Losing bladder control at night. Nighttime Urinary Incontinence: Causes, Solutions, and Prevention Strategies
What causes urinary incontinence at night. How can you manage nocturnal enuresis. What strategies help prevent bedwetting in adults. How does nocturia affect sleep quality. Which products can protect your bed from nighttime accidents.
Understanding Nighttime Urinary Incontinence
Nighttime urinary incontinence is a common issue affecting many adults. It can manifest in two primary forms: adult nocturnal enuresis (bedwetting) and nocturia (frequent nighttime urination). These conditions can significantly impact sleep quality and overall well-being.
Adult Nocturnal Enuresis
Adult nocturnal enuresis, commonly known as bedwetting, affects approximately 1-2% of adults. This condition can occur during any period of sleep, including unintended naps during the day. Urinary tract infections and stress are known triggers for nocturnal enuresis.
Nocturia
Nocturia is characterized by frequent waking during the night with the need to urinate. While it can affect individuals of any age, its prevalence increases after the age of 60. Nocturia is often associated with various health conditions, including urinary incontinence, diabetes, hypertension, and heart disease.
Strategies for Managing Nighttime Incontinence
Managing nighttime incontinence involves a combination of lifestyle changes, behavioral techniques, and medical interventions. Here are some effective strategies to consider:
- Limit fluid intake in the evening hours
- Reduce consumption of bladder irritants like caffeine and alcohol
- Practice elevating your legs in the afternoon to promote fluid circulation
- Engage in bladder training exercises to improve urinary control
- Consult with a healthcare provider about medication options
- Consider using a bedwetting alarm for conditioning
Fluid Management
Can adjusting fluid intake help manage nighttime incontinence? Yes, limiting fluid consumption after dinner or a few hours before bedtime can significantly reduce the likelihood of nighttime accidents. Additionally, avoiding bladder irritants such as caffeine and alcohol, especially in the evening, can help minimize nocturnal urination.
Behavioral Techniques
Bladder training exercises can be an effective way to improve urinary control. These exercises involve practicing holding urine for progressively longer periods during the day, which can help strengthen the muscles responsible for bladder control.
Medical Interventions
In some cases, medication may be necessary to manage nighttime incontinence. Healthcare providers may prescribe diuretics to be taken in the afternoon, anticholinergic drugs to relax the bladder, or hormones like desmopressin to reduce nighttime urine production. Always consult with a medical professional before starting any new medication regimen.
Protective Products for Nighttime Incontinence
While working on managing nighttime incontinence, various products can help protect bedding and ensure comfort:
- Mattress covers
- Absorbent briefs and pads
- Waterproof bedding
Mattress Protection
How can you protect your mattress from nighttime accidents? Mattress covers are an excellent solution. While plastic covers are affordable, they may cause discomfort due to poor breathability. Consider investing in water-repellent fabric covers that allow airflow and moisture evaporation, providing both protection and comfort.
Absorbent Products
Absorbent briefs, often referred to as adult diapers, can effectively contain nighttime accidents. For added protection, absorbent incontinence pads can be placed between the body and the mattress. These products are available in both disposable and washable formats, offering flexibility to suit individual preferences and needs.
The Impact of Overactive Bladder on Sleep Quality
Overactive bladder (OAB) affects approximately 16% of adults over 18, often leading to disrupted sleep patterns and decreased quality of life. For many individuals with OAB, nocturia becomes a significant concern, causing frequent nighttime awakenings and potential bedwetting incidents.
Sleep Disruption
How does nocturia affect sleep quality? The need to urinate multiple times during the night interrupts sleep cycles, leading to fragmented and poor-quality sleep. This can result in daytime fatigue, decreased cognitive function, and overall reduced well-being.
Emotional Impact
Nighttime incontinence can have a significant emotional toll on individuals, causing embarrassment, anxiety, and decreased self-esteem. It’s important to address these psychological aspects alongside the physical management of the condition.
Preparing for Nighttime with Overactive Bladder
For individuals dealing with overactive bladder, preparation is key to managing nighttime incidents and ensuring comfort. Consider the following tips:
- Sleep on a towel for added protection
- Keep baby wipes near the bed for quick clean-up
- Ensure easy access to the bathroom
- Use nightlights to improve visibility during nighttime trips to the bathroom
Creating a Supportive Sleep Environment
How can you create a sleep environment that supports managing OAB? Ensure clear pathways to the bathroom, use nightlights for safety, and keep necessary supplies within easy reach. These simple adjustments can significantly improve nighttime comfort and reduce anxiety associated with potential accidents.
Seeking Professional Help for Nighttime Incontinence
While many strategies can be implemented at home, it’s crucial to consult with healthcare professionals when dealing with persistent nighttime incontinence. Urologists and urogynecologists specialize in treating these conditions and can provide personalized treatment plans.
Diagnostic Process
What can you expect during a medical evaluation for nighttime incontinence? Healthcare providers may conduct various tests, including urinalysis, bladder function tests, and imaging studies, to determine the underlying cause of the incontinence. This comprehensive approach allows for targeted treatment strategies.
Treatment Options
Treatment for nighttime incontinence may include a combination of lifestyle modifications, pelvic floor exercises, medications, and in some cases, surgical interventions. The specific treatment plan will depend on the underlying cause and severity of the condition.
Lifestyle Modifications for Managing Nocturia
In addition to medical treatments, certain lifestyle changes can significantly impact the management of nocturia and nighttime incontinence:
- Maintain a healthy weight
- Engage in regular physical activity
- Practice good sleep hygiene
- Manage underlying health conditions
Weight Management
How does weight affect nighttime incontinence? Excess weight can put additional pressure on the bladder, exacerbating incontinence issues. Maintaining a healthy weight through proper diet and exercise can help alleviate symptoms and improve overall bladder control.
Sleep Hygiene
Practicing good sleep hygiene can contribute to better nighttime bladder control. This includes maintaining a consistent sleep schedule, creating a relaxing bedtime routine, and ensuring a comfortable sleep environment.
Nighttime urinary incontinence, while challenging, is a manageable condition with the right approach and support. By implementing a combination of lifestyle modifications, protective strategies, and medical interventions, individuals can significantly improve their quality of life and achieve restful sleep. Remember, seeking professional help is crucial for developing a comprehensive management plan tailored to your specific needs. With patience and persistence, it’s possible to regain control and enjoy uninterrupted nights of restorative sleep.
Urinary Incontinence at Bedtime – Incontinence and Overactive Bladder Center
If you frequently lose sleep over urinary incontinence, you’re not alone: According to the National Association for Continence, at least two percent of adults lack control over their bladders while sleeping, and more than a third who wake up to go the bathroom do so at least twice a night. Fortunately, there are things you can do to prevent these nighttime interruptions.
There are two ways urinary incontinence can strike in the night:
- Adult nocturnal enuresis. This is what is commonly referred to as adult bedwetting. About 1 to 2 in every 100 adults sometimes loses bladder control while sleeping. It can strike any time you are asleep — for example, if you’ve nodded off during a meeting or on an airplane. Urinary tract infections and stress can cause nocturnal enuresis.
- Nocturia. You wake up frequently with the need to urinate. It can occur at any age, but becomes more common past age 60. Nocturia is associated with many diseases besides urinary incontinence, including diabetes, high blood pressure, and heart disease.
Strategies for Dealing With Nighttime Incontinence
There are several ways to head off nighttime urinary incontinence. Try the following tips:
- Limit your intake of fluid either just after dinner or a couple of hours prior to bedtime.
- Reduce your intake of bladder irritants like caffeine and alcohol, especially in the evening.
- Elevate your legs when resting during the afternoon, which will stimulate the flow of fluid in the body. Compression stockings also could help.
- Use bladder training exercises to improve your urinary control. Practice holding on to your urine during the daytime.
- Ask your doctor for medication. Your physician might prescribe a diuretic that you take in the afternoon to reduce fluid levels prior to nighttime, or anticholinergic drugs that relax the bladder and make it easier to hold more urine. The hormone desmopressin also reduces the amount of urine you produce at night.
- Purchase a bedwetting alarm. This device wakes you up when you begin to wet yourself, either with a sound or a vibration. Often these alarms can help train your body to wake you up before you wet the bed.
It could take some time to get a handle on your nighttime urinary incontinence. While you work on that, there are products available to help protect your bed and linens from urine:
- Mattress covers. Plastic covers are a cheap and easy solution, but they can be sweaty and uncomfortable. For a little more money, purchase newer water-repellant fabric covers that breathe and allow your body sweat to evaporate. These covers are also available for pillows, blankets, duvets, and sleeping bags.
- Absorbent briefs and pads. Also known as adult diapers, absorbent underwear can be worn at night to absorb urine from nighttime urinary incontinence. As a backup, you also can place absorbent incontinence pads between you and the mattress, in case any urine leaks from the briefs. These absorbent products are available in washable and disposable form. When purchasing a bed pad, keep in mind that the longer, wider, and thicker it is, the less likely it is to leak.
If you have a problem with urinary incontinence at night, discuss your options with your doctor and experiment until you find a solution that helps you sleep more peacefully.
Nighttime Frequent Urination (Incontinence): Prevention Tips
After a long day, you’ve settled down for a comfortable night’s sleep. You’re just drifting off when suddenly you feel a warm wetness between your legs — something you haven’t felt since you were about 5 years old. You’ve wet the bed.
For the approximately 16% of people over the age of 18 who have an overactive bladder (OAB), this kind of upsetting incident can become a regular occurrence. Even if they make it to the bathroom in time, they wake up so often to urinate that they aren’t getting a good night’s sleep.
Generally, the amount of urine in our bodies decreases and becomes more concentrated at night, so we can sleep six or eight hours without having to get up to use the bathroom more than once. But many people with OAB have nocturia, the need to urinate several times a night, which interrupts their sleep cycles.
“It can disrupt sleep completely, and people can be extremely overtired,” says Luis Sanz, MD, director of urogynecology and pelvic surgery at Virginia Hospital Center in Arlington, VA.
Even worse, those who are particularly sound sleepers or can’t get out of bed fast enough can wind up with wet sheets.
Getting a Good Night’s Sleep with OAB
“Preparation is everything,” says Melody Denson, MD, a board-certified urologist with the Urology Team in Austin, TX. You might consider sleeping on a towel and keeping a box of baby wipes near the bed in case of accidents, but you can also take these steps to prevent accidents from happening:
- Limit your fluid intake before bedtime. Try not to drink any liquids after 5 p.m. or 6 p.m.
