Frequent urination in a 5-year-old boy. Pathology of the endocrine system in children. Chronic kidney disease

Pollakiuria is frequent urination during the day. A child's body differs from an adult both anatomically and physiologically. Age-related features of the anatomical structure of the kidneys, bladder and the entire urinary system as a whole have a certain impact on the functionality of these organs.

The frequency of urination depends on the age of the child and is normally:

The first 5-7 days after birth - 4-5 times per day;
From 1 week to 6 months – the frequency of urination is 17-25 times (depending on the volume of breast milk consumed);
From 6 to 12 months – 15-17 times a day;
From 1 year to 3 years – 10-12 times a day;
From 3 to 7 years – 7-8 times a day;
From 7 to 10 years – 6-7 times a day;
From 10 years and older – 4-6 times a day.

If your child's trips to the toilet vary slightly over the course of several days, this is not a cause for concern.

It should also be remembered that the bulk of urine should be excreted during the day.

Etiology

There are several reasons why frequent urination in children without pain is normal:

Increasing the volume of fluid consumed. If a child is accustomed to drinking average volumes of fluid, then an increase in fluid intake without objective reasons (physical activity, high ambient temperature) and a constant feeling of thirst with an increase in diuresis may become a cause for concern, as they may be one of the manifestations of diabetes mellitus or diabetes insipidus ;
Taking medications with a diuretic effect: diuretics (diuretics), as well as some medications from the antiemetic, antiallergic groups, for which the diuretic effect is one of the side effects;
Eating berries, fruits, vegetables, as well as drinks that have diuretic properties. These include: black and green tea, herbal teas, coffee, cucumbers, carrots, cranberries, carbonated drinks, melon;
Prolonged exposure to cold can lead to reflex spasm of the renal vessels, which helps accelerate the filtration of urine and accelerate its excretion from the body;
Stressful situations and emotional overexcitation, which lead to the release of adrenaline. Adrenaline increases the production of urine and increases the excitability of the bladder, which leads to frequent urge to go to the toilet (even when the bladder is not completely full) and the release of urine in small portions.

Pollakiuria caused by the influence of these factors is physiological and does not require therapy. This increase in the urge to urinate goes away after the influence of the corresponding factor is eliminated. However, if pollakiuria does not go away after eliminating the provoking factor, then the child’s condition should be monitored more carefully, since frequent urination, even without pain, may be a symptom of the disease.

Pollakiuria as a sign of a pathological process

There are a number of diseases that are accompanied by pollakiuria without pain:

Reduced bladder volume. The cause of such a defect may be a congenital anatomical anomaly or compression of the walls of the bladder by a tumor;
Neurogenic dysfunction of the bladder of the hyperreflex type. This pathology is observed when the development of the nerve centers responsible for regulating the functioning of the bladder is disrupted. This disrupts the collection and removal of urine from the body. The disease is manifested by pollakiuria without signs of inflammation, the appearance of ;
Injuries and tumor processes of the brain and spinal cord, which lead to disruption of innervation processes, which is manifested by increased urination (small portions);
Diabetes mellitus (a disease of an endocrine nature associated with insulin deficiency) in the early stages may be accompanied by a constant feeling of thirst, frequent release of large volumes of urine, and weight loss (with increased appetite);
Diabetes insipidus (a disease associated with impaired synthesis of the hormone vasopressin) leads to the formation of large volumes of urine;
Neuropsychic disorders (neuroses, neurasthenia, vegetative-vascular dystonia) provoke constant pollakiuria and are also accompanied by changes in the emotional background: frequent mood swings, headaches, nervousness, and the development of various phobias.

Thus, if you notice alarming changes in your child’s health, you should immediately consult a doctor and carry out the necessary diagnostics.

Diagnostics

Diagnostics includes laboratory and instrumental research methods. Mandatory laboratory research methods include:

Clinical (general). Urine collection is carried out in the morning, on an empty stomach, and the middle portion (obtained in the middle of urination) is collected for analysis. Before collecting the analysis, it is necessary to carry out the necessary hygiene measures. During the study, the presence (increased level of leukocytes) can be detected, which indicates inflammatory processes; hematuria (increased number), which indicates serious renal disorders; (presence of protein in urine);
Urine culture to detect the presence of bacteria in the urine (.

It is also mandatory to monitor the frequency and volume of urination of the child per day.

Treatment

Treatment for a child is prescribed only after a complete diagnosis. The treatment regimen will depend on the diagnosis:

For inflammatory processes of the urinary system, uroseptic agents and antibiotic therapy are prescribed;
When diabetes mellitus and diabetes insipidus are detected, hormone replacement therapy is carried out;
For neurological reasons - sedatives, nootropic drugs, as well as physiotherapeutic procedures;
When neoplasms are detected and in pathological conditions of the central nervous system, surgical treatment can be performed.

Has your baby started asking to go to the toilet more often? Don't sound the alarm ahead of time. This may be due to the fact that the baby drank more than usual or ate, for example, a lot of watermelon or melon. However, we must not forget that such a phenomenon may be the first symptom of the development of a serious disease.

Let us remember, first of all, that a child is not a small adult. Both the structure of his body and the functions of his internal organs differ from those of adults. That is, often what is normal for an adult is already a pathology (disease) for a child and vice versa. Anatomically (in structure) and functionally, the kidneys of a child differ from the kidneys of an adult (and the younger the child, the more pronounced this difference is) - by the time of birth, the development of the kidneys has not yet been completed and will continue for several years. Therefore, before we talk about possible diseases (the symptoms of which are both changes in the frequency of urination and the appearance of urine), let's try to define the concept of “normal” in this matter.

The baby’s kidneys work as if at the limit of their capabilities, that is, against the backdrop of health, the child’s kidneys cope with their “responsibilities”, but even with small changes (both external and internal environment) disturbances are possible.

