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.
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.
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.
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.
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.
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.