Lukiantseva O. Clinical and pathogenetic features and gender differences in children's enuresis

The thesis is devoted to the study of clinical-pathogenetic peculiarities and gender differences of enuresis in children with the aim of improving diagnostic and therapeutic approaches. A comprehensive examination of 90 children with primary enuresis aged 6 to 17 years using a specially developed questionnaire "Map of the comprehensive medical examination of the child with enuresis" with regard to gender differences. It is established that the appearance of the disease depends upon influence of adverse factors during pregnancy, childbirth, which cause hypoxic-ischemic lesion of the CNS. It shows the influence of precipitating factors various somatic and chronic infectious diseases in the occurrence of enuresis. An in-depth analysis of clinico anamnestic, somato-neurological data was carried out. It was found that the most informative to clarify the pathogenesis and determine the treatment algorithm are data from EEG, bladder ultrasound with determination of residual urine volume, bacteriological examination of urine for pathogenic flora and determination of antibiotic sensitivity, determination of personal and behavioral characteristics of children and peculiarities of intra-family relationships. On the basis of the obtained results, hypertension was diagnosed in (42.42 ± 6.13) % boys and (58.33 ± 10.28) % girls, p ≥0.05. Hypotonic type was diagnosed in (57.58 ± 6.13) % boys and (41.67 ± 10.28) %, p ≥0.05. According to the results of psychodiagnostic examination established the presence of more severe signs of neurotic development of the personality in the group of girls, patients with enuresis, compared with boys. The methods developed differentiated approach to the evaluation and treatment of enuresis in children based on gender. Proven effectiveness in complex treatment of children with enuresis metabolic therapy and nicotinoyl gamma-aminobutyric acid in the fotm of ionic galvanic procedure on the lumbosacral spine has been proven. Justified the appointment of a specific therapy derived nitrofuran to eliminate latent inflammatory process.