Norm

The structural and functional features of the kidneys and bladder in young children lead to the fact that the frequency of urination varies depending on age and, in general, is greater than in adults. So, baby the first months of life will require about 25 disposable diapers per day (with the exception of children in the first week of life - in the first five days the frequency of urination is low - only 4-5 times a day; this is due to high fluid losses by the child and a low supply of breast milk), and by a year, a child urinates approximately 15-16 times. With age, the number of urination decreases: in 1-3 years the number of urinations is about 10 times a day, in 3-6 years- 6-8 times a day, with 6 to 9 years- 5-6 times, and older children They urinate, as a rule, no more than 4-5 times a day. Moreover, most of the urine is excreted during the day. Anything greater than these numbers can be considered frequent urination. As a rule, in medicine deviations from normal values within small limits are always allowed. That is, if a 6-year-old child urinates 6 times a day today and 9 times tomorrow, it’s unlikely that you should immediately panic. And be sure to pay attention to changing conditions (environmental factors, nutrition, etc.): against the background of a large amount of fruit eaten (containing a lot of liquid - watermelon, melon, pears, etc.), diuresis (daily amount of urine) may increase without any pathology. But do not forget that a change in the frequency of urination may be the first symptom of trouble, so even in the era of diapers, mothers need to be careful about this parameter.

Not the norm

In addition to frequent urination, the simultaneous presence of other symptoms is of great importance. What could it be and what should mother pay attention to?

Pain when urinating. Occurs due to inflammation in the lower urinary tract (urethra or bladder), the release of large salt crystals (small stones), and inflammation of the external genital organs. Moreover, if a child of 3-7 years old can actively complain to his mother (the baby may try to delay the painful process of urination), then a baby at the age of several months will wince, grunt or even cry (depending on the severity of the pain) at the moment (or possibly before and/or after) urination.

False calls. As the name implies, the child feels the urge to urinate (perhaps even a few minutes after the previous trip to the toilet), but the urge turns out to be false (there is no urine).

Pain in the abdomen (lower back). If it is easier in this sense with a child 3-7 years old (although many children will point to the area when asked “where it hurts”), then asking a baby about the presence or absence of pain is quite difficult. There may be causeless (naturally, at first glance) crying, kicking of the legs, and a painful grimace on the face.

The pain can be one- or two-sided, of a different nature (dull, aching, cramping, etc.), observed when jumping, running, dancing.

Thirst combined with increased urine output. Such manifestations, of course, can occur in healthy children and adults (in the example already mentioned above - when eating a large amount of fruit), and nevertheless require control (consultation with a doctor, general blood test and blood sugar test). to exclude diabetes mellitus, one of the signs of which is increased urine output).

Enuresis, urinary incontinence. Enuresis usually includes cases of nighttime and daytime enuresis in children over 4-5 years of age. Urinary incontinence - these are cases of spontaneous urination (the child does not feel the urge to urinate), urinary incontinence - the child wanted to urinate, but “did not have time” to get to the toilet. Another unfavorable symptom is the constant leakage of urine drop by drop.

Possible causes of frequent urination include urinary tract infections (urethritis - inflammation of the urethra, cystitis - inflammation of the bladder, pyelonephritis - inflammation of the kidney tissue), malformations of the urinary tract, pathology of the nervous system, and mental illness.

General complaints accompanying the inflammatory process (cystitis, pyelonephritis) - weakness, malaise, loss of appetite, headache, sleep disturbance, in infants - regurgitation, vomiting, increased or decreased bowel movements. An increase in body temperature above 37° C is characteristic of inflammatory diseases of the urinary system. Pay special attention to the rise in temperature for no apparent reason to high numbers within one day, followed by a decrease to normal. This symptom may be evidence of vesicoureteral reflux, a condition in which urine flows upward from the bladder into the ureters or even into the kidneys. Longer rises in temperature in the absence of a runny nose, cough, etc., that is, in the absence of symptoms of a respiratory disease, can be a sign of a urinary infection (a high temperature in this case, as a rule, is difficult to “bring down” antipyretic drugs, but it will respond to a properly selected antibiotic positive). But under no circumstances self-medicate! You should consult a doctor.

Change in urine color. A baby's urine is usually pale yellow (since it is not very concentrated); at an older age, the urine has a straw-yellow color (if there is a lot of drinking, it is lighter). The appearance of a red tint in urine can be either normal (when eating beets, cherries, red food dyes, or some medications), or it can be a serious sign of the presence of blood (more precisely, red blood cells) in the urine, for example, with a kidney disease such as glomerulonephritis - a chronic immunoinflammatory disease with damage to the renal glomeruli located directly in the kidney tissue. Pale, almost colorless urine in combination with its increased excretion and thirst is a suspicion of diabetes mellitus, another unpleasant assumption is impaired renal function.

Let's go to the doctor

So, you suspect something is wrong when you notice any of the listed symptoms in your child. The first step is to consult a pediatrician. After listening to complaints, finding out the necessary details, examining the child, the pediatrician will make a decision - either conduct an initial examination in a clinic, or immediately refer the mother and baby to the appropriate specialist: nephrologist, endocrinologist, neurologist, urologist, gynecologist.

What examinations can be ordered?

General urine analysis. The glass jar for analysis should be washed with a brush in the evening and sterilized by steam. In addition, pharmacies sell sterile plastic containers for urine, which greatly simplifies the process of finding a suitable jar and sterilizing it. If you are going to donate urine at a commercial center, you can go in advance and ask for such a container. The children's potty should also be washed clean and rinsed with boiling water (this can be done in the morning). It is advisable to wash the baby's external genitalia with soapy water.

An older child can be asked to urinate a little (in the potty or directly into the bath), and use a jar for the rest of the urine.

Morning urine is needed for analysis. It makes no sense to collect it in the evening, since storage (even in the refrigerator) distorts the results of the study. In the resulting urine test, the doctor will be able to evaluate indicators such as the number of red blood cells (blood cells). An increase in the number of leukocytes (leukocyturia) may be a sign of inflammatory diseases such as pyelonephritis, cystitis, urethritis; a large number of red blood cells (hematuria) - with glomerulonephritis, the release of large crystals of salts or stones and some other diseases. The presence of protein in the urine may indicate glomerulonephritis, etc.

