Bedwetting, or nocturnal enuresis, refers to the unintentional passage of urine during sleep. Enuresis is the medical term for wetting, whether in the clothing during the day or in bed at night. Another name for enuresis is urinary incontinence.
For many adults, it is hard to even talk about something that is a “kid thing.” It must be noted that bedwetting in adults is actually different than what children go through. And while that might not remove the embarrassment, you must know that nocturnal enuresis is involuntary and not your fault.
Urine is produced by the kidneys and travels through the ureters to the bladder to be stored. The bladder is basically a muscular sac that holds urine until it is ready to be released into the urethra, the tube that connects the bladder to the outside of the body. At the same time the bladder contracts, the urinary sphincter relaxes. The relaxed sphincter acts like an open door, which allows the urine to pass and exit the body. When there is a physical impediment or neurological disconnect, urination can become problematic.
Bedwetting is caused by a number of medical (and maybe spiritual) reasons some of which are:
* Neurological developmental delay: In other words, the person is just late in achieving bladder control but will eventually stop bedwetting at a later age with/without intervention.
* Genetics: A lot of people who bed wet will find out that one of their parents or uncles or aunties did not stop bedwetting until a very late age. It can be hereditary.
* Insufficient production of Anti-Diuretic hormone. This hormone basically reabsorbs water from the kidney thus reducing our urine volume. A larger amount of ADH is produced at night in normal people, helping us to be dry till we wake up. But some people that bedwet don’t produce enough of this hormone at night therefore their urine production goes on as if it is daytime.
* Overactive bladder or a small bladder: These people have bladders that can only hold a small volume of urine before signaling to the brain that it is full so they bedwet continuously through the night.
If the muscles of the bladder, known as detrusor muscles, are overactive, nocturnal enuresis can occur. In fact, detrusor overactivity has been found in up to 70-80% of primary nocturnal enuresis patients. Bladder irritants, such as alcohol and caffeine, can contribute to detrusor instability. Medications are also known to increase bedwetting in adults. Side effects from hypnotics, insomnia medications, and psychiatric medications such as thioridazine, clozapine, and risperidone can increase your risk. Be sure to talk to your healthcare provider about any medications prescribed and their side effects.
As for secondary nocturnal enuresis, there is plenty of research that suggests an underlying health issue is at the root of the bedwetting. Such problems can be associated with the prostate in men or pelvic organ prolapse in women.
Any of these medical issues can also cause bedwetting in adults: diabetes, urinary tract infection, urinary tract stones, neurological disorders, anatomical abnormalities, urinary tract calculi, prostate cancer, prostate enlargement, bladder cancer, or obstructive sleep apnea.
The following may help in controlling bedwetting,
– Bladder retraining: Go to the bathroom at set times during the day and night. Slowly increase the amount of time between bathroom visits — for example, by 15 minutes at a time. This will train your bladder to hold more fluid.
– Don’t drink right before bed. That way, you won’t make as much urine. Avoid caffeine and alcohol, which can stimulate your bladder.
– Use an alarm clock. Set it to wake you up at regular times during the night so you can use the bathroom.
– Try a bed-wetting alarm system. You attach it to your underwear or a pad on your bed. It will alert you as soon as you start to wet the bed.
– Take medicines. Several can help with bed-wetting. Desmopressin (DDAVP) reduces the amount of urine your kidneys make.
If medicines and other treatments don’t work, your doctor might recommend one of these procedures:
Bladder augmentation. It’s an operation that makes your bladder larger, which raises the amount of urine it can hold.
Sacral nerve stimulation. It helps control an overactive bladder. Your doctor puts a small device into your body that sends signals to nerves in your lower back that help control the flow of urine.
Detrusor myectomy. It’s a major operation that treats an overactive bladder. Your surgeon removes part or all of the muscles around your bladder to stop them from contracting at the wrong times.