Bedwetting adults: causes and treatment

Bedwetting adults is not a statement that you hear often. And if the statement is referring to you, then it is definitely one that you don’t want to hear. It is bad enough for a kid to bed wet, an adult bedwetting is hugely embarrassing and stressful

This is even more pronounced in our type of society. We are all quick to judge and make connections where there aren’t any. Sometimes spiritual or cultural beliefs come in. But most times, what is actually needed is a visit to the urologist.

Imagine as an adult, you have a lady or a guy over and you both slept in the same bed. On waking up, you realize that you have just drenched both the bed and your partner in your urine. Yes, that is likely to mess up your day really quickly.

But let us take a step back from all the weirdness surrounding this issue and look at it objectively. What are the possible causes of this medical condition, and how can you treat it?

Adult bedwetting: Is it your fault?

Adult bedwetting is more of an issue than we care to admit, both in Nigeria and in other countries. The stigma and shame that we have associated with it has made it’s control and management difficult.

It is even possible that many that are having to deal with this are too ashamed to talk to a doctor about it. And it might be that the cause is something that can be easily fixed.

You should know that bedwetting in adults is quite different from what kids go through. You should also know that the condition is involuntary and it is not your fault. This might not necessarily make you feel any better, but these are facts.

How your urine is formed

To properly understand what causes your bedwetting as an adult, it is good to know how urine is formed in the first place. Now, urine is produced by the kidneys and moves to the bladder through ureters.

When it gets to the bladders, it is stored until it is full and the urine passes out through the urethra. Urine passes out when the bladder contracts making the urinary sphincter to relax. The sphincter is like a a door that keeps urine in or releases it.

If you have any anatomical or neurological issue with any part of this entire urine formation process, then you might likely bed wet.

Causes of adult bedwetting

There are a few reasons why this might be happening to you, here are some:

• Genetics
  Check your family history, see if you have parents or family members that struggled with bedwetting. If you do, then you are more predisposed to it yourself.
  
• Hormonal issues
  Antidiuretic hormone (ADH) is a substance produced by the body that tells the kidneys to reduces urine production. Now, sometimes, the body does not produce enough ADH or the kidneys are no longer sensitive to it.
  This may lead to the kidneys producing too much urine at night (nocturnal polyuria). This can cause bedwetting in adults, but could also be a Type 1 diabetes symptom. So, go see your doctor
  
• Medications
  Some medications for insomnia, psychiatric problems, and hypnotics may increase your risk. Be sure to consult with your doctor if you are taking any of these.
  
• “Small bladder”
  Some people with a “small bladder” may experience bedwetting even when they become adults. Well, their bladders aren’t small in the sense of reduced size. It only means that the Functional Bladder Capacity (FBC) is small and can only hold so much urine.
  
  

Possible treatments for adult bedwetting

The first step in your treatment is to make an appointment with a urologist. When you go for your appointment, make sure you have some information handy. Information like:

• when your bedwetting episodes happen during the night
• drinking pattern; how much fluid you drink at night
• what you drink; water, sugary drinks
• how you urinate; dribbles, strong stream

Your doctor will use these information to determine which tests would be needed. You might have to go through physical examinations, urine culture, and even neurological evaluations.

As for the treatment, some times the bedwetting is caused by an underlying condition. Fixing this condition usually also fixes the bedwetting.

Behavioural treatments could also be effective. The use of bedwetting alarm systems, and reducing fluid intake at night.

Surgery might be a last resort when all these other methods have proven ineffective. These surgical procedures come with their own risks, so they should be discussed properly and deeply considered. Some of these procedures include:

• Sacral nerve stimulation – sacral nerve roots are given a jolt which helps to increase the tone of the external sphincters.
• Clam cytoplasty – here the bladder is cut up and a piece of the intestine is placed in the cut.
• Detrusor myectomy – A portion of the external detrusor muscles surrounding the bladder is removed. This helps to strengthen bladder contractions and also reduce their number.

Treatment with drugs is also an option. Drugs like Desmopressin, Darifenacin, and so on have been effective in treating bedwetting in adults.

No shame here, please

There are effective treatments available, you can be over this uncomfortable period of your life. You only need to overcome the unpleasantness and open up. Go see a doctor, talk with other adults that are dealing with the same thing.

You would be surprised at the number of adults going through the same thing that are also keeping it secret like you. Who knows, you may find out something that works for them that might also work for you.

There is a helpful thread about bedwetting in adults here. It is only shameful if you allow it to be. Stay safe, and dry.