Urine culture. To detect bacteriuria (the presence of bacteria in the urine), the doctor may order a urine culture, i.e. a small portion of urine is placed on a nutrient medium (special broth). If there are bacteria in the urine, after some time the growth of their colonies on the nutrient medium is noticeable. Usually, before this test, the mother is given a special sterile container or tube for urine. After collection, urine should not be stored; if possible, the container should be immediately taken to the laboratory (short-term storage in the refrigerator is acceptable, but no more than 2 hours).

If a certain number of microbes are found in the urine, the laboratory will conduct an antibiotic sensitivity test, which can serve as a guide when prescribing antibacterial agents.

Collection of daily urine for protein, glucose or salts. If a child urinates in a potty, you will not have any problems with collecting daily urine (except for the night portion, especially if the baby sleeps in a diaper). Each portion of urine should be poured into a large jar. Of course, all the urine will not be needed in the laboratory; they will measure the daily volume of urine excreted and take a small part.

A study of the daily amount of protein is carried out for glomerulonephritis, congenital and hereditary kidney diseases. An increase in the amount of protein in daily urine can also be observed in any disease accompanied by fever (body temperature above 38°C), with increased kidney mobility, as well as in some children after intense physical activity.

An increase in the amount of glucose (or, more simply, sugar) in daily urine can be a sign of diabetes mellitus and hereditary kidney diseases.

If the daily excretion of salts (oxalates, urates, phosphates) exceeds certain figures, then they speak of crystalluria. Against the background of increased salt secretion, other diseases may occur (for example,).

Rhythm of spontaneous urination. Not every mother will be able to give a more or less accurate answer to the question “how many times a day does a child urinate,” and it is completely unrealistic to estimate the volume of each portion by eye. Therefore, at home (with a normal drinking regimen), you should count the number of urinations per day, and also measure the volume of each portion of urine (not approximately, but using a measuring cup). It is advisable to conduct the study within two to three days. On a piece of paper prepared in advance, you will record the time of urination and the volume of urine excreted. There is no need to collect urine; you will only bring to the doctor a piece of paper with notes that can be used to identify frequent urination in small portions or rare urination in large portions. In the first case, we are talking about such a pathological condition as a hyper-reflex bladder (having accumulated a very small amount of urine, the bladder gives a signal about the need to urinate), in the second - about a hypo-reflex (even when a large amount of urine accumulates in the bladder, the urge to urinate is weak or absent). The reasons may be different: impaired regulation of urination on the part of the nervous system, insufficient development (maturation) of the structures responsible for the act of urination, pathology in the bladder itself.

Ultrasound examination of the kidneys and bladder (ultrasound). This study, if possible, is best carried out as planned, that is, by applying on your own, even without any suspicious symptoms indicating diseases of the urinary system. An ultrasound will show whether there are any malformations of the kidneys (such as doubling of the kidney, reduction of the kidney - hypoplasia, absence of the kidney - aplasia, low-lying kidney - nephroptosis, etc.), signs of inflammatory diseases, the presence of stones or large crystals, urinary disorders .

Bring a diaper with you (although some institutions use their own). You can also use it to wipe off the gel from the baby’s skin at the end of the study.

Do I need to come for an ultrasound examination with a full bladder? If the baby can, then yes. Then the specialist will examine the full bladder, then send the child to urinate and repeat the examination of the bladder to find out if there is residual urine (the part of the urine that remains in the bladder after urination with pathology).

It is better to carry out dynamic observation by the same specialist using the same device. And one more thing: if you were sent for an ultrasound of the kidneys and bladder with suspected pathology, try to get examined at a specialized nephrology center.

X-ray examination. Intravenous (excretory) urography. Despite the widespread use of ultrasound devices, X-ray examination has not lost its relevance. This method allows you to evaluate the location and structure of the kidneys and urinary tract, the preservation of kidney function, the process of urination, possible formations or stones. The child is given an intravenous contrast agent. Since the kidneys are involved in the process of purifying the blood from foreign substances, after about 5 minutes the contrast agent appears in the kidneys and then “descends” as part of the urine through the ureters into the bladder. At this time, several X-ray images are taken.

Of course, everything related to injections, especially intravenous ones, is very unpleasant for the child, so it is advisable to have a conversation with him at home about the upcoming examination.

Before this study, preparation is required. Since the intestines, which are loaded with gases and feces, can complicate the assessment of x-rays, 12 hours and 1-2 hours before the examination, the child is prescribed a cleansing enema (for children under the age of 3-5 years, you can limit yourself to only one - 12 hours before the examination). 2-3 days before the test, reduce foods such as raw vegetables, juices, brown bread, and milk in the child’s diet. On the day of the study, children under the age of one year are allowed to be given breast milk or formula (1 - 1.5 hours before), older ones - a bun with tea without sugar.

In addition to a negative psychological reaction to the study, others are possible (in approximately 4-5% of children): nausea, vomiting, decreased blood pressure, facial swelling, chills. Severe reactions occur quite rarely (the X-ray room must have the necessary medications for this case).

Victory cystourethrography. This method is also based on the introduction of a contrast agent, but through the urethra into the bladder.

Immediately before the examination, the child is asked to urinate, then a contrast agent is injected into the bladder through a catheter (thin tube) (before the urge to urinate) and two photographs are taken (before and at the time of urination). Some clinics limit themselves to only one image at the time of urination, which reduces radiation exposure, but practically does not reduce the information content of the study.

This method will help in identifying abnormalities in the development of the bladder and urethra, the presence of vesicoureteral reflux and its severity.

Radioisotope research. Renoangiography. The research technique consists of intravenous administration of a radiodiagnostic substance and recording the passage of this compound through the renal vascular system. The curve obtained as a result of the study is called an indirect radioisotope renoangiogram. This method allows you to evaluate renal blood flow, kidney function, and the process of urination in the ureters. Compared to x-ray methods, the radiation exposure is minimal.