- Avoid foods and beverages that can irritate your bladder. If you can’t cut them out entirely, skip them in the hours before bedtime to help prevent nocturia. That includes:
o Caffeine, which is a diuretic, which increases urine output
o Alcohol
o Citrus juices
o Cranberry juice — though it is touted as great for bladder health, it is actually an irritant if you have OAB
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o Spicy foods, like curries
o Acidic foods, such as tomatoes and tomato sauces
o Chocolate
o Artificial sweeteners
- Double-void before bed. Denson advises that you double-void, or urinate twice, right before bed. “Go to the bathroom, then brush your teeth and go through the rest of your bedtime routine,” she says. “Then, just before you’re about to lie down — even if you don’t feel like you have to go — try to urinate and see if you can squeeze out another tablespoon or so.”
- Do Kegel exercises. Done regularly, they help control an overactive bladder. “They will trigger a reflex mechanism to relax the bladder,” Denson says. “If you feel a tremendous urge to urinate, doing a Kegel before you run to the bathroom will help settle down the bladder spasm and help you hold it until you get there. ”
Kegels simply involve contracting and releasing the muscles around the opening of your urethra, just as you do when going to the bathroom. You can learn what a Kegel exercise feels like by starting, then stopping, your urine stream. Start with three sets of 8-12 contractions. Hold them for 6 to 10 seconds each, and perform these three to four times per week.
OAB and Your Sex Life
OAB can interfere with that other bed activity, too. There’s nothing that can shut down an intimate moment faster than realizing you’ve lost control of your bladder — something that happens for many people with OAB. “Sexual activity itself is irritating to the bladder, and you can lose urine during intercourse,” Sanz says. “About 15% of my patients report having incontinence during sex.”
“When you’re being intimate, you’re used to secretions and moistness, but the thought that it’s actually urine leakage is really upsetting and uncomfortable,” Denson says. “Usually it’s the female patient who has the leakage, and it’s actually more bothersome for her than for her partner. ”
Tips for Getting Your Groove Back
There are some things you can do to ward off discomfort or embarrassment during sex.
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Talk about it. First, know that your partner will probably be a lot more understanding than you expect. Then bring it up before you have intercourse. “Don’t wait until it happens and say, ’Oh, guess what?’” Denson says. “It’s better to be upfront and honest ahead of time.”
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Plan. Prepare for sex, just as you do for bedtime. Double-void, cut back on fluids, and avoid foods and beverages that are likely to irritate your bladder. (This means it’s probably a good idea to skip that romantic glass of wine.)
Keep up the Kegels. Doing these several times a day — and even during intercourse — will help prevent urine leakage during sex.
All of these approaches can help you manage your overactive bladder at night, letting you get a better night’s sleep and have a more active and satisfying sex life. But Sanz adds that if your overactive bladder is really causing you problems, there’s no reason you need to live with it.
“There is hope. There is treatment,” he says. You need to be evaluated by a urogynecologist, who will talk to you about three types of treatment: behavioral modification, medication, and surgical procedures are available, he says. “You don’t have to let an overactive bladder interfere with your life.”
What Causes Bed-Wetting in Adults, and How Can You Treat It?
A lot of folks think bed-wetting is something that only happens to kids, but it’s a problem that can hit grown-ups, too. You may feel embarrassed to wake up to wet sheets, but it’s not your fault. It could be due to a medical condition, medicine, or a problem with your bladder. You’ve got lots of ways to fix it.
Causes
If you start wetting the bed as an adult, see your doctor. You may hear them call your problem nocturnal enuresis, which is the medical name of the condition. Some of the reasons it may be happening to you:
Your kidneys make more pee than normal. A hormone called ADH tells your kidneys to make less urine, and you normally make less of this hormone at night. When you have bed-wetting issues, you may not make enough of this hormone or your kidneys might not respond well to it.
A form of diabetes called diabetes insipidus also affects ADH levels, causing you to make more urine.
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Your bladder can’t hold enough urine. When there isn’t enough room in your bladder, pee can leak.
Overactive bladder (OAB). Your bladder muscles normally squeeze when you’re ready to pee. In OAB, these muscles squeeze too often or at the wrong times.
Medicine. Some drugs you take can irritate your bladder, such as sleeping pills or antipsychotics like:
Your bed-wetting may also be due to conditions that affect your body’s ability to store and hold urine. For instance, bladder cancer and prostate cancer can cause it. So can diseases of the brain and spine, such as a seizure disorder, multiple sclerosis, or Parkinson’s disease.
Some other possible causes are:
How Is Bed-Wetting Diagnosed?
Your doctor will do an exam and ask about your symptoms and health history. Keep a diary so you’ll have the answers to their questions. Write down things like:
- How often and what time your bed-wetting happens
- How much urine comes out (a lot or a little)
- What and how much you drank before bed
- Any other symptoms you’ve had
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Your doctor will do tests to diagnose the problem, such as:
Urinalysis. It checks a sample of your urine to look for an infection or other conditions of the urinary tract — the collection of organs that are involved with urine like the kidneys, ureters, bladder, and urethra.
Urine culture. Your doctor sends a small sample of your urine to a lab, where technicians put it in a special dish with nutrients. This test looks for bacteria or yeast in your urine. It can diagnose a urinary tract infection.
Uroflowmetry. You pee into a special funnel to measure how much urine you make and how quickly it flows out.
Post-void residual urine measurement. This test measures how much urine is left in your bladder after you pee.
How Do You Treat Bed-Wetting?
Your doctor may suggest you start by making a few changes to your daily and nightly routines:
Try 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.
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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.
Other drugs calm overactive bladder muscles, such as:
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.
Tips to Deal With Wetness
Until you can get bed-wetting under control, take some simple steps to manage the situation:
- Put a waterproof cover or pad over your mattress or sheets to keep them dry.
- Wear absorbent underwear or pads to bed.
- Use special skin cleansing cloths and lotions to prevent your skin from getting irritated.
If you try one treatment and it doesn’t work, go back to your doctor. Sometimes it takes a few tries to find the right solution to bed-wetting.
Urinary incontinence – NHS
Urinary incontinence is the unintentional passing of urine. It’s a common problem thought to affect millions of people.
There are several types of urinary incontinence, including:
- stress incontinence – when urine leaks out at times when your bladder is under pressure; for example, when you cough or laugh
- urge incontinence – when urine leaks as you feel a sudden, intense urge to pee, or soon afterwards
- overflow incontinence (chronic urinary retention) – when you’re unable to fully empty your bladder, which causes frequent leaking
- total incontinence – when your bladder cannot store any urine at all, which causes you to pass urine constantly or have frequent leaking
It’s also possible to have a mixture of both stress and urge urinary incontinence.
Find out more about the symptoms of urinary incontinence.
When to seek medical advice
See a GP if you have any type of urinary incontinence. Urinary incontinence is a common problem and you should not feel embarrassed talking to them about your symptoms.
This can also be the first step towards finding a way to effectively manage the problem.
Urinary incontinence can usually be diagnosed after a consultation with a GP, who will ask about your symptoms and may do a pelvic or rectal examination, depending on whether you have a vagina or a penis.
The GP may also suggest you keep a diary in which you note how much fluid you drink and how often you have to urinate.
Find out about diagnosing urinary incontinence.
Causes of urinary incontinence
Stress incontinence is usually the result of the weakening of or damage to the muscles used to prevent urination, such as the pelvic floor muscles and the urethral sphincter.
Urge incontinence is usually the result of overactivity of the detrusor muscles, which control the bladder.
Overflow incontinence is often caused by an obstruction or blockage in your bladder, which prevents it from emptying fully.
Total incontinence may be caused by a problem with the bladder from birth, a spinal injury, or a small, tunnel like hole that can form between the bladder and a nearby area (fistula).
Certain things can increase the chances of urinary incontinence, including:
- pregnancy and vaginal birth
- obesity
- a family history of incontinence
- increasing age – although incontinence is not an inevitable part of ageing
Find out more about the causes of urinary incontinence.
Treating urinary incontinence
Non-surgical treatments
Initially, a GP may suggest some simple measures to see if they help improve your symptoms.
These may include:
- lifestyle changes such as losing weight and cutting down on caffeine and alcohol
- pelvic floor exercises, where you strengthen your pelvic floor muscles by squeezing them
- bladder training, where you learn ways to wait longer between needing to urinate and passing urine
You may also benefit from the use of incontinence products, such as absorbent pads and handheld urinals.
Medicine may be recommended if you’re still unable to manage your symptoms.
Find out more about non-surgical treatments for urinary incontinence.
Surgical treatments
Surgery may also be considered. The procedures that are suitable for you will depend on the type of incontinence you have.
Surgical treatment for stress incontinence, such as a sling procedure, is used to reduce pressure on the bladder or strengthen the muscles that control urination.
Surgery to treat urge incontinence includes enlarging the bladder or implanting a device that stimulates the nerve that controls the detrusor muscles.
Find out more about surgery and procedures for urinary incontinence.
Preventing urinary incontinence
It’s not always possible to prevent urinary incontinence, but there are some steps you can take that may help reduce the chance of it happening.
These include:
- maintaining a healthy weight
- avoiding or cutting down on alcohol
- staying active – in particular, ensuring that your pelvic floor muscles are strong
Healthy weight
Being obese can increase your risk of urinary incontinence. You may be able to lower your risk by maintaining a healthy weight through regular exercise and healthy eating.
Use the healthy weight calculator to see if you are a healthy weight for your height.
Get more information and advice about losing weight.
Drinking habits
Depending on your particular bladder problem, a GP can advise you about the amount of fluids you should drink.
If you have urinary incontinence, cut down on alcohol and drinks containing caffeine, such as tea, coffee and cola. These can cause your kidneys to produce more urine and irritate your bladder.
The recommended weekly limit for alcohol consumption is 14 units.
A unit of alcohol is roughly half a pint of normal strength lager or a single measure (25ml) of spirits.
Find out more about alcohol units.
If you have to urinate frequently during the night (nocturia), try drinking less in the hours before you go to bed. However, make sure you still drink enough fluids during the day.
Pelvic floor exercises
Being pregnant and giving birth can weaken the muscles that control the flow of urine from your bladder. If you’re pregnant, strengthening your pelvic floor muscles may help prevent urinary incontinence.
Find out more about exercise during pregnancy.
Everyone may benefit from strengthening their pelvic floor muscles with pelvic floor exercises.
Find out more about pelvic floor exercises.
Information:
Social care and support guide
If you:
- need help with day to day living because of illness or disability
- care for someone regularly because they’re ill, elderly or disabled (including family members)
Our guide to social care and support explains your options and where you can get support.
Page last reviewed: 07 November 2019
Next review due: 07 November 2022
Symptoms & Causes of Bladder Control Problems & Bedwetting in Children
What are the signs and symptoms of bladder control problems in children?
