What 's also called nocturnal enuresis nocturnal incontinence? It is the definition of a medical term situation relatively common in childhood, namely, the issue of involuntary and unconscious urine, which occurs most often during sleep. This is a crowd psychogenic in nature, since in most cases the urinary tract is perfectly intact and urination is done in a normal manner while impaired or even missing is the mental control for which this act becomes voluntary and physiological conscious.
the mechanisms that regulate urination: urine, continuously excreted by the kidneys, leads, through the ureters into the bladder where it collects, until at a certain amount, does not sound out with the 'voluntary act of urination. Under normal conditions in adults, when you feel the urge to urinate, the act shall be withheld until it takes the right conditions for its implementation. This is achieved continence with voluntary control of the budget of two muscles: the sphincter muscle, whose fibers arranged in a ring around the urethra and bladder outlet remains tight ensure perfect sealing of the globe bladder, and the detrusor that normally relaxed , goes into action when the accumulation of urine, distention of the bladder wall exceeds a certain limit, then it contracts strongly as to squeeze the bladder, while the sphincter relaxes and the urine comes out.
the newborn have not yet developed the neural mechanisms for which voluntary urination is inhibited, so that when the tension of the bladder stimulates the detrusor to contract, the child immediately becomes wet.
Up to a certain age then enuresis is a physiological fact. From the second year of life, especially under the influence of education, gradually creating the mechanism of inhibition by which the voluntary sphincter tone increases and the detrusor decreases. Control over bladder muscles, the exercise becomes automatic and spontaneous, and urination becomes possible only when the will allows.
is easy to understand what happens in an individual during sleep: the progressive distension of the bladder wall increases la contrazione dello sfintere e inibisce il detrusore; tuttavia, raggiunto il grado di massimo riempimento vescicale, la minzione diventa inevitabile, e poiché è ormai un atto volontario e cosciente, non si compie nel sonno, ma il desiderio di urinare provoca il risveglio.
Questo meccanismo nel bambino, si sviluppa gradualmente in un tempo variabile da soggetto a soggetto e in rapporto a vari fattori sia psicologici sia ambientali; il controllo volontario della minzione durante il giorno è abbastanza precoce, mentre agli inizi sfugge nelle ore notturne, fino a che, acquisito un automatismo sufficiente, il bambino non bagnerà piu' il letto. Quando il normale processo evolutivo si arresta, il controllo della minzione rimane incompleto and, according to the stage of development reached by the subject, there are more forms' or less serious, among them is nocturnal enuresis. It is the case less worrying, as usually heals before puberty.
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