Enuresis (Involuntary Urination)



Enuresis from an estimated amount can be found among 5−10% of 5 years old children, 3−5% of 10 years old, and 1% of 15 years old. This disorder mainly disappears by adolescence, but in 1% percent, this may continue till adulthood. About two out of one hundred teenagers and adults face this enuresis problem. Doctors can sometimes treat this enuresis disorder with medicines, but no medication has been proven to cure this problem permanently.

What is Enuresis?

Enuresis is also known as bedwetting. Nocturnal enuresis or bedwetting at night is a type of elimination disorder. Enuresis is a medical term used for involuntary urination. Enuresis is defined as the accidental release of urine during sleep or in the state of awakening. This disorder is most common among children and elderly physically and mentally disabled people. Although it is not a serious condition, it can be treated through some medicines and therapies.

Types of Enuresis

There are four types of enuresis. Those are −

  • Primary enuresis − This type of enuresis is defined as when a child under 18 years has repeated episodes of bedwetting even after achieving urinary control, which can continue over several months and years.

  • Secondary enuresis − This type of enuresis is when an older person who was previously incontinent starts to have problems controlling their bladder.

  • Nocturnal enuresis − This type of enuresis is the most common. Nocturnal enuresis is also known as nighttime bedwetting, and this happens when children have bad dreams during the nighttime.

  • Diurnal enuresis − This type of enuresis takes place in the daytime. This type of enuresis happens mainly in older adults and infants.

Symptoms of Enuresis

There are some common basis symptoms of enuresis. Those are −

  • Severe incidents of bedwetting, i.e., involuntary urination

  • Incidents of wetting at least twice per week for almost three months

  • Wetting incidents involving clothing

  • Wetting bed again after six months of dry nights

Causes of Enuresis

The reason for enuresis, i.e., involuntary urination, is unknown, but several factors may play a role in the enuresis disorder. Those are −

  • A small bladder − A child's bladder is not developed enough to hold the urine produced at night.

  • Inability to recognize a full bladder − If the nerves that control the bladder are not mature enough to recognize that the bladder is full and may not wake a child, especially in a deep sleep.

  • Infection in the urinary tract − A infection in the urinary tract can make it difficult to control the urine.

  • Diabetes − This may be a cause of increased frequency of urination and a large amount of urine at once, which impacts enuresis.

  • Chronic constipation − Same muscles control urine and stool elimination. That is why enuresis may occur during chronic constipation as the muscle becomes dysfunctional.

  • A structural problem in the urinary tract or nervous system − Enuresis is rarely connected with a defect in the child's neurological or urinary system.

Other than these, there are some other causes such as−

  • Psychogenic factors such as anxiety, unconscious or other mental illness

  • Medications that affect the controlling ability of the bladder

  • Injuries related to the urinary bladder

Diagnosis of Enuresis

Depending on the situation, doctors may suggest some tests to identify the cause of enuresis and help to treat them.

Physical exam − Discuss the symptoms, fluid intake, family history, bladder habits, and problems connected with enuresis. Several tests of urine to check signs of infection or diabetes. X-rays or other imaging tests of the kidneys or bladder to see the structure of the urinary tract. Other urinary tests related to the bladder or tract as needed.

Treatment of Enuresis

In the case of children, this disorder is overcome by themselves. If treatment is needed, the parents of the child or the adults facing this problem may consult a doctor and identify which treatment will work best for their situation. If an individual limit the use of fluid intake and use of caffeine, then they can overcome this situation easily. If these basic lifestyle changes do not work for them, they must take a doctor's opinion to cure this disorder. If the cause of this disorder is constipation or other psychological problem, the doctor must mention it before the treatments start. Sometimes moisture alarms and medication can help treat enuresis disorder.

Moisture alarm − This is a small device operated by a battery and is available in any pharmacy without a prescription. A moisture-sensitive pad is connected to the bed or the individual's pants, and as soon as the pad senses wetness, it starts ringing. This alarm can help the individual stop urinating and go washroom. It takes 2-3 months to see the changes, and it may take up to 16 months to resolve this issue completely without the help of medicine.

Medication − If the treatment with moisture alarm fails and the individual is facing this issue due to mental illness or other health-related problems, then there is a need to consult a doctor to prescribe medicines for curing this disorder. Types of medications used −

Slow nighttime urine production − The production of urine can be controlled by the drug desmopressin. Drinking too much water while taking this medicine can create a problem, and it must not be taken if the individual has a fever and diarrhea.

Calm the bladder − To decrease bladder-related contractions and increase the bladder's capacity, the doctor prescribes an anticholinergic drug such as oxybutynin (Ditropan XL). This medicine can be used along with other medicines and is generally suggested when all the other treatments fail to cure this disorder.

Conclusion

From the above discussion, it can be concluded that Enuresis, i.e., involuntary urination, is mainly seen among children up to 5 years, older adults, and mentally disabled people. This disorder has several symptoms, like urinating in the bed and clothes. The main cause of this situation can be diagnosed by several tests and causes involving the small-sized bladder, diabetes, and other issues. To cure this disorder, some lifestyle changes can help sometimes, and some medications can also help individuals cure enuresis.


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