Dynamic and static scintigraphy (scanning) of the kidneys. The patient is intravenously injected with a radiodiagnostic drug, which causes radioactive radiation from the organ being examined, and special devices - gamma cameras or scanners graphically record it. The received data undergoes special processing on a computer and is displayed in the form of a static or dynamic image. The method allows you to evaluate the size, shape, location of the kidneys, as well as identify formations in the kidney (for example, a tumor). The radiation dose is almost the same as during intravenous urography, that is, quite high. You don’t have to prepare for radioisotope research methods in advance, but some clinics recommend taking iodine supplements 3 days before the examination (to “protect” the thyroid gland).

Cystoscopy. Using an optical device (cystoscope) inserted through the urethra, the doctor examines the bladder from the inside to evaluate the mucous membrane, examine the openings (ostia) of the ureters and assess some other points (including the presence of stones, tumors, foreign bodies). Special preparation is usually not required, except in cases where the examination is carried out under general anesthesia (anesthesia) for boys and very young children.

Your child may need other tests. Do not be shy and always check with your doctor for what purpose and how exactly the necessary research is carried out.

Where can I get tested?

To carry out diagnostic measures in order to clarify a specific disease and/or impaired renal function, and decide on treatment tactics (for example, the need for surgical intervention), the child may be hospitalized in a specialized department of a children's hospital. Some clinics practice partial stay in the department - intermittent hospital stay (in the evenings, weekends and holidays, the child and mother can be sent home).

In addition to clinics and hospitals, there are also diagnostic centers where you can undergo examination in a day hospital setting. For subsequent follow-up monitoring of the child’s health, you can contact either the advisory department of the diagnostic center or the nephrologist at the district clinic.

If the examination reveals a serious pathology (pyelonephritis, glomerulonephritis, tuberculosis of the urinary tract, stones in the urinary tract, suspected diabetes mellitus, renal failure) and intensive treatment is required, the parents are offered hospitalization of the child.

Why is it dangerous?

Urinary tract infection (and frequent urination is one of the manifestations of pathology) is far from a harmless disease, especially if not only the lower urinary tract is affected, but also the kidneys. Here are just the dry statistics: out of 100 untreated children, 20 have partial (or complete, which happens quite rarely) death of the kidney tissue, and out of 100 treated children, only one has. The death of 80% of kidney tissue cells leads to persistent and irreversible impairment of kidney function - chronic renal failure. Is it worth the risk? Particular attention to possible pathology in urine tests should be paid to those who, during an ultrasound examination, were found to have malformations of the kidneys and urinary tract (small kidney - renal hypoplasia, horseshoe kidney, duplication of the kidney, etc.). Such children are more prone to developing pyelonephritis. And the situation is further aggravated by the presence of the above-mentioned vesicoureteral reflux, since even in the absence of infection, the thrown urine damages the kidney tissue, and in the presence of infection, this process goes several times faster.

Prevention measures

It cannot be said that by observing certain measures, you can completely insure your child against diseases of the urinary system. This would not be true. But identifying the pathology in time (and, therefore, starting treatment on time) to prevent possible unpleasant complications is very important. To do this you need the following:

be attentive to the child’s condition, noting possible signs of illness;
do not neglect preventive examinations of the pediatrician (remember that children under one year are examined every month, from one to three - every three months, from three to seven years - every six months);
do not allow hypothermia (do not allow the child to sit on cold ground, stones, swim in cold water, etc.);
Breastfeed your baby as long as possible - such children are less likely to develop intestinal dysbiosis (dysbacteriosis), which means there is less chance of pathogens from the intestines entering the urinary system with the subsequent development of a urinary tract infection. In addition, breastfed children have a higher level of immunoglobulin A in their urine, which provides local protection of the urinary tract from infectious agents;
If a child has a high fever and there are no other signs of illness (runny nose, cough, etc.), be sure to call a doctor (do not self-medicate).

Olga Mayorova
Pediatrician, assistant at the Department of Children's Propaedeutics
diseases of the St. Petersburg State
Pediatric Medical Academy, Ph.D. honey. Sci.
Article from the magazine "Mom and Baby" No. 11, 2006

Discussion

What to do if the child pees drop by drop every 5-10 minutes, but the tests are normal, including at the pediatric gynecologist? The urologist also didn’t find anything interesting for himself?

10/18/2008 18:13:02, Irina Fedorova

Comment on the article "Frequent urination in children"

All ladies who accidentally encounter cystitis for the first time initially mistake it for other diseases. And only after all the painful, unpleasant symptoms that arise no longer raise the slightest doubt, they are immediately sent to the doctor. As a rule, there are now a few individuals who, due to being very busy at home, overload at work, lack of money, and out of fear of being diagnosed with a sexual disease, are obstinately afraid to get checked by a doctor. And this is one...

Hygiene for boys: mistakes When caring for boys, the main thing is not to overdo it. Many parents find it extremely important to pull back the foreskin and thoroughly clean their baby's penis. However, compared to adult men, the structure of children's genital organs has its own characteristics. In most newborns, the head of the penis is completely covered by the foreskin, which moves with difficulty or does not move at all. This is a normal phenomenon, the head of the penis opens...

Discussion

But the pediatrician didn’t tell us anything about this. Yes, we didn’t ask. I'm still afraid to touch this organ. We don’t move anything there, especially with force. It will reveal itself. Just wash it well with warm water, once a week with soap.

Of course, forcefully push back the foreskin, otherwise it may fester and you will have to clean it.

In a family, the birth of a boy is a wonderful event. But along with the joys and worries of a little man, you may also encounter “male problems” that parents need to know about. Thus, in 96% of newborn boys, exposure of the head is impossible at birth. This is explained by the presence of adhesions between the head and the foreskin (prepuce), a narrowed prepuce ring, and a short frenulum. This condition is called physiological phimosis. In addition, phimosis occurs...