Losing urine by accident is the main sign of a bladder control problem. Your child may often have wet or stained underwear—or a wet bed.
Squatting, leg crossing, and heel sitting can be signs of an overactive bladder.
Daytime Wetting
Signs that your child may have a condition that causes daytime wetting include
- the urgent need to urinate, often with urine leaks
- urinating 8 or more times a day, called frequency
- infrequent urination—emptying the bladder only 2 to 3 times a day, rather the usual 4 to 7 times a day
- incomplete urination—not fully emptying the bladder during bathroom visits
- squatting, squirming, leg crossing, or heel sitting to avoid leaking urine
Bedwetting
Nighttime wetting is normal for many children—and is often not considered a health problem at all—especially when it runs in the family.
At ages 5 and older, signs that your child may have a nighttime bladder control problem—whether due to slow physical development, an illness, or any cause—can include
- never being dry at night
- wetting the bed 2 to 3 times a week over 3 months or more
- wetting the bed again after 6 months of dry nights
Your child’s doctor can suggest when treatments may help control bedwetting.
When should my child see a doctor about bladder control problems?
If you or your child are worried about accidental wetting, talk with a health care professional. He or she can check for medical problems and offer treatment, or reassure you that your child is developing normally.
Take your child to a health care professional if there are signs of a medical problem, including
- symptoms of bladder infection such as
- pain or burning when urinating
- cloudy, dark, bloody, or foul-smelling urine
- urinating more often than usual
- strong urges to urinate, but passing only a small amount of urine
- pain in the lower belly area or back
- crying while urinating
- fever
- restlessness
- your child dribbles urine or has a weak urine stream, which can be signs of a birth defect in the urinary tract
- your child was dry, but started wetting again
Although each child is unique, providers often use a child’s age to decide when to look for a bladder control problem. In general,
- by age 4, most children are dry during the day
- by ages 5 or 6, most children are dry at night
Seek care right away
If your child has symptoms of a bladder or kidney infection, or has a fever without a clear cause, see a health care professional within 24 hours. Quick treatment is important to prevent a urinary tract infection from causing more serious health problems.
What causes bladder control problems in children?
Bathroom habits, such as holding urine too long, and slow physical development cause many of the bladder control problems seen in children. Less often, a medical condition can cause wetting. Learn which children are more likely to have bladder control problems.
What causes daytime wetting in children?
Daytime wetting in children is commonly caused by holding urine too long, constipation, or bladder systems that don’t work together smoothly. Health problems can sometimes cause daytime wetting, too, such as bladder or kidney infections (UTIs), structural problems in the urinary tract, or nerve problems.
When children hold their urine too long, it can trigger problems in how the bladder works or make existing problems worse. These bladder problems include:
Overactive bladder or urge incontinence
Bladder muscles squeeze at the wrong time, without warning, causing a loss of urine. Your child may have strong, sudden urges to urinate. She may urinate frequently—8 or more times a day.
Underactive bladder
Children only empty the bladder a few times a day, with little urge to urinate. Bladder contractions can be weak, and your child may strain when urinating, have a weak stream, or stop-and-go urine flow.
Disordered urination
Muscles and nerves of the bladder may not work together smoothly. As the bladder empties, sphincter or pelvic floor muscles may cut off urine flow too soon, before the bladder empties all the way. Urine left in the bladder may leak.
What causes bedwetting in children?
Nighttime wetting is often related to slow physical development, a family history of bedwetting, or making too much urine at night. In many cases, there is more than one cause. Children almost never wet the bed on purpose—and most children who wet the bed are physically and emotionally normal.
Sometimes a health condition can lead to bedwetting, such as diabetes or constipation.
Bedwetting often runs in families, where it is usually a normal growth pattern, not an illness.
Slow physical development
Between ages 5 and 10, slow physical development can cause your child to wet the bed. Your child may have a small bladder, deep sleep cycles, or a nervous system that’s still growing and developing. The nervous system handles the body’s alarms—sending signals about a full or emptying bladder—and the need to wake up.
Family history
Bedwetting often runs in families. Researchers have found genes that are linked to bedwetting. Genes are parts of the master code that children inherit from each parent for hair color and many other features and traits.
Making too much urine
Your child’s kidneys may make too much urine overnight, leading to an overfull bladder. If your child doesn’t wake up in time, a wet bed is likely. Often this excess urine at night is due to low levels of a natural substance called antidiuretic hormone (ADH). ADH tells the kidneys to release less water at night.
Sleep disorders
Sleepwalking and obstructive sleep apnea (OSA) can lead to bedwetting. With OSA, children breathe poorly and get less oxygen, which triggers the kidneys to make extra urine at night. Bedwetting can be a sign that your child has OSA. Other symptoms include snoring, mouth breathing, ear and sinus infections, a dry mouth in the morning, and daytime sleepiness.
Stress
Stress can sometimes lead to bedwetting, and worry about daytime or nighttime wetting can make the problem worse. Stresses that may affect your child include a new baby in the family, sleeping alone, moving or starting a new school, abuse, or a family crisis.
Urinary Incontinence in Adults – Kidney and Urinary Tract Disorders
Doctors first ask questions about the person’s symptoms and medical history. Doctors then do a physical examination. What they find during the history and physical examination often suggests a cause of the incontinence and the tests that may need to be done.
Doctors ask questions about the circumstances of urine loss, including amount, time of day, and any precipitating factors (such as coughing, sneezing, or straining). People are asked whether they can sense the need to urinate and, if so, whether the sensation is normal or comes with sudden urgency. Doctors may also ask the person to estimate the amount of urine leakage. Doctors will also ask whether the person has any additional problems with urination, such as pain or burning during urination, a frequent need to urinate, difficulty starting urination, or a weak urine stream.
Sometimes doctors may ask people to keep a record of their urination habits over a day or two. This record is called a voiding diary. Each time the person urinates, the volume and time are recorded. After an episode of incontinence, the person also records any related activities, especially eating, drinking, drug use, or sleep.
Doctors ask about whether the person has other disorders that are known to cause incontinence, such as dementia, stroke, urinary tract stones, spinal cord or other neurologic disorders, and prostate disorders. Doctors need to know what drugs a person is taking because some drugs cause or contribute to incontinence. Women are asked about number and types of deliveries and any complications. All are asked about previous pelvic and abdominal surgery, particularly prostate surgery in men.
The physical examination can help doctors narrow possible causes. Doctors test strength, sensation and reflexes in the legs, and sensation around the genitals and anus to detect nerve and muscle problems that may make it difficult for the person to remain continent.
In women, doctors do a pelvic examination to detect abnormalities that could cause incontinence, such as vaginal atrophy (menopausal changes in which the lining of the vagina becomes thinner, drier, and less elastic and may be accompanied by urinary tract changes) or weakness of pelvic muscles. In men and women, doctors do a rectal examination to look for signs of constipation or damage to the nerves supplying the rectum. In men, the rectal examination allows doctors to check the prostate because an enlarged prostate or occasionally prostate cancer can contribute to incontinence. The person may be asked to cough with a full bladder to detect whether stress incontinence is present. Women may be asked to repeat this procedure during a pelvic examination, to see whether supporting some pelvic structures (with the doctor’s fingers) eliminates the leak of urine.
How To Stop Adult Bed Wetting (Sleep Enuresis)
It’s worth noting 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.
To fully understand why you may be experiencing adult bedwetting, a quick anatomy refresher course could be helpful.
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 or mistimed.
Read on for more information, or click here to jump down the page, where you’ll find free downloadable materials that can help you better understand the nature of your condition and provide you strategies to talk with your doctor and develop a treatment strategy that works for you.
Causes Of Adult Bedwetting
There are several factors that can contribute to an adult experiencing nocturnal enuresis, or adult bedwetting.
Genetics
Like with so many medical issues, the first place to check is family history. Evidence has shown that adult bedwetting is hereditary. One study has shown that someone with two bedwetting parents has a 77% chance of becoming a bedwetter. When one parent wet the bed as a child, his son or daughter was found to have a 40% chance of becoming a bedwetter. These probabilities carry into adulthood as well.
Hormone imbalance
Another factor that may have to do with ADH, the antidiuretic hormone. Its main function is to signal the kidneys to decrease the amount of urine produced. Instinctively, the body normally produces more ADH to avoid nocturnal enuresis. However, some people do not produce the appropriate amount of this hormone at night, which leads to high urine production.
In other cases, the body produces ADH, but the kidneys do not respond and continue to produce the same amount of urine. This excessive production of urine during sleep is defined as nocturnal polyuria. This abnormality can cause nocturnal enuresis in adults, but it is also a symptom related to type I diabetes. Consulting a healthcare professional is helpful especially if you feel that you may be experiencing diabetes or nocturnal enuresis.
Small Bladder
Patients with a “smaller” bladder are often dealing with primary nocturnal enuresis. The physical size of the bladder isn’t actually smaller, rather, the functional bladder capacity (FBC) can hold a smaller volume of urine.
Overactive Bladder Muscles
If the muscles of the bladder, known as detrusor muscles, are overactive, nocturnal enuresis can occur. In fact, an overactive bladder muscle has been found in up to 70-80% of adult bedwetting patients.
Bladder irritants, such as alcohol and caffeine, can contribute to detrusor instability. Try tracking your diet and bladder activity in a bedwetting diary to see if you notice any correlations with what you eat and drink and wetting the bed.
Urinary Tract Infection
An infection in the urinary tract can sometimes cause bedwetting
Medications
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.
Stress
Stress or anxiety can sometimes cause people to wet the bed.
Other Health Issues
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.
90,000 Urinary incontinence | enuresis
Definition of urinary control problem (urinary incontinence)
Accidental loss or leakage of urine, called urinary incontinence, is one of the most common urinary control problems. It is not a disease, but a condition that may be related to another health problem or life event, such as pregnancy in women or prostate problems in men.
Problems with urination control can be a minor concern or can greatly affect a person’s quality of life, depending on the severity.The person may be overly embarrassed or afraid to participate in social activities, or may not be able to complete normal routine work. For example, incontinence can occur while running or coughing. Or it may be difficult to get to the toilet on time.
Your life can improve with the right treatment. Talk to your healthcare professional about urine leaks. A doctor can help resolve the problem or relieve symptoms, including urine odor. Caregivers can seek help from a healthcare professional or support group.Gynecologists, urologists, and geriatricians – doctors who specialize in the health and care of the elderly – often talk to people about bladder control problems. The sooner you get help, the faster the patient’s life will improve.
What are the problems with bladder control?
