Women health


 Which doctor to consult for bedwetting in adults

Children and bedwetting are frequently linked. In fact, nocturnal enuresis, or urinating while asleep, can be a problem for up to 25% of kids. When their bladders enlarge and mature properly, most kids recover from the condition.

According to studies, 1 to 2 percent of adults have bedwetting issues. The amount could, however, be higher. It's conceivable that some individuals are too ashamed or reluctant to discuss the issue with their doctor.

It is probably nothing to worry about if you occasionally wet the bed or do so once in a while as an adult. Mistakes can occur. However, regular and persistent enuresis warrants discussion with your doctor and is cause for concern. Let's examine the potential causes and treatments for the disease.

POSSIBLE FACTORS

Manic depressive disorder

Your kidneys respond to the antidiuretic hormone (ADH) by decreasing urine output. In order to get you ready for sleep, your body makes more of the hormone at night. Your need to urinate while you're sleeping is lessened as a result. Some people, however, either don't make enough ADH or have poor ADH responses in their bodies. Even while some hypotheses contend that a number of variables interact to generate the issue, ADH abnormalities do appear to have a part in nighttime bedwetting.

This syndrome is frequently caused by a confluence of troubles with ADH, challenges with waking and sleeping, as well as bladder problems during the day.

The amount of ADH in your blood can be determined with a quick test. Your doctor might suggest a drug like desmopressin if the amount is low (a laboratory-made ADH). Your doctor might also check for underlying diseases that might be affecting your ADH levels.

Smaller bladder

A little bladder isn't really any smaller than other bladders in terms of size. Instead, it seems fuller at lower volumes, which makes it appear smaller. As a result, you might need to urinate more often throughout the day and even at night. Bedwetting could happen if you have a tiny bladder, which can be difficult to control while you sleep.

People with functionally small bladders benefit from bladder training. By retaining pee for long periods of time, this method aids your body in anticipating frequent urination. You could also want to set a wake-up alarm for the evening so you can get some urination.

Muscle jerking

The muscles in your bladder are called detrusor muscles. When your bladder is about to urinate, they relax and then constricts. You might not be able to regulate urine if these muscles contract improperly. Overactive bladder is the name for this condition (OAB).

The aberrant nerve impulses between your brain and your bladder or irritation to the bladder, such as alcohol, coffee, or drugs, may be the reason for your bladder muscles contract. These goods may reduce muscular stability. You may require more frequent urination as a result of that.

ALSO READ: How to Stop Frequent Urination at Night: HLK

Cancer

Urinary tract obstruction or blockage can result from prostate and bladder cancer tumors. In particular, at night, this could result in an inability to contain urination.

Physical examinations and certain imaging studies may be necessary for cancer diagnosis. Typically, a biopsy is required to detect cancer. The tumor may get smaller or disappear if the cancer is treated. That might aid in preventing further incidents of bedwetting.

Type 2 diabetes

Diabetes and poorly managed blood sugar levels might alter urination. As the kidneys work to control blood sugar levels, more urine is produced when blood sugar levels are elevated. Bedwetting, excessive urination (greater than 3 liters per day), and frequent urination may result from this.

Numerous urinary symptoms are frequently relieved by diabetes treatment. Typically, oral medicines, insulin injections, and lifestyle modifications are used to treat diabetes. Your overall health and the type you have will affect your treatment approach.

Sleep problems

You repeatedly stop and resume breathing as a result of the sleep disorder obstructive sleep apnea. One study discovered that bed-wetting affects 7% of those with this sleep condition. As your sleep apnea progresses, urinating while you sleep might become more often.

You'll be able to breathe easier and have better sleep if you receive continuous airway pressure therapy for sleep apnea. It can help lessen ancillary symptoms like bedwetting.

Medication

You may urinate more often and experience more frequent bladder contractions as a result of several prescription drugs. Bedwetting may result from this. These medicines range from antipsychotics to sleep aids.

Changing drugs could put an end to nighttime urination. Lifestyle modifications may help you avoid bedwetting if the medicine is required to treat another problem. Never discontinue taking a prescription without consulting your doctor first.

Genetic inheritance

The problem of bedwetting is frequently passed down from generation to generation. The genes that cause this disease to be passed down are unknown. However, you are more likely to develop nocturnal enuresis if one of your parents did.

A doctor will perform a number of examinations and tests to rule out alternative explanations before diagnosing unexplained nocturnal enuresis. Unknown bedwetting is treated by addressing symptoms and avoiding recurrences. Medication and alterations in lifestyle are examples of this.