Acute pyelonephritis (kidney inflammation) is one of the most common diseases of the urinary system in children; This is a disease that is an acute microbial inflammatory process in the pyelocaliceal system and tubulointerstitial tissue of the kidneys. Routes of infection of the kidney during pyelonephritis: ascending (more often in older age groups, in girls the source of inflammation can be the vulva, in boys - inflamed foreskin, glans penis) hematogenous (in...

Bedwetting, or enuresis, has been known for a long time. This disease was first mentioned in the papyri of ancient Egyptian aesculapians, who drew attention to this problem back in 1550 BC. Avicenna described this deviation in the “Canon of Medical Science,” noting that it is most difficult for children to control urination during sleep. Many years have passed since then, but the problem of enuresis is still relevant today. What should you do if your child has bedwetting? This question is answered...

Cystitis is an inflammatory disease of the mucous and submucosal layer of the bladder. Cystitis is one of the manifestations of urinary tract infection in children. Acute cystitis begins with a urinary disorder. Children have an urgent urge to urinate every 10-20-30 minutes. The frequency of urination depends on the severity of the process. Cystitis occurs in children of both sexes and of any age, but more often occurs in girls of preschool and school age. Teenage children...

At school age, more than half of children complain of recurring abdominal pain. In some cases, the pain goes away without a trace and does not require serious treatment, but in 50–70% it continues to bother patients, turning into chronic gastroenterological diseases. There are a large number of diseases that are accompanied by abdominal pain. By nature, acute, chronic and recurrent abdominal pain is distinguished. Acute abdominal pain may be a consequence of acute...

Today a new section has appeared on the 7th - Child Development Calendar from birth to 3 years [link-1] We hope that the published information will be useful to young parents!

Once I noticed that my back was hunched and my shoulders were drooping. I stood up against the wall (15-20 minutes a day). But: - sometimes there is not enough time, sometimes the day is short, sometimes the wall is cold... in short, the effect is close to 0. I noticed that I slouch the most while sitting at the computer. If I remember, I’ll straighten up. But: - sometimes I was busy, sometimes I got distracted, sometimes I didn’t remember, sometimes I forgot.... I went to the websites to look for reclinators (you sit on a chair - and it straightens you up! - beauty!) from Orteka - 1600-1800, from the crate - 700 -1100, at...

Frequent urination in children. Ultrasound examination of the kidneys and bladder (ultrasound). An ultrasound will show whether there are any malformations of the kidneys (such as kidney doubling, kidney shrinkage - hypoplasia...

Discussion

Firstly, forcing yourself to calm down is only a possibility, not a diagnosis at all.
What risk were you told? how high? If the risk is really high, you should definitely go to a specialist. Everything will be explained there - what can be done and when, what the dangers are. And even if they send you for amnio, it’s not the end of the world - I’ve had several friends do it - everyone is fine. Here, after 35, this is a common practice.

Well, don't be nervous! the threshold result is not bad. I had almost the threshold, which means the risk is 1:250. and mine was 1:253.
bad is when 1:50, for example. And here there were examples when healthy children were born. but in any case, such a risk value is an indication to do an amnio.
But be sure to go for a good, expert ultrasound.

That year the doctor prescribed a cystography. But we won’t do that, because... all year, either a cold or some other illness. But cystography is not done in a hospital, but on an outpatient basis and, apparently, without anesthesia. But I have a hard time imagining how this will happen. Even though my son is 8 years old, I still have to force him to sit still when they insert something..... The treatment we were prescribed was as follows: And then I noticed that if we walk for a long time or ride on a slide, he forgets and doesn’t ask to go to the toilet at all. Well, if there were urges, it doesn’t matter whether you’re walking or sitting at home, it would still be the same. 09/12/2002 07:42:47, Masha and the Bear

my advice is to see a good doctor, not a gynecologist, but a urologist or nephrologist, because kidney disease is quite serious, and almost all drugs used to treat them during pregnancy (and especially in the early stages) are, to put it mildly, undesirable (I say this as kidney specialist with 30 years of experience), only a doctor, based on tests, can choose for you what will bring maximum benefit to you and minimal harm to the baby! Don’t self-medicate, rose hips and Brusniver, of course, won’t hurt (if you don’t overdo it too much :)), but I wouldn’t take any medications without a doctor’s prescription.

Frequent visits to the toilet in a child may be associated with a large amount of fluid drunk. Parents should not panic ahead of time, but they should not let the problem take its course. If, in the mother’s opinion, the child’s frequent urination without pain is not a consequence of eating watermelon, then it is advisable to visit a doctor to understand the cause. And there can be many of them, we’ll talk about this further.

Normal urination in children

In order to panic and rush to the doctor for help if the child begins to visit the toilet frequently, you need to know the norms of urination at different ages:

In the first week after birth, the newborn urinates 5-6 times a day.
Up to six months, urination up to 15-20 times a day.
From the age of 6 months to a year, the number drops to 13-15.
From one to three years, the baby can sit on the potty up to 10 times.
3-6 years - 5-6 times a day.
Children aged 6-9 years urinate 5-6 times.
After 9 years, urination up to 5 times a day.

As the child gets older, the frequency of toilet visits decreases. This can be explained by the fact that the baby’s excretory system is formed gradually. Almost only by adolescence the final development of all organ systems ends.

Kidney functions in the body

The kidneys are the main organ of the excretory system. They are responsible for many important functions:

Maintaining the balance of body fluids.
Removal of toxic substances.
Stabilization of blood pressure.

The child is actively growing, experiencing stress, and natural changes occur in the structure of the kidneys, which affects their functioning. This can also be expressed in an increase in the frequency of urination.

According to medical data, about 20% of children suffer from frequent urination, but do not experience any discomfort.

Natural causes of frequent urination

Pollakiuria or frequent urination can occur under the influence of some natural factors, then it is called physiological. Once these factors are eliminated, everything returns to normal. Frequent urination in a child without pain can be caused by:

Drink a large amount of liquid. This can be observed in the summer, when it is hot outside and the baby often asks for a drink. But if a child is constantly thirsty, then this is a reason to consult a doctor.
Diuretic drugs provoke an increase in urine output. If therapy is carried out using such medications, then after recovery everything returns to normal.
If your child urinates frequently without pain, the reason may be the use of foods that have a diuretic effect. These include: watermelon, currants, lingonberries, herbal tea made from chamomile or rose hips.

