Nocturnal enuresis or bedwetting is the involuntary release of urine during sleep. Bedwetting can be a symptom of bladder control problems like incontinence or overactive bladder or more severe structural issues, like an enlarged prostate or bladder cancer.
Studies shows that 1 to 2 percent of adults wet the bed, though researchers think that statistic is underreported due to the embarrassing nature of the problem. Rather than hiding your secret, you should explore effective treatments that can help
lessen the likelihood of bedwetting and reduce the anxiety of going to sleep at night.
NOTE: This section focuses on bedwetting when it affects adults. For more information on childhood bedwetting, please visit the
Beaumont GROW (Get Rid Of Wetness) program.
What causes Enuresis?
Hormonal Causes
The body produces an antidiuretic hormone at night called ADH, which slows the kidney's production of urine while you sleep. In people with enuresis, this hormone is not produced in significant enough quantities to slow the production of urine, which
often leads to bedwetting. This can be a symptom of both Type I and Type II Diabetes.
Neurological Causes
People who suffer enuresis can also have a smaller functional bladder capacity, meaning the amount of urine they can hold before the bladder sends a signal to the brain that it's full is smaller than average. Coupled with overactive bladder or bladder
instability, this can lead to bedwetting.
Structural Causes
Enuresis can also be a symptom of problems in the
urethra,
prostate
or
pelvis, including urinary tract infection, urinary tract stones, enlarged prostate, prostate cancer and bladder cancer.
Medication and Diet
Bedwetting can be a side effect of certain insomnia medications and drugs taken for psychiatric purposes like Thioridazine, Clozapine and Risperidone. Bladder irritants such as alcohol and caffeine can also contribute to bladder instability and act as
diuretics to increase the production of urine.
How can Enuresis be treated?
Many treatments for enuresis have been effective. Consult your doctor before trying any treatment on your own.
Behavioral Treatment
- Monitoring Fluid Intake:
The first step towards preventing bedwetting is limiting the intake of fluids in the afternoon and evening, which creates a decrease in the amount of urine produced at night. Reduce or avoid caffeine and alcohol intake, which act as diuretics
and increase the likelihood of accidents.
- Bladder Volume Control:
This technique attempts to increase bladder capacity in those with smaller functional bladders. Training involves drinking large amounts of fluid during the day and refraining from urinating for as long as possible to increase functional bladder
capacity.
- Bedwetting Alarm System:
Wet-detection alarms can be used in underwear or on the bed itself to vibrate or give off sound when bedwetting occurs. This wakes you and allows you to stop the flow of urine and finish in the restroom. Eventually, the body conditions itself
to wake before the urge to urinate gets too strong.
- Waking:
Setting a random alarm each night to get up and urinate may be helpful in preventing bedwetting. Avoid setting an alarm at the same time each evening in case your body becomes accustomed to emptying at a set time each night.
Medication
Medication can be an effective treatment for enuresis, but only for as long as it is taken. Medication only deals with the symptoms rather than the underlying causes of bedwetting, so it's recommended that you try behavioral treatments as well. The most
common medications mimic the hormone ADH, slowing production of urine in the kidneys and lessening the instances of bedwetting.
Surgery
Surgery should only be considered once other non-invasive options have been exhausted.
Talk to your health care professional about other options before choosing surgery.
- Sacral Nerve Stimulation:
Sacral nerve roots are stimulated, causing decreased activity in the bladder muscles, which helps the muscle to relax and not contract constantly. This form of surgery is recommended if you also have moderate to severe urge incontinence.
- Clam Cytoplasty:
The bladder is cut open and a patch of intestine added to increase bladder capacity and reduce bladder instability.
- Detrusor Myectomy:
A portion of the exterior muscle surrounding the bladder is removed, strengthening bladder contractions and reducing the number of them.
Learn more about possible treatments for bladder control problems.