Wetting The Bed As An Adult

Causes of wetting the bed

Heritage

Research has shown that there is a link between the genetics and wetting the bed as adults. There is evidence that wetting the bed is hereditary. If both your parents have bedwetting problems, then there is 77% chance that you get bedwetting issues. If one the parent wet the bed as a child, then your chances are 40%., which can be carried into adulthood.

ADH

Your body produces a hormone called anti-diuretic hormone or ADH. ADH sends a signal to your body to decrease the production of urine. More ADH hormones are released at night to prevent you from wetting the bed. Some people’s body don’t produce sufficient levels of ADH which causes adult bedwetting. Other people’s body make the appropriate amount, but the kidneys don’t respond. In both situations, your body produces the same amount of urine and your bladder can’t hold the higher volumes of urine.

FBC

Another cause of adult bedwetting is having a smaller than average bladder. The size of the bladder isn’t smaller, but the functional bladder capacity (FBC) can only hold a smaller volume of urine.

OAB

You may have an ‘’overactive’’ bladder (OAB), which causes you wetting the bed as an adult. An overactive bladder means that the muscles of the bladder, also known as detrusor muscles, are never fully relaxed during the filling phase. Therefore, the capacity of the bladder is not as large either. Overactive bladder is often related to FBC. 70-80% of the people who are wetting the bed as an adult have an overactive bladder.

Drinks

A number of drinks can contribute to an overactive bladder, but also the type of drinks. Alcohol and caffeinated drinks can irritate the bladder or cause a faster urine production, which might cause wetting the bed as an adult.

Medications

Some medications can also be one of the causes of adult bedwetting, even though it’s completely unrelated problem. Those medicines can change your urinary system, which causes you to have less control over your bladder than normal. It can be a side effect from insomnia medications, hypnotics and psychiatric medications such as risperidone, clozapine and thioridazine.

Underlying medical issue

• Urinary tract infection (UTI)
• Urinary tract stones
• Diabetes
• Neurological disorders
• Anatomical abnormalities
• Urinary tract calculi
• Prostate cancer
• Prostate enlargement
• Bladder cancer
• Obstructive sleep apnea

Determining the causes of adult bedwetting

Determining the causes of adult bedwetting can be difficult as it is often an underlying cause of another medical issue. It is recommended to keep a symptom diary to help your doctor better discovering the causes of adult bedwetting. Some very important bedwetting information include:

• When your accidents usually occur (day or night time)
• Amount of urine voided
• Daily drink intake patterns
• Types of drinks (alcohol, caffeinated, sugary, carbonated etc.)
• Number of wet versus dry nights
• Recurrent urinary tract infections
• Nature of urine stream (strong & steady or weak & dribbling)

Before the doctor prescribes any treatment, you can expect one or more of the following routine tests to find the causes of adult bedwetting:

• Physical examination
• Urine tests
• Urologic examination and tests
• Neurological evaluation

Further tests may include:

• Post-void residual urine measurements This includes ultrasound kidneys and bladder to see how much urine is left in the bladder after voiding

• Uroflowmetry This requires you to urinate in a special funnel to determine the flow rate, the amount of urine and how much time is needed for urination.

Treatments for wetting the bed

Management

• Mattress covers Protect your bed and mattress with special mattress covers. Look for mattress covers or sheet protectors that include vinyl, waterproof and are absorbing to make it easier to clean up after wetting the bed.

• Absorbent briefs Absorbent underwear helps to prevent leakage. You can choose if you want to purchase reusable or disposable ones.

• Skincare products The skin can get irritated from the frequent bedwetting. To protect the skin, there is a variation of soaps, lotions and cleansing cloths for every skin type.

Lifestyle Modification

• Fluid intake Don’t drink too much in the late afternoon and evening. Also, avoid alcohol and caffeinated drinks before bed. This can decrease the amount of urine production at night.

• Bedwetting Alarm system There are different wet-detection devices that can be attached to a pad or your underwear during sleep. These bedwetting alarms will wake you up when you start wetting the bed with alarm sounds or vibrations.

• Waking up between sleep Use an alarm clock to wake you up in the middle of the night for urination. Use different time settings every night to avoid your bladder making a habit of avoiding urination around a particular time.

Medication to treat the causes of adult bedwetting

• Desmopressin Desmopressin decrease the urine production in the kidneys that can prevent you from wetting the bed.
• Imipramine Imipramine is a type of antidepressant with a success rate of 40% treating the causes of adult bedwetting, but it is easy to overdose.

• Anticholinergic medication Anticholinergic medications are effective for treating the overactive bladder. However, side effects are dry mouth, dizziness and blurry vision.

Surgery

• Sacral Nerve Stimulation Sacral Nerve Stimulation causes fewer urination episodes. It is recommended for people whom treatments weren’t successful and for whom prescription are contraindicated. Also, for people with moderate to severe loss of bladder control.

• Clam Cystoplasty In this surgery, the bladder is cut open to place a patch of intestine between the two halves. The intent is to increase bladder capacity and reduce bladder instability.

• Detrusor Myectomy Detrusor Myectomy is also known as auto augmentation. A portion or all of the exterior muscle surrounding the bladder will be removed. The goal is to strengthen bladder contractions and reduce the number of them.