Eating salty and spicy foods leads to extreme thirst, which means going to the toilet will become more frequent.
When the body is severely hypothermic, a reflex spasm of the kidney vessels occurs, which provokes the urge to go to the toilet. Once the baby is warmed up, everything goes away.
Increased activity leads to the release of adrenaline into the blood, which raises blood pressure and the heart begins to beat faster. Metabolic processes accelerate, the kidneys filter a larger volume of blood, and therefore urination becomes more frequent.
Stressful situations at home, in kindergarten or school provoke frequent urination in a child without pain. Parents should try to eliminate this negative factor; if they cannot do it on their own, they will have to seek help from a psychologist.

When all provoking factors are eliminated, the number of visits to the toilet returns to normal. Parents should be wary if frequent urination in a child 5 years of age or older is accompanied by other symptoms: pain in the lower abdomen, changes in the color or odor of urine. In this case, you should not postpone visiting the doctor.

Urination without pain - pathological reasons

There are some pathologies that are also accompanied by frequent urination in a child without pain. These include:

Reduced bladder size. This may be a congenital pathology or caused by a tumor growing nearby.
Disruption of the development of nerve centers responsible for regulating the functioning of the bladder.
Brain injury or tumor development, which leads to disruption of the innervation of internal organs. There may be frequent urination in small portions and the development of enuresis.
Diabetes mellitus provokes severe thirst; drinking a large amount of liquid leads to frequent visits to the toilet.
Neuropsychic pathologies: neuroses, vegetative-vascular dystonia, neurasthenia. These diseases are usually accompanied by other symptoms: headache, nervousness, sleep disturbance, emotional lability.

Important. If parents notice suspicious changes in their health, then this is a significant reason to visit a doctor as soon as possible to identify the cause, conduct a diagnosis and prescribe the necessary therapy.

Symptoms of diseases of the urinary system

If you notice that your child is using the toilet frequently, it is important to talk to him. Ask him what he feels when urinating, whether there is pain in the lower abdomen. Parents should pay attention to the color and smell of urine, since frequent urination can be caused by the penetration of pathological microflora. If an inflammatory process develops, the following signs will be present:

Burning and pain during urination, the child simply cannot help but notice. If the baby is small, then crying while sitting on the potty should alert the mother.
Increased body temperature.
The urine becomes cloudy, flakes appear, and an unpleasant odor appears.

Need to know. It is easy to recognize cystitis and pyelonephritis in a baby at an early stage; if a small amount of urine is released when laughing or sneezing, then bacteria are rampant in the body.

Pathologies of the excretory system must be treated urgently. Otherwise, serious complications are possible.

Frequent urination in an infant

Considering that the baby is breastfed, the work of his body largely depends on the mother, on what her diet is, and whether she takes medications.

If there is frequent urination in the baby without visible painful conditions, then it can be assumed that the mother has pathologies of the kidneys or urinary tract. It is necessary to visit a doctor for a nursing mother, and then examine the child.

Diagnosis of kidney pathologies

Frequent visits to the toilet may signal the development of serious kidney pathologies or diseases of other internal organs. A visit to a urologist is simply necessary. After a conversation with the child, if he can speak and is able to say something about his feelings, the doctor prescribes laboratory tests of blood and urine. A preliminary diagnosis can already be made based on:

Increased content of proteins, uric acid, leukocytes in the urine. This may indicate the development of an inflammatory process.
If a low hemoglobin content is detected in the blood, then we can talk about a general deterioration in the child’s health.

Differential diagnosis of the bladder and kidneys is important, for this they carry out:

Computed tomography.
X-ray.
Cystoscopy.

It must be taken into account that CT and MRI are not prescribed for newborns and infants, since the child is not able to maintain a motionless position for a long time, unless in emergency cases.

After clarification of the diagnosis, treatment is prescribed.

Treatment of frequent urination in children without pain

If frequent urination is a consequence of the development of pathology of the kidneys or urinary tract, then serious therapy is required. Treatment is carried out in a hospital; you can try to cope with uncomplicated cystitis at home, but only after visiting a doctor and prescribing medications.

Within the hospital walls it is possible to constantly monitor the child’s condition. The following areas are used in therapy:

Drug treatment.
Physiotherapeutic procedures.
The use of folk remedies.

A treatment regimen is prescribed only after a complete examination and an accurate diagnosis.

Drug therapy

Depending on the diagnosis, the treatment regimen may differ. Only a doctor should select medications; self-medication, especially for a child, is unacceptable. To get rid of the same pathology, there are many remedies; the attending physician should prescribe them and prescribe a treatment regimen:

If an inflammatory process is detected, uroseptic agents and antibiotics are prescribed.
Frequent urination due to diabetes is treated with hormone replacement therapy.
If there are neuropsychic abnormalities, then you cannot do without taking sedatives and nootropics.
For neoplasms, surgical treatment is indicated.

When prescribing medications, it is important to follow the dosage and treatment regimen, then the treatment will take place without the development of side effects.

Physiotherapy in the treatment of pathologies of the urinary system

If a child has frequent urination, mothers ask what to do. Visit a doctor and follow all his recommendations, take medications and attend physical treatments. They will be a good help in treatment. If an inflammatory process occurs, then the following are considered effective:

Electrophoresis.
Amplipulse therapy.
Laser therapy.
Exposure to heat.

Parents must understand that a complete recovery of the child can be achieved if they complete the full course of prescribed procedures and take medications.

