Definition of Enuresis Nocturna: “Wetting in sleep at least two nights a month at the age of 5 without daytime symtoms or urinary tract infections”
Bed wetting in children is the most common urological symptom: 15-20% of 5-year-olds suffer from this condition and it is very often observed in children over the age of 5 years.
The urinary system has many roles such as cleansing the blood and ridding the body of metabolic waste products, regulation of PH, regulation of blood pressure and more. The final filtration of the blood by kidneys called urine. The kidneys filter about 200 litres of filtrate every day but the urine, the final waste content is about 2 litres per day. The capacity of the bladder can be from 1 – up to 2 litres. The minimum amount of 150-500ml is needed to trigger the micturition reflex or Bladder Stretch Reflex. The stretch receptors in the bladder wall transmit nerve impulse to the sacral region of the spinal cord to generate a spinal reflex. The parasympathetic neural outflow causes contraction of the detrusor muscle and relaxation of the involuntary internal urethral sphincter. At the same time, the spinal cord inhibits somatic motor neurons, resulting in the relaxation of the skeletal muscle of the external urethral shincter. The micturition reflex is active in infants and disappears with maturity. Children learn to override the reflex by controlling the external shincter by will. This reflex may be preserved after spinal cord injuries that results in paraplegia or quadriplegia. Voluntary micurition requires an intact spinal cord and functional pudendal nerve, arising from the sacral plexus which is the main nerve of the perineum. This nerve can be damaged, most commonly by childbirth or injuries.
The urine passes through the ureter and is propelled by waves of peristalsis into the bladder. The quality and quantity of the urine depends on how much water is intake, exercise, outside temperature, sweating and other factors. Read More