Immaturity of the bladder, one of the causes of enuresis

BUJUMBURA February 21st (ABP) – “Enuresis or urinating when in bed is a phenomenon that can gradually get better,” it was said on Tuesday February 20, 2018 by François Ntahorwamiye, a clinical psychologist in charge of social services at “Prince Régent Charles” Hospital of Bujumbura, in an interview he gave to the ABP.
Mr. Ntahorwamiye said that when you are still a child, the call of nature is unlimited, either in bed or in the cradle. As you grow up, it disappears but, you see that in some adults, the practice persists.
For him, a child who does his call of nature especially urinating in his bed before the age of five, is a natural and normal phenomenon and will get better over time. But it becomes worrying when, once the call of nature for a child who has already the age of four to five years old is still observed in the bed or on his own. At this time, we can say that the child suffers from nocturnal enuresis, which is a transient disorder, obviously common among children. This can, at some point, stop especially when the child begins primary school. For him, it is a phenomenon that is gradually adjusted because, in principle, parents should be patient and accompany their child.
According to that clinical psychologist, the causes of enuresis are multiple. Enuresis can be caused by a parenting history, that is to say, a hereditary cause from when one of the parents or grandparents of the child has suffered enuresis in his/her youth and there is a great risk that their child is affected, he said.
On the other hand, enuresis can be caused by immaturity of the bladder where there are problems related to neuromuscular reflexes that control the bladder. At this moment, the bladder contracts and opens automatically to finally let out the urine without waiting for the overflow signal that controls the brain of the child so that the child has the feeling of going to the toilet, he explained.
According to Mr. Ntahorwamiye, there is also another cause that is related to a hormonal disorder. In this case, he pointed out, one can have a bladder that is not very developed to contain all the urine produced during the night and there, the hormone goes wrong and the bladder swells and the urine overflows.
The fourth cause is emotional disorder, which, according to Ntahorwamiye, is very basic and very common. Examples include stress, significant emotion, significant change in the child’s life such as the birth of another child, separation, moving, school, bullying, sexual assault, to name but a few. These can cause transient problems of enuresis because, under the effect of an emotion or shock, the person can no longer control his bladder and it overflows. This kind of enuresis can be treated by talking with the child to relieve him of his psychological tensions, adding that if the problem seems more serious, it is necessary to go to see a psychologist or a child psychiatrist.
According to Mr. Ntahorwamiye, the other cause may be related to an illness. The disorder can result from a urinary infection, diabetes, constipation, a malformation of the urinary system.
As advice, Mr. Ntahorwamiye asks parents whose children suffer from enuresis to avoid aggressive reactions that can stress the child from an early age. He calls on them to ban the behavior of vexing, to humiliate the child who continues to relieve himself in bed or on himself. For him, we should never punish this child, but rather, we must be by his side and make sure to hold him accountable.
For a child who is over the age of 11 and continues to urinate on himself, it is advisable to consult at least a psychologist or preferably a child psychiatrist. They can help him control his bladder but also, to strengthen his self-esteem, he pointed out.
As for people who are getting married, who still suffer from this enuresis disorder, he asks them to approach a psychologist for advice and if it persists, he calls on them to approach a Doctor because, there are drugs that affect enuresis.
Mr. Ntahorwamiye advises enuretic children to reduce the amount of water they drink just after 6:00 pm, and the same goes for adults who urinate on themselves at night when they are in an unconscious state.
Note that according to that clinical psychologist, there are two types of enuresis namely primary enuresis that affects children who have never been clean and can continue until the age of adolescence. There is also secondary enuresis for children who have had a period of six months to a year of cleanliness. It stops and comes back, it is a form of relapse after a while, he said.

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