Folk recipes

Traditional medicine will be a good addition to the main treatment. The use of medicinal decoctions and infusions will help quickly get rid of pathologies of the kidneys and urinary tract. The following recipes have proven effective:

Pour 20 grams of mint into 1.5 liters of boiling water and boil for 10 minutes. Take 150 ml three times a day.
Take a decoction of corn silk.
A decoction of rose hips works well. You can infuse it in a thermos and give it to your child to drink throughout the day.
Birch bud tea. Add a teaspoon of kidneys to a glass of boiling water. Leave for 2 hours and take 50 ml 3 times a day.

Herbal treatment of a child should begin only after consultation with a doctor. It must be borne in mind that not all plants can be used in the treatment of children.

Disease Prevention

Considering the size of the kidneys in children and the incomplete development of all organ systems, it is impossible to completely insure against pathologies of the urinary system, but if preventive measures are taken, the likelihood of their development can be reduced:

Visit your doctor regularly, even if you think your baby is absolutely healthy.
Dress your child according to the weather, avoid hypothermia and overheating.
Do not allow sitting on cold ground or steps.
Monitor your bladder emptying as often as your baby does. If you have any suspicions, you should immediately visit a doctor.
Don't give up breastfeeding. It protects the baby from many infections.

You should not look for the cause of deviations on your own. Only a specialist can make a correct diagnosis. Self-medication of a child is fraught with serious complications in his health.

Frequent urination in children: why it occurs and how to treat it

A constant urge to go to the toilet is called pollakiuria. In some cases, the cause may be minor, but it happens that the symptom is associated with a disease (kidney or bladder). We tell you how to recognize a child’s ill health by frequent urination and cope with the problem.

Normal child urination

For newborns and babies less than six months old, it is absolutely normal to urinate 15 to 25 times a day; about 15-17 trips to the toilet “in a small way” are made by babies aged from six months to a year; the number of urinations is reduced to 10 in the period 1-3 years; then up to seven years the figure fluctuates 7-9 times; 7-10 year old children urinate up to seven times a day; for children over ten years old, the number of urinations is five to seven.

Physiological pollakiuria

Before thinking about your child’s possible illnesses, pay attention to how much liquid he drinks. By the way, it’s worth clarifying here: a baby can drink a lot of the same teas and juices because he’s used to it or feels thirsty, but it is also possible that drinking a lot and frequent urination are associated with the development.

Plus, sometimes medications with a diuretic effect become provocateurs: the same furosemide and other diuretics. After taking certain medications, the child’s frequency of urge to go to the toilet increases, as this side effect has occurred (here, for example, metoclopramide with diphenhydramine).

In addition to medications, certain foods and drinks often make you want to go to the toilet: green tea with soda, coffee, carrot juice, cranberries and lingonberries (in the form of compotes, decoctions and fruit drinks), watermelons, melons, cucumbers. Another reason may be hypothermia, when the kidney vessels reflexively spasm, urine is quickly filtered and also quickly eliminated from the body. As soon as you warm up, pollakiuria goes away. Stress and overexcitement can also affect the frequency of urination: adrenaline actively secreted by the body simultaneously increases urine production, the bladder becomes more excitable. Once the stressful situation is resolved, the symptom will cease to appear.

Illness and frequent urination

If the cases described above are not dangerous to the child’s health and the number of urges returns to normal when the factor is eliminated, then in a situation with bedwetting you should be wary. The child may complain of abdominal pain with sudden urges, burning, high fever, sweating with weakness; noticeable weight loss. All this suggests that you need to contact a specialist so that he can diagnose and prescribe treatment.

The most common pathology is cystitis, associated with inflammation of the bladder. With cystitis, pollakiuria is accompanied by pain during urination, and the lower abdomen often hurts. If the urethra is inflamed (), pain and burning occur at the time of urination. But (inflammation of the pyelocaliceal system and connective tissue structures of the kidneys) in itself is not characterized by such active urges, until it manifests itself along with it. The child feels weak, pale, eats poorly, and may report abdominal pain; he also feels sick, vomits, and has a fever. In addition to the described disorders, the cause may be a small volume of the bladder (congenital anomaly or tumor in the bladder); ; ; ; other hereditary and acquired pathologies (the same renal diabetes with phosphate diabetes, congenital tubulopathy, etc.).

Neurogenic bladder dysfunction (hyperreflex type)

The disorder is manifested by improper functioning of the bladder: collection, “storage” of urine and untimely emptying. The cause of the pathology is a delay in the maturation of the nerve centers responsible for the functioning of the organ. Pollakiuria in this case is isolated, aggravated by stress and, while there is no inflammation of the urinary tract with pain when urinating. Sometimes, against the background of dysfunction, enuresis with urinary incontinence is possible.

Pathologies of the endocrine system

We are talking about diabetes mellitus and diabetes insipidus. The first pathology (glucose accumulates in the blood without reaching the body’s cells) involves controlling sugar levels. In the initial stages there is thirst with increased appetite and weight loss. A lot of urine is released, boils with folliculitis, blepharitis, and itching often develop on the skin. As for the second pathology, it is associated with improper functioning of the pituitary gland or hypothalamus, which produces the hormone vasopressin. It helps absorb water as blood is filtered through the kidneys, so if the hormone is low, more urine is produced than needed. Signs other than pollakiuria include thirst with polyuria (large amounts of urine).

Disorders of the central nervous system

The bladder is emptied under the influence of brain impulses passing through the spinal cord to the nerve cells of the organ. Interruption of the chain threatens with frequent urination, little by little, and urinary incontinence. This happens due to injuries, tumors of the spinal cord and brain, and inflammatory diseases of the spinal cord.

External reasons

This refers to situations where the volume of the bladder is reduced not only due to abnormal development, but also compression of the organ from the outside: these are pelvic tumors, pregnancy in adolescence.

Neuroses with psychosomatic disorders

We have already said that stress often forces a child to visit the toilet more often. Also, in addition to them, neuroses, neurasthenia and psychosomatic conditions (the same, etc.) can influence. Pollakiuria in this case is constant, although not clearly expressed. In addition to frequent urination, there is nervousness with mood swings, tearfulness or aggressiveness, phobias, etc.

