Evening Urination
/BEDWETTING
Overview
The condition of bedwetting refers to involuntary urination during sleep beyond the typical age at which this behavior usually stops. In most cases, seven is considered the age past which bedwetting is a cause for concern.
Bedwetting can also be called nocturnal enuresis or nighttime incontinence. When adults who have not experienced the condition in the past begin to urinate during sleep, it’s referred to as secondary enuresis. Bedwetting is uncommon in adults and generally requires evaluation and intervention.
Many factors can cause bedwetting in both children and adults. In cases where a small bladder is a cause, the volume of the bladder is insufficient to hold overnight urine production. The nerves that identify a full bladder could be at fault, failing to wake the sleeper when the bladder is full.
Urinary tract problems can be the cause of sudden or irregular bedwetting. These issues can include urinary tract infections and blockages such as kidney stones or bladder stones. In addition to these common causes, diabetes or rarer urinary tract or nervous system problems could be the cause.
Symptoms
Bedwetting is always a cause for concern in adults that will require a medical evaluation to determine the root cause. In children, bedwetting is a cause for concern when it occurs past the age of seven or begins to recur after several months of successfully growing out of the behavior.
Diagnosis
A physician will attempt to determine the underlying causes leading to bedwetting. That will generally entail a thorough discussion of the issue with the patient. Here, the physician will ascertain the patient’s fluid intake habits, urination habits, and family history. Based on this information, they could suggest changing habits to address the issue.
Suppose the bedwetting is accompanied by other problems such as frequent urination, pain during urination, and red or pink urine. In that case, your physician will likely request imaging tests like X-rays to determine if kidney or bladder stones are a factor or to evaluate the urinary tract structure.
In adult men, an enlarged prostate is another potential cause that can be diagnosed through a prostate exam. Beyond this, additional testing could be required to diagnose possible neurological disorders.
Treatment
In most cases, the first line of treatment is to address the underlying cause of bedwetting. That could include antibiotics for urinary tract infections, treatment for kidney stones, or other interventions.
Habit Interventions
In many cases, the extent or severity of bedwetting can be mitigated by instituting simple lifestyle changes. Among the most commonly recommended are:
- Reducing fluid intake in the evening
- Avoiding caffeine consumption
- Urinating before going to bed
- Encouraging regular urination throughout the day
While some cases of bedwetting have additional underlying causes, these measures are often sufficient.
Bedwetting Medication
There are several approaches through which medication can help reduce bedwetting. Desmopressin is a drug that limits urine production overnight. Patients must limit fluid consumption at the time they take medicine.
Oxybutynin and similar anticholinergic drugs serve to reduce bladder contractions, reducing the likelihood of bedwetting. They also help increase bladder capacity. These drugs are often prescribed where involuntary urination during the daytime also occurs.
It has 2 procedures
Transurethral Resection of the Prostate (TURP)
Transurethral Resection of the Prostate (TURP)
Benign prostatic hyperplasia (BPH) is very common. It will affect 50% of men between the ages of 51-60 and up to 90% of men over the age of 80. Common symptoms include frequent urination, urgency, difficulty emptying the bladder or starting urination. This procedure is particularly important in men when have kidney failure due to poor bladder emptying or trouble with urinary infections and/or bladder stones. Transurethral resection of the prostate (TURP) is considered the gold standard for the surgical management of BPH. Approximately 150,000 men have this procedure each year.
It is performed under spinal or general anesthesia. The urologist inserts an instrument called a resectoscope through the penis into the urethra. This instrument uses fluid and a light source to visualize the prostate, as well as an electrical loop that is used to shave out the obstructing prostate tissue. This loop is then used to cauterize and seal any bleeding blood vessels. The resected tissue is irrigated into the bladder and then removed and sent to a pathologist to examine under a microscope. You can think of the prostate as an orange and the obstructing tissue is the inner substance of the orange. The goal is to “shave out” the substance of the orange without injuring the “orange peel” or capsule of the prostate. At the end of the procedure, a catheter is placed into the bladder and is used to continuously irrigate the bladder with fluid. It is typical for a patient to go home the following day or two. It is possible to sometimes go home the same day in some circumstances when a bipolar TURP is performed. There is no surgical incision, and the entire procedure is performed through the penis. The catheter often stays in for a few days and may be removed either at home or in the urologist’s office. When a patient goes home with a catheter, the catheter is attached to a leg bag for convenience. Instructions will be given before one leaves the hospital.
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FAQ's
Several factors increase the likelihood of bedwetting in children. Anxiety and stress from significant events in their lives, such as going to a new school, are common factors. A family history of bedwetting and ADHD are also both indicators. While bedwetting is common among both, it is significantly more common in boys than in girls.
Certain medications can be a factor contributing to bedwetting. Sleeping medications can contribute, as they prevent the patient from waking when the bladder is full. Antipsychotic medications like clozapine and risperidone have also been known to contribute to bedwetting.
Some diseases and conditions often include bedwetting among their symptoms. That is common in bladder cancer and prostate cancer. Several nervous disorders can cause bedwetting, such as Parkinson’s disease, multiple sclerosis, and seizure disorder.
Urinalysis is an effective method for evaluating urine for infections or other problems with the urinary tract, bladder, and kidneys. A physician can also utilize a urine culture test to assess urinary tract infections. They can also use post-void residual urine measurement to determine how much urine remains in the bladder after the patient urinates.