Your type of incontinence depends in part on your symptoms. The most common bladder control problems include
Stress urinary incontinence
Stress incontinence occurs when moving – coughing, sneezing, laughing or physical activity – puts pressure on the bladder and causes urine to leak.
Urgent urinary incontinence
Urgent urinary incontinence occurs when someone has a strong urge to urinate, leaking occurs if they cannot go to the bathroom on time. Doctors often refer to urinary incontinence as an overactive bladder, which can happen when certain nerves and muscles in the bladder don’t work together.
Occasionally, a person may have urge incontinence and stress incontinence at the same time, which is also called mixed incontinence.
Reflex urinary incontinence
Leaking urine without warning or urging may be reflex urinary incontinence. This can often happen when a person’s bladder nerves are damaged and do not “speak to the brain correctly.” During reflex incontinence, the bladder may contract or reflexively at the wrong time, causing urine to leak. Nerve damage due to health conditions such as NIH multiple sclerosis or injuries such as spinal cord injury are some of the causes of reflex urinary incontinence.This is sometimes also referred to as “unconscious” or “unconscious” urinary incontinence.
Overflow incontinence
Overflow incontinence occurs when the bladder does not empty completely, leaving too much urine in the bladder. With overflow incontinence, urine leaks because the urine is overstretched and cannot hold more urine.
Functional incontinence
Functional incontinence occurs when a physical disability is present or a barrier or difficulty speaking or thinking prevents someone from reaching the toilet in time.For example, a person in a wheelchair may not be able to get to the toilet on time, a person with arthritis may have trouble unbuttoning his or her pants, or a person with Alzheimer’s may not realize they need to plan to use the toilet.
Temporary urinary incontinence
Temporary incontinence is short-lived due to a transient situation, such as the use of a certain medication or a medical condition that is causing the leak, such as a violent cough from a cold.
Bedwetting
Bedwetting, also called nocturnal enuresis, is not exclusive to children. Some adults drip during sleep for a variety of reasons. Certain medications or drinking caffeine or alcohol at night can make it difficult to sleep during the night without urine leakage. In some cases, the bladder cannot hold enough urine overnight. Lifestyle changes can often improve these symptoms.
Some people wet the bed because they do not produce enough of a certain hormone at night, which may be a sign of diabetes insipidus.Other health problems such as urinary tract infections, kidney stones, enlarged prostate, or obstructive sleep apnea can cause adults to urinate at night.
How common are bladder control problems?
Bladder control problems are common. Nearly half of all women encounter them at some point in their lives. Women are more likely to develop incontinence during and after pregnancy, childbirth and menopause.These events and the way the female urinary tract is constructed make incontinence more common in women than in men. However, don’t accept incontinence as a routine part of a woman’s life or aging.
Every third man can accidentally lose urine. A man is more likely to experience incontinence with age, when prostate problems are more common.
Who has more bladder control problems?
Factors that increase the likelihood of developing problems with bladder control include
- Female
- Older age, with age, the muscles of the urinary tract weaken, making it difficult to retain urine
- Life events such as pregnancy, childbirth and menopause in women and prostate problems in men
- Health problems such as diabetes, obesity or long-term constipation
- Smoking
- Birth defects.You may have problems with the structure of the urinary tract
Your doctor can help you find the cause of your bladder control problem and advise on treatment options.
You are more likely to have a special type of incontinence if a family member also has one. For example, bedwetting often occurs in families, and children may outgrow it at about the same age as their parents.
Complications of a problem with bladder control?
Physical inactivity
Urine leakage can slow down or stop a person’s physical activity.For example, running, jumping, or brisk walking can make it difficult to control if someone is suffering from urinary incontinence. Or perhaps the woman feels that the disposable pads or underpants are uncomfortable to move, so the activity may be less fun.
Staying active is important to a person’s overall health and can prevent further problems with bladder control. Urinary incontinence can get worse for those who are not physically active. Physical inactivity can lead to weight gain.People who are overweight or obese are more likely to have bladder problems. Being active can lead to better bladder health.
Tell your doctor if your bladder control problems are preventing you from being active.
Emotional Distress
Unresolved bladder problems can lead to frustrating lifestyle changes. A person may avoid activities that he or she once enjoyed. People may stop going to the movies, meetings, or church because they don’t want to use the toilet in the middle of an event or get into an awkward situation.These changes can lead to depression.
Intimacy Issues
Problems with bladder control sometimes cause people to avoid intimacy because they are worried they might wet themselves during sex. Talk to your healthcare professional if problems with bladder control are interfering with your sex life. Gynecologists and urologists regularly communicate with people about health problems that interfere with sex. A healthy sex life is part of a healthy life.
Associated symptoms and bladder problems
If you have urinary incontinence, you are more likely to have other symptoms or bladder problems, such as
- frequent urination
- awakening at night to urinate is called nocturia
- Difficulty urinating
- problem of emptying the bladder completely, also called urinary retention
- urine leakage after urination
Working with a healthcare professional to prevent and treat these associated symptoms and problems is essential to your bladder health and your overall health.
What are the symptoms of bladder control problems?
Signs and symptoms of urinary incontinence may include
- Urine leakage during daily activities such as lifting, bending, coughing or exercising
- feeling of sudden, strong urge to urinate immediately
- Urine leak without warning or prompting
- inability to get to the toilet on time
- bedwetting
When should I see a healthcare professional?
See a healthcare professional if you have symptoms of a bladder problem such as urinary problems, loss of bladder control, pelvic pain, or urine leakage.
Bladder problems can affect your quality of life and cause other health problems. Your doctor can help you treat your bladder by recommending lifestyle changes or changing the amount of medication you usually take.
See a doctor if you are
- unable to empty the bladder
- urinate too often – 8 or more times a day
- see blood in urine, also called hematuria
- have symptoms of a bladder infection, including painful urination
These symptoms can signal a serious health problem, including inflammation of the bladder, also called cystitis, or even the possibility of bladder cancer.
What Causes Bladder Control Problems in Women?
Certain life events and health problems can lead to stress incontinence in women by weakening the pelvic floor muscles
- pregnancy and childbirth
- Injury or trauma such as sexual assault
- cystocele and pelvic organ prolapse
- menopause
Weak pelvic floor muscles can make it difficult to hold the bladder during stress incontinence.Stress incontinence occurs when some of your movements – coughing, sneezing, laughing, or physical activity – put pressure on your bladder and cause urine to leak. A weak pelvic floor can also cause fecal incontinence or problems with bowel control.
What Causes Bladder Control Problems in Men?
Men sometimes develop incontinence along with prostate problems.
Prostate problems
Men have a prostate gland that surrounds the opening of the bladder.The prostate gets bigger with age. When the prostate becomes too large but not cancerous, a man has a condition called enlarged prostate, or benign prostatic hyperplasia. Men with an enlarged prostate can have
- problems with the onset of urination
- slow urine flow
- problems with complete emptying of the bladder
Men with a history of prostate cancer may have short-term or long-term urinary incontinence.Cancer can damage or block the urinary tract. Either surgery, radiation, or other treatments for prostate cancer can result in nerve damage, bladder spasms, or stress urinary incontinence. Problems with bladder control after prostate cancer may improve over time.
What else causes bladder control problems in women and men?
Other health problems, including problems with your nervous system and lifestyle factors, can cause or contribute to urinary incontinence in women and men.
Changes and Health Problems
Certain health changes and problems can lead to urinary incontinence
- aging
- bladder infection
- constipation
- birth defects
- blocked urinary tract – from a tumor or urinary stone
- chronic or prolonged cough
- diabetes
- overweight or obese
Certain health problems can be short-term, such as cough or constipation, and can cause temporary urinary incontinence. When a disability or difficulty speaking or thinking prevents you from reaching the toilet on time, you develop functional incontinence.
The nerves and muscles of the bladder can be damaged at
- Alzheimer’s disease
- stroke
- Parkinson’s disease
- multiple sclerosis
- diabetes
- Certain Medicines
- spinal cord injury
- alarm
Triggers for urinary incontinence include: drinking or touching water, the sound of running water, or being in a cold environment, such as being placed in a grocery store freezer.
Lifestyle factors
Lifestyle factors that increase the likelihood of developing UI in women and men include:
- Eating habits such as constipation-causing foods
- Drinking habits such as drinking alcohol, caffeine or carbonated drinks
- Certain Medicines
- physical inactivity
- smoking
Temporary urinary incontinence is usually a side effect of a drug or short-term health condition. Temporary incontinence can also be the result of eating habits, including drinking alcohol or caffeine.
Diagnosis of bladder control problems (urinary incontinence)
How do doctors find the cause of a bladder control problem?
Your doctor will review your medical history and do a physical exam to find the cause of your bladder control problem. Your doctor may also order laboratory and other diagnostic tests.
Even if you feel embarrassed, it is important to discuss urinary incontinence with your healthcare professional.The types of healthcare providers that can treat you include
- family doctor
- General practitioner or general practitioner
- Physiotherapist
- obstetrician-gynecologist
- gynecologist specializing in pelvic medicine and reconstructive surgery
- urologist
Medical history
The healthcare professional will record your medical history and may ask you to tell
- symptoms, also sometimes called lower urinary tract symptoms
- eating and drinking habits
- OTC and prescription drugs
- current and past medical problems and operations
- history of pregnancy and childbirth if you are a woman
- prostate problems if you are a man
Your doctor may diagnose the type of urinary incontinence you have based on your medical history and physical examination, or may use this information to decide if you need additional testing.
Treatment of problems with bladder control (urinary incontinence)
How can I treat my bladder control problem?
Treatment depends on the type of incontinence you have. Your doctor may recommend that you try self-care treatments first.
Make lifestyle changes
You can reduce leaks by making lifestyle changes.
Drink the right amount of liquid at the right time. Ask your doctor if you should drink less fluids throughout the day.However, do not limit fluid volumes to the point of dehydration. Your doctor can tell you how much and when to drink based on your health, activity, and local climate.
To limit your nighttime trips to the bathroom, you can stop drinking fluids a few hours before bed, but only if your doctor recommends it. Limiting caffeinated foods and beverages such as chocolate, tea, coffee, and sodas can help reduce leaks. You should also limit your intake of alcoholic beverages, which can increase the amount of urine your body produces.
The amount of urine a person produces is different for everyone, depending on how much fluid you drink, how much sweat, how much fluid you use when breathing, and what medications you are taking.
Be physically active.
Although you may not feel physically active when you are incontinent, regular physical activity is important for weight control and overall wellness. Even something like walking can improve your health. If you are concerned about not having a bathroom during your physical activity, find an area with nearby toilets, such as a mall, public park, or local gym.