How to find out the causes of pollakiuria

First, physiological causes are excluded. Then, after questioning and examination, a specialist needs to check the urine (general analysis) to check for cystitis or pyelonephritis. Plus, this analysis can detect glomerulonephritis with urolithiasis and diabetes mellitus. Further research is carried out based on the results of the analysis. It may be necessary to do Nechiporenko, Addis-Kakovsky tests (to detect hidden inflammation of the urinary tract); Zimnitsky (assessment of kidney function). Diagnostics is complemented by a biochemical blood test, ultrasound of the bladder and kidneys (check for stones, inflammation, etc.). Sometimes a glucose load test, a study of blood hormones, and consultations between a nephrologist and endocrinologist with a neurologist (or psychiatrist) and neurosurgeon cannot be avoided. As a rule, these diagnostic methods are sufficient to determine the cause of the disorder.

Pollakiuria (tamuria) is frequent urination, which can be both a symptom of various pathological conditions and a reaction to changes in living conditions. Symptoms can appear only during the day or only at night, and can also be the same in intensity throughout the day. When experts talk about pollakiuria, they mean disturbances in urination during the day, since a special term was introduced for the nocturnal pathology of this type - nocturia.

What is pollakiuria

In pediatrics, pollakiuria refers to frequent urination in children without pain. This symptom can accompany diseases of the genitourinary, endocrine, nervous and cardiovascular systems of the body.

It is characteristic that the amount of urine excreted per day remains consistent with the age norm. The child often goes to the toilet, every 10-15 minutes, but little by little.

This symptom is sometimes accompanied by urinary incontinence (or urgency), but it would be a mistake to combine them into one problem. With pollakiuria, it is extremely difficult to control the time intervals between trips to the toilet, but involuntary urination does not occur.

According to statistics, most cases of frequent urination occur in boys aged 4 to 6 years.

Why does a child pee often?

Frequent urination in children can be caused by various diseases. In this case, this symptom is often accompanied by problems with appetite, excessive sweating, high body temperature, pallor and lethargy.

Disruption of the rhythm of bladder emptying is one of the indirect symptoms of endocrine system pathology (diabetes mellitus and diabetes insipidus). With this disease, the child constantly feels thirsty, drinks a lot and, as a result, pees a lot.

Various inflammatory processes of the genitourinary system, such as cystitis and urethritis, are always accompanied by pollakiuria.

Tamuria is the main symptom of neurogenic dysfunction - a pathology in which the development of nerve centers responsible for the proper functioning of the bladder slows down.

Frequent urination is caused by compression of the bladder, for example, by tumors of organs in the pelvis or by an incorrectly positioned uterus in girls.

Pathologies of the central nervous system, arising from various injuries, inflammatory-degenerative diseases and brain tumors, also provoke the child to often go to the toilet in small quantities. This happens because the emptying of the bladder is responsible for impulses that the brain transmits through the spinal cord. With pathologies of the central nervous system, the chain is disrupted and the correct rhythm is disrupted.

A child may want to write often due to neuroses and psychosomatic disorders. Due to stress and overexcitement, some children constantly run to the toilet, but this is a temporary phenomenon that lasts no more than 10 hours. In pathologies of a psychosomatic nature, the symptom is constantly observed, but may not be pronounced and is often supplemented by aggressiveness and sudden changes in mood.

Household reasons for frequent trips to the toilet

The reasons for frequent visits to the toilet can be everyday situations not related to illness. In this case, we are talking about physiological pollakiuria.

If a child drinks a lot of liquid, he, accordingly, pees a lot. Here we need to look at why this happens. If it is due to heat or intense physical activity, there is no need to worry. However, it is also possible that the child begins to drink much more liquid for no apparent reason - in this case, you need to contact a specialist.

It is necessary to monitor and prevent hypothermia, as this leads to reflex vascular spasms, which causes the child to urinate more frequently.

The symptom of tamuria may appear while taking medications (diuretics, antihistamines and antiemetics) that have a diuretic effect. Some foods also have a diuretic effect, for example, cucumbers, beets, melons, tomatoes, lettuce and watermelons.

If a baby pees often, first of all you need to pay attention to the diet - perhaps this is how he reacts to a change in diet or to the mother’s consumption of foods with a diuretic effect. Such a reaction is possible to family quarrels or a radical change of situation. If these causes are excluded, but the symptom remains, the help of a pediatrician is required.

How often should a child write at different ages?

In order to understand whether a child has frequent urination or not, you need to know the age norms.

In the first week of life, children pee little (up to 5 times a day), since a large volume of fluid is lost during childbirth, breastfeeding is not yet sufficient, and the functioning of the urinary system has not yet been established.

However, already in the second week the situation changes, and up to 6 months, children pee 20-25 times a day. Over the next six months, the intensity decreases slightly - up to 15-16 times a day.

At the age of 1 to 3 years, a child goes to the toilet 10-12 times. For children from 3 to 9 years old, it is enough to write 7-9 times, and from 9 to 13 years old - only 6-7. For teenagers, the norm is to urinate no more than 5 times a day.

Although the frequency of urination in a child is a very important indicator of health, there is no need to worry if there are slight deviations from the norm. It is necessary to analyze what has changed in the rhythm of life, observe the further development of the situation, and only then make a decision about a visit to the doctor.

How to help your child

Frequent urge to urinate in children should not be ignored by parents. Due to the absence of pain, the child may not complain for a long time while the disease develops.

If symptoms do not disappear within 24 hours, you will need to consult a pediatrician. You can first submit your urine to the laboratory for analysis.

If any pathology is discovered, the doctor will prescribe further treatment, and parents can only help by strictly following the recommendations.

In the absence of diseases, tamuria can last up to 2-3 months. If the doctor says that treatment is not required, relatives need to behave very tactfully. You should not constantly ask your child questions about going to the toilet and remind him of this situation. The problem is sensitive, and constant discussion can provoke stress, which will not allow the symptom to disappear.

It is necessary to monitor the child’s nutrition, prevent hypothermia, and monitor routine examinations with a pediatrician and specialists.