Some religious fanatics tag it as spiritual problem and as such go spiritual because they believe the spiritual controls the physical, oh yeah that's true, I wouldn't argue that with them. We all have every right to believe whatever we want but my question is, can't we really give science a chance to explain some little things that could actually be solved easily once the root cause is known.
Just recently, scabies mite wrecked havoc in the Eastern part of Nigeria and a close friend of mine was infected, I observed that he kept scratching his genital region so hard that he felt like pulling off his penis. The sensation he gets as a result of the scratch can be likened to that gotten when you clean your ear with a cotton bud ; this he told me.
As a concerned friend, I simply asked him few questions necessary e.g did you sleep with any one? Do you share your towel... Bla Bla Bla. All the response I got from all the question were emphatic no! Except for this question ; the bed you lie on, how many of you use it? Haha, this time I got the answer I wanted, the bed has no owner because many of his friends lay on it as well. I simply asked him to go for a test, and the result was clear, he was infested with scabies mite.
Sarcoptes scabies An insect that is microscopic (can't be seen with naked bare eyes) and causes serious itching when they feed and lay eggs in the skin after infestation. They find the scrotum and the genital region much more favourable for habitation. They cause intense itching which later produces nodules around the region where they are found. Don't conclude yet until a test had been done to determine the pathogenesis (aetiology) of the problem you have. Just with a cheap sulphonamide - based drug, the itching stopped and he was whole again.
Before he contacted me, his friends had already concluded that he had contracted a sexually transmitted disease and according to what he told me, many said he probably had contracted gonorrhoea or staphylococcus. Result without diagnosis! My friend was scared to death as to how on earth he could have contracted gonorrhoea when he didn't have any sexual intercourse with any lady.
What if?.....🤔
What if he had not done the test? What if he had not called to enquire about his problem? What if he didn't do the test? What if there was no diagnostic tests to investigate medical conditions? What if I had no education? What if there was no education at all? Whoever says education is expensive probably has not tried ignorance. You could imagine how our late ancestors suffered several illnesses without having the slightest idea that the illness which plagued them then could be cured just by simple diagnostics procedures.
Case study
A surprising case that will shock you is the case of a man who was arrested for inhumane treatment. This man comes to the hospital, liaises with a hospital staff to collect the deadly bacteria culture plates - Mycobacteria tuberculosis which causes tuberculosis in humans.
As the case was reported, this man kept visiting the hospital to collect the inoculated culture plate (a transparent plate on which a bacteria organism has been grown in the incubator) of a patient who has been diagnosed and confirmed as one suffering from tuberculosis- a disease called 'ukwara-nta' in my native igbo language.
He collects the used inoculated plates which contain bacteria that was meant to be autoclaved (the process of killing microorganisms using moisture) before destruction and sells them to native doctors in exchange for money.
What does the native doctor do with the culture plate🤔
The question you might want to ask now is; what on earth does this native doctor do with the bacteria culture plate. It's just so ridiculous; he uses this bacteria to prepare charm for the ignorant villagers who come to his shrine to request for 'juju' (charm) or those who wish to either hurt or kill their enemies probably due to a serious quarrel or dispute over an issue and you know, most times the problem is usually land disputes. To the ignorant villager, the charm was prepared from supernatural means meanwhile he doesn't have an inkling that a deadly bacteria has been given to him to hurt his fellow man.
The fate of the innocent villager
If he succeeds by putting this so called charm in his enemy or neighbour's food or drinks or by any means, these people end up suffering ignorantly till they die. What a world! 😢 How I wish I could turn back the hands of time, who knows some diseases that killed people in the past due to ignorance might have been a minor case to deal with. This is just a surface detail of the case, as it extends far beyond what you just read here.
So tell me, who said education is not important? I am sure if these villagers were educated enough to know about this bacteria, they obviously wouldn't leave their fate at the hands of their deities and gods for cure. This is a typical example of what ignorance can cause.
Enough of the story, let's now talk more about the main issue of the day - bed wetting.
Let's go scientific and physiological about bed - wetting
Growing up as a kid, has it ever occurred to you why suddenly you stopped urinating unconsciously on your body? Obviously there must be a reason for that. Infants naturally are unable to control micturition reflex (urination) and as a result of this, they urinate without control on their body. They lack the ability to voluntarily void urine when the micturition reflex comes.
Why is this so?
The neurons (electrically excitable cell that generates electrical and chemical signals in order to process and transmit information in the body) are majorly the building blocks of the nervous system. In the brain alone, you have about 100 billion neurons which are actively processing information in the brain. These nerve cells are made up of a cell body, a long axon and dendrites which makes contact with the neurotransmitter- acetylcholine.
The axon I mentioned above is the longest part of the nerve cells and it can either be covered by a myelin sheath or may not be covered. Now those that are covered with a myelin sheath are called myelinated nerve fibres while those that are not covered are called non-myelinated fibres. Read along, you will get to understand the reason and importance of the myelination.
There are sympathetic and parasympathetic nerves that innervates the longitudinal muscle of the bladder - detrusor muscle, bladder sphincters (muscles that surround the urethra to keep it closed so that urine does not leak out of the bladder) and other muscles that are involved in the contraction and relaxation of bladder. There are two types of nerves, myelinated and unmyelinated nerve.