Keep a healthy weight.
You are more likely to develop incontinence and other diseases such as diabetes if you are overweight or obese. Losing weight can help you reduce leaks, and preventing weight gain can prevent incontinence. Research shows that with an increase in your body mass index (BMI), you are more likely to leak. If you are overweight or obese, talk to your doctor about how to lose weight.
Avoid constipation.
Constipation can impair urinary tract health and lead to incontinence. Talk with your doctor about drinking plenty of fluids and getting enough fiber to avoid constipation.
Stop smoking.
If you smoke, get help to quit smoking. Quitting smoking at any age is beneficial for bladder health and overall health. Smoking increases your chances of developing stress incontinence because smoking causes a chronic or prolonged cough.You can improve your health if you can stop coughing.
Smoking also causes the majority of bladder cancers. Some people say that smoking makes their bladder more sensitive.
Train your bladder
Bladder training is when you urinate on a schedule to help reduce leakage. Your doctor may recommend that you use the toilet on a schedule called “urination on time.”Increasing the time between urinations gradually can help stretch the bladder so that it can hold more urine.
Exercise your pelvic floor muscles
Strong pelvic floor muscles retain urine better than weak muscles. You can strengthen your pelvic floor muscles by doing Kegel exercises. These exercises involve contracting and relaxing the muscles that control the flow of urine. A review of studies found that women who received pelvic floor muscle training were much more likely to get rid of leaks than women who did not receive training.Do not exercise your pelvic floor muscles while urinating.
Men can also benefit from pelvic floor exercises. Strengthening these muscles can help a person urinate less often.
Surgery
If you have overflow incontinence caused by a blockage or narrowing of your urethra, your doctor may treat it surgically to remove the blockage.
For women.
A weak bladder neck or poorly supported urethra can cause stress urinary incontinence and may be treated with surgery.Sling surgeries are performed through the vagina to insert a strip of material – usually a mesh – into the tissue between the vagina and the urethra. A mesh is a screen-like material that doctors can implant into your body to support your bladder or urethra or to correct a hernia. The doctor performs an operation in the clinic. You will receive general or local anesthesia. Most women can leave the clinic the same day, although some may need to stay overnight. Full recovery takes 2 to 3 weeks.
Although mesh sling, sometimes referred to as a “mid-urethral sling,” is generally successful and safe, some women can have serious complications. Your doctor can explain the risks and benefits of stress incontinence surgery and what results you can expect. He or she can help you decide if surgery is right for you.
For men.
Stress urinary incontinence in men is sometimes treated with surgery.The surgery includes an artificial urinary sphincter (AUS) and a male sling surgery. The doctor performs operations in the clinic. You will receive general or spinal anesthesia. Most men can leave the hospital the same day, although some may need to stay overnight. Your doctor can explain the user interface risks and benefits of surgery and what results you can expect.
Minimally invasive surgeries are available for men with an enlarged prostate.
Emotional support
Problems with bladder control are common, but many people feel too embarrassed to talk about them.At the very least, talk to your doctor about bladder problems. Your doctor can help you connect with a support group for people with similar problems.
Talk to your family and friends about your incontinence. Your family and friends can also help you find easier ways to use the bathroom regularly. By sharing your struggles, you may find that other people in your life have bladder problems as well.
Enuresis: description of the disease, causes, symptoms, diagnosis and treatment
Enuresis is a medical condition characterized by urinary incontinence, uncontrolled and involuntary urination.This mostly happens during sleep. Enuresis can be organic or inorganic.
The appearance of the organic form of the disease is associated with diseases of the urinary and nervous system. In most cases, this can happen because the bladder is damaged during pregnancy. However, other pathologies can also provoke this form of the disease.
The onset of inorganic enuresis is observed mainly in children. The reason is insufficient formation or impaired functioning of the conditioned sentry reflex, which controls the bladder.This form of enuresis is characterized by impaired communication “brain – bladder”. There is no signal to the brain that indicates that the bladder is full. In turn, the brain does not send signals in the opposite direction to start emptying or close the sphincter and urethra. It is they who contribute to the prevention of urine excretion.
Some experts believe that the presence of inorganic enuresis is not a disease, but a developmental stage at which control over the work of the bladder is formed.
Urinary incontinence occurs in about 13% of children under the age of seven. At the same time, there are significant differences between indicators for different age categories. In children who are less than four years old, the disease occurs in 35% of cases. As the child grows up, this indicator decreases. Preservation of urinary incontinence is observed in 5% of adolescent children, and only 0.7% in adults. Most of the patients diagnosed with enuresis are males.Their nervous system matures somewhat differently.
Physiology
Conscious physiological adjustments are controlled by the cerebral cortex. This part of the central nervous system sends a signal to the bladder sphincter. The muscles relax, the organ is emptied. Before this moment comes, the bladder fills, the receptors of its walls are excited. They are the ones that signal the brain. When there is already a quarter of the fluid in the bladder, the person begins to urge to empty the organ.Even if the bladder is severely overflowing, there is conscious control of the sphincter.
The central nervous system develops even when the child is in the womb. All parts of the brain are formed, as well as the cerebral cortex. In addition, in a small child, multiple reflexes are significantly altered. This means that there are some differences in the conscious regulation of physiological recovery. Therefore, babies need diapers.
Another important aspect of physiology is conscious control at night. In sleep, the cerebral cortex functions in a slightly different rhythm. Therefore, a person has no control over motor activity. It is normal for an adult to prevent the sphincter from urinating involuntarily even at night. Imperfect reflex regulation contributes to the violation of this function.
How enuresis is classified
The disease can be primary and secondary, day and night, complicated and uncomplicated.
Depending on when the disease appeared, it is primary and secondary. The primary form is characterized by a lack of bladder control from the first months of life. The secondary form means that the child had a dry spell, which varied in duration from six to nine months. The incontinence appeared due to psychological trauma. Basically, this form of the disease disappears spontaneously. An important condition for this is the exclusion of a traumatic situation.
Why does the disease
develop
An acute traumatic situation is caused by the fact that the processes in the nervous system are inhibited. As a result, the bladder control reflex is inhibited. This happens for the following reasons:
The onset of fright.
The child was separated from his mother.
Strong conflict with mom and dad.
The child is often physically punished.
The family changed their place of residence.
A close relative died.
A brother or sister is born.
The child suffered a severe trauma, surgery.
Chronic traumatic situations include:
Parents divorced.
One of the parents abuses alcohol or drugs.
The child has a dysfunctional family.
Parents are too strict with the child, there is tyranny.
The child is worried about the excessive workload in the educational institution.
Hormonal disturbance. Vasopressin is a hormone, under the control of which water and salts are removed from the body. If it lacks this hormone, the volume of urine at night doubles.
Genetically hereditary factor. If a parent has impaired development of bladder control, their child may be affected.According to statistics, approximately 70% of children diagnosed with bedwetting have their parents suffering from urinary incontinence. How severe the disease will be in a small patient depends on how the gene is damaged and where it is located on the chromosome.
Elderly age. In elderly people, there is a weakening of the connection between nerve cells, a decrease in the intensity of impulse transmission from the bladder to the brain, resulting in urinary incontinence.
Slight damage to the baby’s brain while in the womb or as soon as the baby is born. This happens with an umbilical cord entanglement, fetal asphyxia, birth trauma, an infectious disease that a pregnant woman has suffered. Under the influence of these factors, the brain stem and the medulla oblongata do not function properly. They are responsible for the vegetative function – the work of the respiratory system, digestion, excretion.
Weak sphincter. It is presented in the form of a circular muscle, the contraction of which occurs at the required moment, as a result of which the lumen of the bladder is blocked.This contributes to the accumulation of urine in the organ cavity. To empty the bladder, the sphincter must be relaxed. This happens with the help of a volitional effort of a person. With old age, the sphincter weakens, so if the bladder overflows, urine can leak out.
Social factor. If a person belongs to an unprotected social group (poor, refugee), lives in a dwelling with poor conditions. In addition, the development of enuresis occurs if the parents do not wean the child from diapers after he reaches the age of two.
Why does organic enuresis
occur?
The development of the disease is influenced by the presence in the patient:
Epilepsy.
Hyperthyroidism.
Diabetes mellitus of one type or another.
Abnormally developed spine (this includes the spinal cord).
Cystitis (inflammation of the bladder) or urethritis (inflamed urethra).
Abnormally developed urinary organs.
Delayed development of the mind.
If we talk about adult patients, then the cause of their illness may be:
one.Disease of the genitourinary system. The most common cause of enuresis is the presence of cystitis or urethritis. It is an inflammatory disease of the bladder and urethra that is bacterial or fungal in origin. More common in women. The reason is the structural features of the urinary system, that is, the presence of a wide and short urethra, as a result of which there are practically no obstacles for pathogenic agents, they easily penetrate the bladder.
2.Disease of the prostate. Adult men experience enuresis, which is a consequence of prostatitis or prostate adenoma.
3. Stroke. After a stroke, basically, a person becomes disabled, that is, there is no possibility of self-service. The development of enuresis after a stroke is a consequence of the impaired function of the central nervous system.
4. Strong alcoholic intoxication. When an excessive amount of alcohol is consumed, the central nervous system is inhibited, the functioning of the sphincter is disrupted, as a result of which urine can be involuntarily excreted.
5. Failure of hormonal levels. In most cases, the disease develops in women with menopause.
Identification of the causes of the development of the organic form of enuresis occurs during a medical examination. Timely treatment of the disease will help completely eliminate urinary incontinence.
How enuresis is manifested
The emergence of the primary reflex is associated with an unformed reflex or its triggering not in all situations.This disorder has nothing to do with the stressful state. If the reflex is formed with some delay, the following symptoms will appear:
1. The child is hard to potty.
2. Even with an overflowing bladder, the child does not go to the potty or to the toilet.
3. During the day, the first portion of urine can be seen on the clothes, the rest in the pot.
4. If the child is over six years old, the disease will manifest itself mainly at night.
5. The emotional state of the child does not play a role in the incidence of urinary incontinence.
6. As the child grows up, urinary incontinence is less common.
With secondary enuresis, a weakening or disappearance of the formed reflex occurs. In this case, the child has already learned how to control his bladder, and has successfully practiced it for six months or a year. However, the stressful situation caused the loss of this skill.This form of enuresis is characterized by the following signs:
The first case of urinary incontinence appeared during a stressful situation or three to four days after it.
If stress is chronic, before the onset of urinary incontinence (namely, two to three months), tics, fear, and sleep disturbances may appear.
Involuntary leakage of urine can occur every day or once every 5-7 days.In the frequency of enuresis attacks, the state of the child’s nervous system plays a role.