Diseases of the brain

Bladder control may be hampered by the following neurological conditions:

  1. erythematosus multiplex
  2. Seizures problems
  3. Parkinson's syndrome

This can cause you to urinate frequently or suddenly when you're trying to sleep.

Treatment for the condition can help with symptoms as well as side effects including bedwetting. Your doctor might suggest a specific course of treatment if the bedwetting doesn't cease. This can involve making lifestyle adjustments, using medications, and more.

Your urinary tract having an obstruction or blockage

Urine flow may be hampered by obstructions like:

  1. Renal stones
  2. glomerular stones
  3. Tumors

Consequently, voiding could be challenging. Bedwetting and unexpected urine leakage may result from this at night.

The muscles of the bladder may also unnecessarily contract due to pressure from a stone or tumor. This may cause irrational and frequent urination.

Larger stones can occasionally be broken down or removed using a process. Most of the time, smaller stones will move along on their own.

While some tumors can be reduced in size by cancer treatment, others might require surgical removal. Following the removal of the obstructions, you ought to have better urinary management and less bedwetting.

Infection of the urinary tract

Urination can come on suddenly and frequently as a result of a urinary tract infection (UTI). A UTI frequently results in bladder inflammation and irritation, which can exacerbate nighttime bedwetting and incontinence.

Enuresis should stop if the UTI is treated. You might wet the bed more frequently if you have recurrent UTIs. In order to avoid more infections and bedwetting, work with your doctor to identify the underlying cause of the recurring UTIs.

Anatomy

Your ureter and bladder are the two organs where urine is transported from your kidneys. Urine will flow through your urethra and out of your body when it's time to urinate, causing your bladder to contract. You might feel symptoms or have trouble urinating if any component of that system is twisted, kinked, constricted, or otherwise malformed. And bedwetting is included.

Your physician can search for abnormal structures using imaging procedures like an ultrasound or X-ray. A surgical repair may be possible for some. If you continue to urinate while you sleep, your doctor may recommend lifestyle changes and medicines.

Symptomatic treatments

There are three primary types of treatment for adult bedwetting:

Psychological treatments

Watch your fluid intake. In the afternoon and evening, try to reduce how much liquid you consume. When you can easily use the restroom in the morning, drink more. Don't overindulge in the evening.

In the evening, wake up. You can avoid bedwetting by setting an alarm for the middle of the night. You won't be carrying as much urine on you if you get up once or twice at night to urinate.

Symptomatic psychotherapy

There are three primary types of treatment for adult bedwetting:

PSYCHOLOGICAL TREATMENTS

Watch your water intake. In the afternoon and evening, try to reduce how much liquid you consume. When you can easily use the restroom in the morning, drink more. Don't overindulge in the evening.

In the night, wake up. You can avoid bedwetting by setting an alarm for the middle of the night. You won't have as much urine on you if you get up once or twice at night to urinate.

Make frequent urination a habit. Establish a routine for when you'll urinate during the day and follow it. Prior to going to sleep, remember to urinate.

Reduce the irritants that cause bladder distress. Your bladder may become irritated by caffeine, alcohol, artificial sweeteners, and sugary drinks, which could result in more frequent urination.

Medications

Depending on the underlying reason, there are four main types of drugs that are used to treat adult bedwetting:

Antibiotics to alleviate urethral infections

anticholinergic medications can soothe bladder muscles that are agitated or hyperactive.

Acetate of desmopressin to increase ADH levels to reduce nighttime urine production from your kidneys

Finasteride (Proscar), a hmg coa reductase inhibitor, shrinks an enlarged prostate.

SURGERY

Activation of the sacral nerve Your doctor will insert a tiny device during this surgery that communicates with the muscles in your bladder to prevent pointless contractions.

cystectomy using clams (bladder augmentation). To implant an intestinal muscle patch, your doctor will cut open your bladder. To avoid bedwetting, this additional muscle aids to improve control and capacity while reducing bladder instability.

 Detrusor myectomy Your bladder's contractions are managed by your detrusor muscles. During this treatment, portions of these muscles are removed, which helps to reduce contractions.

Repair of a prolapsed pelvic organ. This can be required if your female reproductive organs are misaligned and pressing against your bladder.

CONCLUSION

If you're an adult who frequently wets the bed, there may be a deeper issue or concern. To halt the nocturnal enuresis and address the underlying cause, treatment is essential.

Schedule an appointment to talk to a doctor about what's occurring. Your symptoms, medical history, family history, prescriptions, and prior operations will all be reviewed. To search for an underlying reason, the doctor could prescribe a number of tests. Finding a therapy will help you feel better by reducing or stopping your bedwetting and any other symptoms you may be having.

 

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