifestyle corrections first such as plenty of rest and exercise, and combine medication and behavioral therapy after a hospital visit.
– Urology Counseling Doctor Hydak Youngjin Lee (Daegu Cornell Urology Clinic)

* This article has been reproduced from a Haidak expert answer.

Support = Haidak Counseling Doctor Choi Ho-seong (Urology Specialist Neoyu Women’s Urology Clinic), Haidak Counseling Doctor Lee Hyuk-jun (Urology Specialist Purun Urology Clinic), Haidak Counseling Doctor Kim Joo-nam (Urology Specialist Neoyu Women’s Urology Clinic), Haidaq Counseling Physician, Director Lee Young-jin (Urology Specialist Cornell Daegu Urology Clinic)

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