A calm environment can help reduce the incidence of urinary incontinence. When eliminating traumatic situations, you can safely count on the independent disappearance of the disease after a couple of months.
With the occurrence of various kinds of experiences, emotional stress, enuresis manifests itself more often.It should be borne in mind that the intensification of the disease occurs due to both positive and negative emotions.
It is necessary to remember that if urinary incontinence provoked acute short-term stress, then attacks will appear less and less often. An important condition for this is the absence of repeated trauma to the child’s psyche. When a child is in constant stress, for example, if the parents are constantly in conflict, the attacks will only become more frequent.
There are a number of common symptoms that occur with enuresis in a child. He becomes:
In addition, his physical development slows down, he grows more slowly and gains muscle mass. A child with enuresis slows down speech and movement, sleep and appetite are disturbed. He is sleepy in the morning and active in the evening.
Features of physiotherapy
Physiotherapy is an important component in the complex treatment of enuresis.The patient is prescribed from ten to fifteen sessions in one course. Two courses are required throughout the year.
Warm up the bladder. A paraffin application is applied above the pubis. At home, this can be replaced with a bag containing heated salt or cereal. The procedure is repeated every day. The duration should not exceed 20 minutes.
The use of magnetotherapy. Thanks to this method, tension, inflammation and edema that have arisen in the bladder and sphincter are relieved.This helps to reduce the number of trips to the toilet throughout the day.
The use of transcranial magnetotherapy. The procedure involves applying a magnetic field to the brain. As a result, the functioning of the central nervous system improves, the connection between the sphincter and the brain is strengthened. The procedure is performed once every two days. The duration of each session does not exceed 10-15 minutes.
Child mode
Parents should teach the child to immediately empty the bladder at the first urge.Thanks to this, the capacity of the bladder increases, and the skills of its management are developed.
The child goes to the toilet a couple of hours before bedtime and before going to bed. Regardless of whether he wants to use the toilet or not. This technique promotes complete emptying of the bladder and slows down the rate at which it refills.
Night awakenings. The child should be lifted up at night and asked to go to the toilet. Determination of the time of awakening occurs on an individual basis.Parents should wake up the child completely. If the emptying of the bladder is half asleep, this will only provoke the strengthening of enuresis. After five to seven days, you should shift the awakening by half an hour. As a result, the child will learn to go to the toilet in the morning.
For some time, namely a couple of hours before bedtime, active games, watching TV, computer, etc. are excluded. Because of such factors, the psyche is excited. Alternatively, take a walk outside.
Strict adherence to the daytime regimen. Put the child to bed at the same time. This improves the work of the central nervous system, the hormone vasopressin is produced, and urine accumulates less at night.
Diet food for enuresis
Adherence to a specific diet helps to reduce bladder irritation and reduce the amount of urine during sleep. There are basic rules for dietary nutrition:
Moderately salty food.Her reception falls in the afternoon. It must be remembered that excessive salt intake throughout the day contributes to water retention in the body, and less urine is produced.
Limiting fluid intake after lunch. It is not recommended to eat soup, vegetables, fruits that contain large amounts of water in the afternoon.
Do not drink coffee, tea, Coca-Cola at night, do not eat chocolate.
Do not drink any liquid just before going to bed.
In the evening, the use of acidic foods is excluded: citrus fruits, sour berries and fruits, carbonated drinks, spicy foods, spices. They irritate the bladder and increase the urge to empty it.
The problem of female urinary incontinence – Clinic of urology MGMSU
Urinary incontinence is the involuntary discharge of urine from the urethra.According to statistics, urinary incontinence in women is twice as common as in the stronger sex. This is due to a large number of provoking factors that affect a woman at different periods of her life.
Of course, this disease does not threaten the patient’s life, but it causes her considerable anxiety, and is always associated with problems in the social sphere and in the field of personal hygiene. According to the WHO, at the age of 40-60, about 38-44% of women have signs of urinary incontinence. Also, this problem is observed in about 10% of girls.
Urinary incontinence in older women
Patients of age almost always have comorbidities that affect the ability of the bladder to retain fluid. So, urinary incontinence in an elderly woman can be associated with Parkinson’s disease, dementia and other cognitive disorders, taking sedatives, lowering the pressure of diuretics, etc. Any pathologies that are characteristic of older age and affect the nervous system can also become causes female urinary incontinence.These include, for example, degenerative diseases of the spinal cord or herniated discs.
Endocrinological disorders in the stage of decompensation, in particular, diabetes mellitus, lead to a violation of the water-salt balance in the body. This, in turn, causes bedwetting in older women. Finally, involuntary discharge may be due to disorders of the musculoskeletal system. Even feeling the urge to urinate, the woman does not have time to reach the restroom.
Postpartum urinary incontinence
According to numerous studies, urinary incontinence in adult women is definitely associated with whether the patient has given birth. In this case, it is not the number of births that is of key importance, but their nature and complexity. If during labor, injuries to the perineum or ruptures of the pelvic floor muscles were observed, then this can cause urinary incontinence in young girls.
Heavy, prolonged or rapid labor increases the risk of developing the disease.
Urinary incontinence in women: symptoms
Of course, the main manifestation of this pathology is the involuntary discharge of a certain amount of urine and the woman’s inability to control this process.
Also, symptoms of urinary incontinence may manifest as unexpected urge, pain or difficulty in urinating routinely and an increase in its frequency. Uncontrollable urge occurs mainly in stressful situations. The same conditions often provoke urinary incontinence at night in girls.
Often, the inability to hold urine is associated with coughing, laughing, or increased physical activity. The tension of the abdominal wall in such cases increases the pressure on the bladder, which leads to the release of a certain amount of urine.
Urinary incontinence in women: causes
- Extensive gynecological operations. Surgical intervention in this area is always associated with a high risk of damage to the pelvic nerves, which are responsible for maintaining the tone of the urethral sphincter.
- The onset of symptoms of urinary incontinence in women is most often associated with intrauterine growth disorders. Genetically determined inferiority of the pelvic floor tissues leads to an inability to fully control the process of urination.
- Age-related urinary incontinence in women is largely associated with the onset of menopause and hormonal imbalance in the body. Although the influence of this factor has not yet been proven, it is possible that urinary excretion occurs as a result of a weakening of the general muscle tone in old age.
- Any trauma to the perineum, even not associated with labor, also leads to loss of control over urination. Damage to the nerve pathways, as well as a violation of the anatomical integrity of the urinary tract, can lead to the development of urinary incontinence.
- The causes of urinary incontinence may lie in the patient’s increased body weight, bowel dysfunctions, neuropsychiatric diseases, etc.
- To a partial loss of the ability to control urination can also lead to constant serious physical exertion associated with heavy physical labor or engaging in certain sports.
Female urinary incontinence is not only a medical but also a social problem. Many people are embarrassed to talk about it with their doctor. This is a completely wrong approach, since this disease can be successfully treated in the vast majority of patients.
Overactive bladder and urinary incontinence – Urology – Departments
Overactive bladder (OAB) is one of the diseases manifested by symptoms of urinary dysfunction .Elderly patients do not always consult a doctor about this, believing that this is a manifestation of age-related changes. Young patients suffering from OAB often find it inconvenient to talk about their problems, despite the fact that the disease sometimes makes them completely change their usual way of life. Frequent urination, urgency, frequent urination at night, and urge incontinence are the main manifestations of overactive bladder.
The disease limits the patient’s activity.The constant urge to urinate forces patients to be in the immediate vicinity of the toilet. In extreme cases, these patients plan their travel route in advance and tie it to the location of the toilets. And, sometimes, the constant fear of “not having time to get to the toilet” in the event of an irresistible urge to urinate makes them completely refuse to leave the house.
Currently, there are effective methods of treating overactive bladder, and the role of the doctor in this situation is to convey this information to patients.
It is believed that OAB is a complex of symptoms, including dysfunction of the lower urinary tract, the main manifestation of which is an imperative, uncontrollable urge to urinate – the so-called urgency.
ICS (International Continence Society) defines urgency as follows: “urgency is a sudden and irresistible urge to urinate that cannot be delayed.” Despite this definition, there is still a time for which the patient can delay urination.This time is called the “urinary warning time”. The shorter this period of time, the more likely the patient will not be able to hold urine.
Urgent urinary incontinence is an extreme manifestation of OAB. Urinary incontinence can be one of the manifestations of OAB, along with increased urination, manifested both during the day and at night. It should be especially noted that not all patients with OAB suffer from urinary incontinence, and not all patients with urinary incontinence have an overactive bladder.
OAB diagnostics, as a rule, does not present significant difficulties. When collecting anamnesis, it is necessary to pay special attention to the onset and duration of the disease, the intensity of the urges that arise, the frequency of urination during the day and at night. Sudden complaints of urgency and frequent urination against the background of complete health are more likely a sign of a lower urinary tract infection than a manifestation of an overactive bladder. Consuming large amounts of caffeinated beverages (coffee, tea, some soft drinks) can be a provoking factor that leads to unbearable urge to urinate.Sometimes, patients deliberately increase the volume of fluid intake, hoping in this way to get rid of the imaginary infection, which, in their opinion, is the cause of the urgency. In such cases, simple regulation of the drinking regimen often helps to eliminate urinary frequency. Some somatic diseases can be manifested by an overactive bladder. These include latent diabetes, multiple sclerosis, parkinsonism, lower urinary tract obstruction, dementia, and others. Many drugs can provoke or worsen the condition of patients with OAB, the most commonly used are diuretics and antihistamines.
The main indicator of the severity of the disease can be called the degree of its impact on the social life of the patient. Often, the disease forces the patient to change their profession, limits career growth, and affects family relationships. Sometimes patients completely change their lifestyle, refusing any kind of physical and social activity that restricts their immediate access to the toilet, thus defeating the disease. But this accordingly leads to social maladjustment and negatively affects their physical and emotional state.
Both diagnosis and treatment of overactive bladder require close cooperation with the patient from the doctor. The patient should receive from the doctor an exhaustive answer to the question about the methods of treating OAB – both medicinal and others. The doctor should also discuss with the patient the effectiveness of a particular method, possible complications and financial costs. Only by having realistic expectations and understanding the methods of treatment, the patient is able to consent to the use of one of the treatment options.Such patients, who have complete information on their disease and treatment options, have a good chance of coping with the disease.
The main method in the diagnosis of OAB is a comprehensive urodynamic study (KUDI), in which special attention is paid to signs of bladder obstruction (uroflowmetry, pressure-flow study), the appearance of varying intensity of urges, the presence of involuntary detrusor contractions, their amplitude and frequency , cystometric bladder capacity (cystometry), urethral sphincter function (profilometry).In our center, this study is carried out on the modern urodynamic system “Uroscrin”.