By being myelinated it means that the nerve is covered by a myelin sheath which increases the saltatory conduction of impulse signal through the nerve. Myelination of nerve fibres makes it faster for nerve impulse signal to be transmitted through it.
At the early stage of development, these nerves are unmyelinated and as we grow older, they gradually become myelinated. In some people, these myelination process is slow while in some it is quite fast. One of the major nerve that control a lot of muscular actions around the genital region is the pudendal nerve, this nerve plays a role in both defecation reflex (process of voiding faeces) and micturition reflex.
Its specific role during micturition is the control of the external sphincters contraction and relaxation via acetylcholine (a neurotransmitter) release. At higher acetylcholine release, there is contraction of the muscles in the external sphincter which results to urine retention but in the case of reduced acetylcholine, there is relaxation thus allowing the contents of the urinary bladder to be voided.
What happens in babies?
Note at this point that, the external sphincter of the urinary tract is made up of skeletal muscle and this simply means that it is under voluntary control ( you can either choose to urinate or choose not to). The reverse is the case in babies.
Owing to the fact that their nerve fibres are not myelinated, the transmission of nerve impulse is not under any voluntary control and the contraction and relaxation of the external sphincter is solely beyond the control of the baby.
As the baby matures, they gradually become able to control urination because of the gradual and if not complete myelination these nerve fibres in the brain. Most people that bed-wet are able to control the micturition reflex during the day but not at night. Babies on the other hand do not control this reflex at both day and night untill they reach a certain age when they gradually begin to have control during the day but in the night, they find it difficult.
The nerves and the muscles must work hand in hand to ensure normal process of micturition. When the bladder is full, there is continuous contraction of the muscle that hold urine, impulse are sent to the brain which in turn responds by causing the release of neurotransmitters (acetylcholine) whose level determines the contraction and relaxation of the external sphincter just like I explained earlier.
As long as the nerves of the brain are not myelinated, the baby won't be able to control the external sphincter of the bladder whose opening causes voiding of urine. I know of a friend who stopped bed wetting at a very late age of about 20 years. The complete myelination of the nerves could happen either very fast of very slowly in different individuals since
The conclusion of the whole matter here is that, the voluntary control of urine is dependent on the effective transmission of impulse along the nerves from the central nervous system (CNS) and this in turn depends on whether the nerve is myelinated or not. Hope you understand now? Alright, let's go pathological!
Pathological basis for bed wetting
By pathological I mean in a case of disorder or disease conditions which could either occur during child birth or may be congenital gene disorder (mutation in the genes). A trauma or damage to the nerve which controls the sphincter could also pose a serious challenge to the individual affected.
When the nerves to the sphincters are damaged, the ability of the sphincter to keep the urethra (passage route for urine) closed is affected and this leads to leakage of urine from the bladder unconsciously. People who are born with damage to pudendal nerve are likely sufferers of enuresis since they are unable to voluntarily control the external sphincter. Usually, a damage to the pudendal nerve could result to wrong signal being sent to the bladder to contract and release urine without the awareness of the individual affected.
When all is well
In a normal individual, it is expected that at night, regardless of whether the individual is conscious or not, the micturition reflex is supposed to give the individual a discomfort that makes him or her conscious of the fact they the bladder is filled up. But those with damaged nerve never feel this discomfort since there is a damage to the nerve, wrong signal is sent to the brain which in turn reduces acetylcholine level that brings about the relaxation of the external sphincter.
They pass out the urine at night totally unaware. They only wake up to discover that they have messed up themselves on bed again. This could be quite embarrassing, I could remember how a friend of mine do feel when ever i wake him up once I discover he has bed wetted. Most times, I wouldn't blame him because it was something he could not just control. He later stopped bed wetting after serious legal exercise and some bladder training. This is the physiologic aspect of enuresis and this is an indication that the condition is specifically pathologic.
Anything that will affect the brain or nerves that run from the brain down to the sacral or lumber region will definitely affect micturition.
Do dreams have effect?
Have you ever dreamt and saw yourself urinating in the dream, yeah it happens. Most people that bed wet complain about urinating in the dream only to wake up and realise that they actually urinated in reality. Our dreams have interconnection with reality and most of what we think of and do in reality have correlation to what we dream about. Dreams do really have part to play in micturition.
Likely solution to enuresis?
Basically the truth here is that self training can go a long way to ameliorate the problem of enuresis just like the case of my friend I explained earlier. For babies, it is something that we just have to adapt to untill the myelination of their nerve cells in the brain is complete, so you just have to brace up for more urines by simply buying diapers which are absorbents.
Some exercises like kegels which can really be of great help in strengthening the muscles of the urinary bladder. Kegel exercises help to build the muscles of the pelvic region as well as the detrusor muscle of the bladder. Training the bladder to retain more urine by refusing to urinate when the first micturition reflex comes can also go a long way. Bladder training help to increase the urine volume capacity of the urinary bladder.
To round it up, enuresis could be physiogical when it is at the level of a baby's development but when it extends to older age, then one would want to query a pathologic condition. Like I said above, it is expected that enuresis stops as children begin to mature till a certain age. There is no specific age at which one is expected to stop bed-wetting.
Until next time 😎✌️
References
¶pudendal nerve
¶Neurophysiology of the urinary tract function
¶Urologic-diseases-bladder control disease
¶Britannica-urination
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