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医者の男

病院で行われるさまざまな専門的な夜尿症の治療法

医者

夜尿症(おねしょ)の改善のため病院で専門的な治療を受けるということも効果的なものとしておすすめできます。病院で行われる専門的な夜尿症の治療法としては、行動療法や薬物療法、生活指導などがあります。

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夜尿症とは

夜のライト

夜尿症とは、いわゆるおねしょのことです。夜尿症は多くの場合には、小学校入学頃をひとつの目安として治る方向性に移行します。もちろん、個人的な年齢差があり、小学校中学年から高学年、そして中学校入学時の頃までには、夜尿症はおさまるのが通常です。

しかし、中学校就学後などいわゆる思春期以後も夜尿症が続くことがあり、この場合には病院での医学的な治療の対象となりえます。(夜尿症がてんかんなどの脳の器質的な病変の一症状である場合などもありえます)

ここでは、一般的に病院で行われる医学的な治療について見ていきたいと思います。

行動療法(夜尿アラーム療法など)

病院で行われる夜尿症の治療法としては、行動療法が中心となります。具体的には、夜尿アラーム療法、心理療法、排尿訓練、バイオフィードバック療法、超音波療法などの治療法が行われます。

病院で実施される行動療法の中で、もっとも広く用いられているものは、夜尿アラーム療法です。夜尿アラーム療法は特殊な装置を使い、尿を感知するとアラームがなることで目が覚めることを期待して行われる治療法です。夜尿アラーム療法は病院で指示・指導される行動療法のうち、特に効果があると認められているものですので、夜尿症の場合には、多くのケースで用いられることとなります。

夜尿アラーム療法を用いた病院での治療・指導は自宅で器具をつけて実施することとなるので、治療に手間がかかるというデメリットやアラーム音で目が覚めないこともあるなどのデメリットもありますが、病院の指導による夜尿症に対する行動療法としては最も広く用いられているものということができます。

薬物療法

次に、病院の指導・観察のもとで薬物療法が取られる場合があります。薬物療法は、薬の投薬による夜尿症の改善方法ですが、具体的には、三環系抗うつ剤や抗利尿ホルモン剤、選択的セロトニン再取り込み阻害薬(いわゆるSSRI)漢方薬など夜尿症の症状や薬に対する相性などを考慮して医師の判断で処方されることとなります。

薬物療法の場合、夜尿症を患っているのが小児の場合には副作用に配慮して病院は薬を処方します。

薬物療法は行動療法に比べた場合、薬を飲むだけなので簡易な方法ではありますが、薬がなくては夜尿症がおさまらないという状況では根本的な解決とはなりません。また、先も述べましたように副作用のおそれもあります。

そのため、夜尿症の治療のために病院が薬物療法を用いることは、比較的少ない傾向があります。

生活指導

夜尿症の改善のために行動療法とともに用いられるものが、病院による生活指導です。生活指導は具体的には、食事、水分の摂取、排尿習慣、就寝前の排尿などを指導することとなります。また、精神的な切迫感を生まないように、病院の生活指導では夜尿症の改善をあせらせないということも行われます。

病院の生活指導が夜尿症改善にどれほどの効果があるのかという点に関しては、医学的には疑問とされる面もあります。病院の生活指導によって夜尿症が改善されたということが客観的に証明・説明されることは難しいためです。

しかし、経験的に病院・クリニックが夜尿症改善の生活指導をすることで夜尿症が治るというケースも多いことも事実です。夜尿症については、専門に扱っている病院(個人のクリニックなどに多い傾向があります)もあり、そのような病院であれば生活指導を中心として必要に応じて行動療法、薬物療法を併用するという形で夜尿症の治療に当たってくれます。

一般に夜尿症で病院へ行った場合には、はじめは生活指導から実施される傾向が強いということができるでしょう。

新 おねしょなんかこわくない―子どもから大人まで最新の治療法
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まとめ:病院における夜尿症治療のまとめ

以上、本文で述べました病院で実施される夜尿症の治療についてまとめますと以下のようになります。

  • 行動療法-夜尿アラーム療法が効果が高いものとして多くの病院で用いられる治療法です。夜尿アラーム療法は自宅でご自身や家族の協力のもと、夜尿症改善のために実施されるものですが、高い効果がある行動療法です。
  • 薬物療法-病院・医師の判断で薬物を投与することにより、夜尿症を治そうとするものです。三環系抗うつ剤・抗利尿ホルモン剤・選択的セロトニン再取り込み阻害薬(いわゆるSSRI)・漢方薬などが夜尿症の患者の方の症状や体質・年齢などに合わせて処方されます。ただ、薬物療法は、特に子供の場合には、副作用がある可能性があるのであまり用いられない傾向があります
  • 生活指導-例えば睡眠前の排尿などを指導することで夜尿症を改善することを目指すものです。病院の生活指導が客観的に効果があるものかどうかという点に関しては不明確なところがありますが、個人のクリニックなどでは生活指導を主として用いて夜尿症改善に成功している病院も多数あります

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