Treatment of overactive bladder
Like any other chronic disease, OAB is treated with a combination of medication and non-medication. Medicines can be used as monotherapy or in combination with other drugs. Recently, long-acting drugs have been developed based on anticholinergic substances, or, more precisely, antimuscarinic substances.These drugs can be used once a day, which in turn makes them more convenient to use. It has also been proven that these drugs are more effective than fast-acting drugs.
A variety of non-drug treatments such as behavioral therapy and pelvic floor muscle rehabilitation (commonly referred to as Kegel exercises) can also help improve urinary control.
It is known that the results of treatment among patients in whom only behavioral and rehabilitative therapy was used are comparable to the results of treatment with medications.It can be assumed that the combined use of both drugs and non-drug treatment can lead to mutual potentiation of the action and better results.
Studies of the role of combined therapies in the treatment of OAB disease prove that the use of drugs in combination with non-pharmacological methods significantly increases the effectiveness of treatment. In this case, it does not play a special role with which method the patient begins treatment (i.e., whether he chooses behavioral / rehabilitative therapy or prefers traditional treatment with drugs, or uses both drugs at the same time).The main components of behavioral and rehabilitation therapy in the treatment of OAB are: control over the amount and frequency of fluid intake, “training” of the bladder, and exercise to strengthen the pelvic floor muscles. In particular, for the elderly, it is not recommended to limit fluid intake until the person begins to consume excessive amounts of water. Keeping a diary, which records the time and amount of fluid intake, helps to correct problems associated with drinking regime (for example: excessive consumption of caffeinated or alcoholic beverages, or excessive fluid intake before bedtime).The recommended fluid intake is 6-8 cups per day, including fluid found in food. Undoubtedly, when determining the amount of fluid consumed, it is necessary to take into account the individual characteristics of each individual person, his concomitant diseases, etc. This is especially true for the elderly. It would be wrong to recommend that you consume a certain amount of fluid. In general, half your daily fluid intake should be water, which is best drunk in small portions throughout the day.
Behavioral therapy – training of the bladder, implies going to the toilet for the purpose of urinating strictly on schedule. This approach can lead to up to 50% improvement in symptoms associated with overactive detrusor. the patient learns how to suppress urgency, increase bladder volume and reduce toilet visits. It can be said to be a modified form of bladder training using certain exercises that are used in the early stages of behavioral therapy.Too frequent urge to urinate in order to avoid intense urgency and the likelihood of urinary incontinence can lead to a weakened bladder function and even a reduction in its volume. In general, patients are advised to visit the toilet every hour or two throughout the day and increase the intervals between visits by 15-30 minutes during each week. To achieve this goal, they are also encouraged to use special techniques to promote urinary retention.
In this case, patients are taught not to immediately run to the toilet as soon as they feel the urge to urinate, but, on the contrary, to sit or stand still, while continuously monitoring the work of the pelvic floor muscles, which is much more difficult to do if the patient is constantly running around the room.Relaxing and distracting techniques such as math counting to oneself or deep, measured breathing are also very helpful.
It is an indisputable fact that teaching people how to control the muscles of the pelvic floor plays an important role in the treatment of patients with the help of rehabilitation therapy. These exercises are very beneficial as they help control the retention of urine in the bladder. This skill can be useful to everyone, especially those who are unable to consciously isolate and contain the pelvic floor muscles.After the patients have learned all these exercises, those of them who have a sufficiently high degree of motivation can continue to do them on their own. Pelvic floor muscle rehabilitation therapy can be performed by doctors, nurses, physician assistants, or physical therapists, who may also be responsible for monitoring the patient.
In our center training of the pelvic floor muscles is carried out at the modern complex “Uroproktokor”.
However, it should be borne in mind that success in treatment largely depends on the patients themselves, their ability and desire to learn and adhere to the results achieved.The combination of a drug with one of the functional methods makes it possible to achieve significant results in the treatment of such a complex category of patients as patients with overactive bladder.
Recently botulinum toxin type A ( Botox, Lantox ) has been actively used to treat overactive bladder. In general, botulinum toxin has been used in the treatment of various spastic conditions since the 1970s and 1980s. To treat involuntary detrusor contractions, a toxin is injected into the bladder wall using an endoscopic needle.In this case, a partial temporary denervation of the bladder occurs, which makes it possible to eliminate urinary incontinence associated with an urgent urge to urinate. The action of botulinum toxin is reversible, therefore, most often, repeated treatment is required after 6-12 months. This technique is also used in our center.
Stress urinary incontinence
Stress urinary incontinence is the inability of a woman to keep urine while laughing, coughing, sneezing, exercising and other activities that increase the level of intra-abdominal pressure.In practice, the synonym is also widely used – “stress urinary incontinence – NIPI”. According to many urologists, this term more accurately reveals the mechanism of pathology. This type of disease in women is unusually widespread. About 30% of the female population suffers from any form of urinary incontinence, with older women prevailing in this statistic. As the level of intra-abdominal pressure increases, urine leaves the bladder through the urethra (urethra). Due to the violation of the state of the function of the closing device, the liquid escape is not prevented.The bladder is not involved in stress incontinence: with loss of urine, the smooth muscles of the bladder wall continue to be relaxed.
Diagnosis of the disease is based on the history, listening to the patient’s complaints and examining her. Conducting combined urodynamic study allows you to confirm this diagnosis.
Treatment of stress urinary incontinence consists in the joint selection of safe and effective medicines with a urologist, as well as in the training of the pelvic floor muscles.In our center for training the muscles of the pelvic floor, we use a modern highly effective complex “Uroproktokor”.
Also, in modern urological practice for the treatment of stress urinary incontinence, various surgical methods are used.
One of them is the injection of volume-forming gels into the submucous layer of the urethra, which makes it possible to form characteristic thickenings under the mucous membrane of the urethra. With the introduction of the drug at several points, the lumen of the urethra becomes narrower, which will allow for better retention of urine over time.The operation takes no more than 10 minutes and is done under local anesthesia. Depending on the choice of tactics, the urologist can use a cytoscope or do without it. The method is good in certain clinical cases, but less effective in comparison with surgical intervention, is relatively expensive and in some situations requires repeated gel injections. The question of the safety of gels for body tissues is still open.
Nowadays TVT / TVT0 sling surgery is a safe and highly effective treatment for female stress urinary incontinence.The operations are well tolerated by patients due to their high-tech and minimally invasive characteristics. During the operation, a free synthetic loop is placed under the middle part of the urethra to support the urethra and prevent the loss of urine in a state of tension.
Surgical methods for the treatment of female incontinence are minimally invasive and are carried out in the day surgery hospital of the polyclinic. The operations are performed under intravenous or local anesthesia and the patient is discharged from the hospital on the same day.
90,000 Frequent urination: causes, symptoms and treatment
Usually, an adult excretes 1.5-2 liters of urine and has to go to the toilet 3-7 times a day. A disturbance in the usual frequency may be a sign of a health problem.
A condition in which more than 3 liters of urine are released per day is called polyuria. Usually this condition is caused by reasons that can be eliminated with simple treatment.
However, frequent urination may indicate a very serious health problem.Early detection of these problems will provide timely and effective medical care and prevent complications.
Urination is a way of getting rid of waste fluids from the body. Urine contains water, uric acid, urea, and toxins and wastes that are filtered out by the body. The kidneys play the most important role in this process. Urine accumulates in the bladder until it reaches the point of fullness and urges to empty. At this point, urine is excreted from the body.
It is necessary to distinguish frequent urination from urinary incontinence, which is caused by poor control of the bladder.Frequent urination is the need to visit the toilet more often, but this condition can also be observed along with incontinence.
As already mentioned, most adults urinate up to 7 times a day. Frequent urination can be defined as the need to empty the bladder more often than 7 times a day, with a volume of fluid about 2 liters drunk.
In childhood, only learning to control urination occurs, in addition, children simply have a small bladder volume, so they usually urinate frequently.
It should be noted that most patients visit a doctor only when urination becomes so frequent that it seriously impairs the quality of life.
Urination is a complex process involving many body systems. Some features can cause an increased activity of the urinary system.
For example, a lifestyle-related cause may be drinking a lot of fluids, especially those containing caffeine or alcohol, which can disrupt the sleep cycle with urge to urinate.Frequent urination can also develop as a habit.
However, frequent urination can be caused by problems with the kidneys, ureters or bladder, such as diabetes mellitus and diabetes insipidus. Frequent urination can also be caused by prostate problems or pregnancy.
Reasons can also be:
- anxiety
- taking medications, (for example, diuretics act to remove urine from the body)
- Stroke and other conditions of the brain or nervous system
- cardiovascular failure
- urinary tract infection
- Tumor or neoplasm in the pelvic region
- interstitial cystitis
- cystocele (prolapse of the bladder)
- overactive bladder syndrome (OAB, causing involuntary contractions of the bladder, which in turn leads to a sudden urge to urinate)
- oncological diseases of the genitourinary system
- kidney or bladder stones
- urethral stricture – a sharp narrowing of the lumen of the urethra.
- colon diverticulitis (saccular protrusions in the colon)
- sexually transmitted infections (eg chlamydia)
Naturally, the main symptom of polyuria is frequent urination. However, there are symptoms that may indicate a possibly more serious condition or illness. For example, one of these symptoms is nocturia – the need to urinate at night while sleeping. This symptom may indicate diabetes mellitus or diabetes insipidus.
Symptoms of frequent urination that need special attention include:
- pain or discomfort when urinating
- bloody, cloudy or unusual colored urine
- gradual loss of bladder control or urinary incontinence
- Difficulty urinating with clear urge
- discharge from the vagina or penis
- increased appetite or thirst
- fever or chills
- nausea or vomiting
- back pain or side pain
If you have these symptoms or if the frequency of urination affects your quality of life, it is strongly recommended that you see your doctor.
As an example, frequent urination may be a sign of a kidney infection. Lack of treatment in this case can cause irreversible damage to the kidneys. In addition, bacteria that are the source of infection, entering the bloodstream, can cause infection of other organs of the body, thereby posing a serious threat to life.
When diagnosing the causes of frequent urination, the doctor carefully examines the patient’s medical history, conducts his physical examination, asks the patient about the frequency of urination and other symptoms.
Questions may concern:
- the nature of frequent urination (for example, when it started, how it has changed, at what time of day it occurs)
- current medication intake
- amount of consumed liquid
- changes in color, odor or consistency of urine
- the amount of caffeine and alcohol consumed
Diagnostic tests may include:
- urinalysis to detect any abnormalities in urine
- kidney ultrasound
- X-ray of the abdomen and pelvis
- Neurological Tests and Scales for Nervous Disorders
- laboratory tests for sexually transmitted infections
Both men and women can see a urologist, women are seen by a gynecologist.
To assess the functional state of the bladder and urethra, urodynamic studies are prescribed.
Simple urodynamic studies include:
- Measurement of time required for urine production
- accounting for the amount of urine produced
- tests for the ability to stop urination
Methods such as uroflowmetry, cystometry, intraurethral pressure profile recording, electromyography, and pressure-flow studies can be used for accurate measurements.
The patient may need to change the volume and type of fluid intake or stop taking certain medications before testing. It may be necessary to come to the clinic with a full bladder.
Treatment for frequent urination depends on the underlying cause.
In the event that the doctor diagnoses diabetes mellitus, treatment will focus on controlling blood sugar levels.
For bacterial kidney infection, typical treatment is a course of antibiotics and pain relievers.
In cases of overactive bladder, anticholinergics are used to prevent involuntary detrusor muscle contractions in the bladder wall.
Attention: drug therapy must be prescribed and monitored by a specialist only!
Drug-free therapy focuses on urinary frequency control, but not the underlying cause.
Non-pharmacological treatment methods may include:
- Kegel Exercises.Regular daily exercise often performed during pregnancy. Exercise helps support the muscles of the pelvis, urethra, and bladder
- Bladder continence training
- Control of fluid consumption
The primary methods of preventing frequent urination are a balanced diet and an active lifestyle.
For example, you should limit your alcohol and caffeine intake and avoid foods that irritate the bladder or act as a diuretic.These foods include chocolate, spicy foods, and spicy foods, and artificial sweeteners.
Foods high in fiber help relieve constipation. Because a crowded rectum can compress the bladder or urethra, these foods indirectly help improve the passage of urine through the body.
To clarify the schedule of appointments by urologists and gynecologists at the Professorial Clinic, you can sign up for a consultation by calling a single telephone number in Perm 206-07-67 and also using the “appointment” service on our website.
90,000 Because of what most often occurs incontinence in women with cystitis
Inflammation of the walls of the bladder and ureters is a bacterial disease that is triggered by bacteria of several groups, including chlamydia and Escherichia coli. Regardless of the origin, the pathology is manifested by painful urination, and sometimes drip. Associated symptoms are pain in the lower back and lower abdomen.An advanced stage leads to pyelonephritis. Women get sick more often than men, which is due to the peculiarities of the structure of the genitals. For the same reason, women experience incontinence after cystitis 10 times more often than men.
If the disease is started, it will become chronic, and exacerbations will occur from time to time.
Causes of post-cystitis incontinence in women
Cystitis-induced urinary incontinence is manifested by uncontrolled secretion of fluid.Exacerbations occur in the following conditions:
- complex course of natural childbirth. If a woman has a narrow pelvis, her urethra is injured when the baby passes through the birth canal;
- age-related changes. Over time, the muscles of the bladder weaken and lose their ability to hold urine;
- menopause. The climacteric period is accompanied by a decrease in estrogen levels. As a result, the muscles holding the bladder lose their tone and do not hold it as effectively;
- Injuries and operations of the pelvic organs, when the nerve endings are damaged;
- diseases of the central nervous system;
- obesity and diabetes mellitus;
- chronic cough;
- congenital anomalies of the structure of the bladder;
- Injuries, tumors and inflammation in the spinal cord area;
- excessive sports or workload, etc.
Even with a slight accumulation of urine, the nerve endings give a sharp signal for emptying. The situation escalates so suddenly that many do not have time to reach the bathroom.
Classification of types of incontinence after cystitis
There is a definite classification of cystitis incontinence in women. In order to properly prescribe the treatment, it is required to diagnose the cause and degree of the pathology. Taking into account the symptoms and provoking factors, such types of pathological conditions are distinguished as:
- extraurethral – occurs due to a fistula connecting the vagina and the bladder;
- obstructed outflow of urine from an overflowing bladder due to the presence of inflammation, stones, tumors and other obstacles to natural emptying;
- enuresis – loss of control of urination at night during sleep;
- reflex – provoked by problems with the spinal cord;
- stressful – occurs when coughing, exercising, laughing and other actions in which the bladder has high pressure;
- imperative – the urge is provoked by external factors (temperature drop, water noise, etc.)).
It is easy to detect the symptoms of cystitis incontinence in women. There are a number of characteristic signs that will not allow the pathology to be confused with other diseases:
- Constant feeling of fullness of the bladder, even after leaving the bathroom;
- lack of control over urges and work of the genitourinary system;
- multiple visits to the bathroom at night;
- clouding of urine and the appearance of a specific odor;
- constant pain in the lower abdomen;
- in some cases – an increase in temperature, and most often this happens against the background of renal pathologies.
What unpleasant consequences can await you?
Cystitis-related urinary incontinence has unpleasant symptoms but can be tolerated early on. If you postpone the trip to the doctor for a long time, the disease will not go away, but it will be complicated by the following consequences:
- significant decrease in the quality of life: there is no desire to go for a walk, meet friends, although physiological discomfort can be eliminated with urological pads;
- psychological discomfort.If there are no special pads, the woman smells a strong urine smell. In the future, even gaskets that completely eliminate the smell cannot get rid of the feeling that others feel this unpleasant smell;
- problems in intimate life. Pressure on the bladder provokes the release of urine, which during intimacy will become an unpleasant incident;
- Constant fatigue. Night sleep becomes nervous, intermittent – the body does not rest, physical and psychological health suffers.
Options for effective treatment of the disease
Women who experience incontinence after cystitis are often embarrassed to see a doctor. We strongly advise against self-medication! From this, the problems only multiply. To choose a treatment method, a gynecologist or urologist will refer you for diagnosis. Standard procedures: general and bacteriological analysis, cystoscopy, ultrasound examination of the bladder.
Treatment is conservative, in exceptional cases, an operation is performed.Prescribed drugs that suppress the development of detected fungi or bacteria. With a strong pain syndrome, antispasmodics are taken. To reduce the frequency of voluntary urination, drugs are prescribed that reduce the activity of the bladder. In parallel, nootropics are shown that improve the transmission of signals to the brain. The general condition of the body is improved with vitamins. Sedatives are recommended to stabilize the nervous system. The doctor will make the decision about what treatment to carry out, after analyzing the results of the diagnostics performed.It is impossible to use any means, including recipes of traditional medicine, without consulting a doctor, so as not to aggravate the situation.
A prerequisite for treatment is nutritional correction. Doctors usually recommend limiting salt in the diet, avoiding fried and spicy foods. Fluid is consumed in moderation, if there is little of it, the urine will be more concentrated, but this will not relieve enuresis. It is advisable to adhere to the schedule of visits to the bathroom, gradually increasing the time intervals.
Preventive measures recommended by doctors
Having recovered, do not forget about prevention in order to prevent the recurrence of unpleasant symptoms. Basic measures:
- regularly empty the bladder, do not tolerate for a long time;
- avoid hypothermia;
- to quit smoking;
- to increase the amount of vegetables and fruits in the diet;
- consume about 1.5 liters of water per day;
- change linen daily, avoid synthetics;
- in sedentary work, arrange a warm-up every hour;
- to strengthen the immune system;
- Do gymnastics, including Kegel exercises.
The disease is easier to prevent, so the listed preventive measures should be remembered and strictly observed. In case of unpleasant symptoms, consult a doctor immediately!
90,000 Causes of urinary incontinence during pregnancy
During pregnancy, even healthy women may have problems with urinary control. The changes that occur in the body during this period become the source of a number of factors that trigger incontinence.More often, control over urination may worsen, starting from the second or third trimester, less often – a woman may experience incontinence in the first months. It is important to understand that there are many opportunities now to get through this important period in a woman’s life in comfort, even if the problem of incontinence has not spared you.
According to statistics, more than half of women face incontinence of varying degrees during pregnancy. As the time approaches the time of childbirth, the problem may worsen and persist, on average, for six months after the birth of the baby.
Problems with urination control may manifest as occasional drips. Usually these episodes are associated with sudden exertion – coughing, sneezing, laughing, lifting weights, a sudden change in body position.
This problem significantly limits the freedom of movement of a pregnant woman and her ability to lead a socially active lifestyle. This is especially acute in the later stages. Expectant mothers feel awkward and worried that they cannot leave the house for a long time.In some cases, women may not have time to get to the toilet when they feel the urge. Such troubles in pregnant women can happen at night.
But expectant mothers do not need to voluntarily expose themselves to social isolation. With the help of modern absorbents, you can regain your self-confidence and completely eliminate the discomfort associated with incontinence. Special urological pads will help to keep this delicate problem a secret. Having chosen the right size, depending on the absorbent characteristics, a woman can not worry and allow herself long walks and going out.
If during pregnancy there is a problem with urinary control, it is important to inform your doctor so that he can help you make sure that there are no pathological causes of this problem. You will need to pass a urine test. If necessary, the doctor will prescribe other additional examinations.
If, according to the survey, health problems are excluded, then incontinence has exclusively physiological causes that are reversible and will disappear some time after childbirth.
The most common causes of urinary incontinence in pregnant women are:
• Strong increase in the size of the uterus.
The volume and weight of the organ increases with the growth of the fetus. The enlarged uterus gradually displaces adjacent organs and puts pressure on them, including the bladder. The amount of urine produced by the kidneys increases. As a result, the bladder overflows faster. Due to constant pressure, its volume is limited, and the urge to urinate becomes more frequent.Leakage associated with this cause is more likely to occur in the third trimester.
• Loss of tone and hyperextension of the pelvic floor muscles. This occurs not only against the background of the mechanical effect of the increasing mass of the fetus, but also under the influence of the hormone progesterone. As a result, it is more difficult for a woman to control urinary retention.
• Active movements of the child. When the baby, during a change in position in the uterus, hits the bladder with a handle or leg, this can lead to involuntary urine leakage in the expectant mother.
• Initially decreased tone of the pelvic floor muscles. It more often occurs in women who have recently given birth, in mothers with many children, in pregnant women with poor physical fitness or large excess weight.
• Stress incontinence. During periods of strong nervous tension, the conduction of nerve impulses and the regulation of urination may be disrupted. This type of incontinence occurs already in the first weeks of pregnancy.
In rare episodes of leakage of small volumes of urine, the use of a urological pad will be enough to make the woman feel free and confident again.
In addition to the main reasons listed, you can recall the factors that affect the severity of the problem.