Enuresis in adults? Causes and treatments

Enuresis is a disorder that results in involuntary, irrepressible and uncontrollable urination (the act of urinating or "peeing"). When it occurs during the day, it is known as diurnal enuresis. 

At night, it is nocturnal enuresis. The two phenomena are not inseparable. In adults, controlled urination during the day can be involuntary at night (adult enuresis). The term "nocturnal enuresis" can be used from the age of 5, when children have control of their bladder sphincter. From the age of 15 onwards we talk about adult enuresis. When they occur during the day, they are called daytime enuresis. 

There are many possible causes for this condition. Enuresis (incontinence at night or during the day) can be the result of a physical illness or mental disorders. To combat involuntary urination, it is important to consult a doctor who defines its cause (sphincters, kidneys, hormone, urethra and other possible causes) and its treatment (adult enuresis treatment).

Enuresis in adults: the causes

Accidental enuresis 

In adults, enuresis or bladder leakage can be accidental. Involuntary urination then occurs occasionally. The main causes that can explain these accidents are drunkenness, dreaminess, overactive bladder, drug treatment and smoking.

Excessive alcohol consumption increases urine production. It can also impair waking up when the need to go to the toilet arises. Before you know it, the adult will have urinated in bed.

Then, uncontrolled urination can occur during a dream. While sleeping, the adult imagines himself to be in the toilet. The subconscious then causes the bladder to relax by transposing dream and reality.

Finally, smokers who suffer from coughs can be affected by bedwetting. When coughing, the adult may experience some involuntary urination.

Physical causes 

Heredity can be a factor in "enuresis". Studies show that when parents are enuretic, the child and then the adult have many chances of suffering from the same condition.

Adults who have suffered a traumatic brain injury or have laterality disorders are often prone to enuresis. Hypotonic, they perform contraction movements slowly. As a result, they can no longer control their bladder when they feel the need to urinate.

A physical disorder can also cause this condition. A bladder that is too small or distended, a urinary tract infection or hormonal imbalance are all possible causes. 

Some pathologies occur with age, such as diabetes or an enlarged prostate. Older people are therefore more likely to suffer from incontinence. In order to know the precise causes of nocturnal incontinence, a diagnosis will have to be made by a doctor.

Psychic causes 

If there is no physical disorder that explains the bedwetting, the psychological aspect should be analyzed. Emotional shock or trauma can explain incontinence in adults.

Other psychological problems such as depression or fear can affect proper bladder function. A vicious circle can then be created: stress, shame and low self-esteem can increase the phenomenon of bedwetting. It is therefore important to consult a specialist as soon as possible.

For each cause, there is a treatment. To find out, a medical consultation with a specialist is essential.

Enuresis treatment in adults

Re-education of urinary rhythm

As soon as enuresis appears in adults (enuretic), it is important to adopt good lifestyle habits. By urinating regularly during the day and reducing fluid intake after 6 p.m., the risk of uncontrolled urination decreases. To limit the risk of bladder irritation, and therefore bedwetting, it is advisable to avoid drinking coffee or soft drinks.

Finally, it is recommended to get out of bed as soon as you feel the urge to urinate so as not to take any risks.

Hypnosis and Verbal Therapy 

Sleep disorders, often due to a mental disorder, can disrupt urinary cycles. Hypnosis and verbal therapies can help solve the problem at its source.

The "stop peeing" alarm 

As its name suggests, the "stop pee" alarm is a system that alerts the adult as soon as the first drop of urine is detected. The alarm, connected to the mattress, wakes the sleeper at the slightest involuntary urination. The adult can then go to the toilet and avoid the accident. 

This device is prescribed by a doctor for an average duration of 3 to 4 months. According to a study published in Springer Open Choice, the success rate of the alarm is 60% and relapses are low.

Medications 

A prescription drug based on desmopressin can block the secretion of urine during the night. According to the same study, its success rate is also 70% but the cases of relapse are much more numerous than with the alarm. For optimal treatment, it is recommended to combine these two treatments.

Motor rehabilitation

When enuresis is due to a physical problem, motor re-education is used to restore the bladder system to normal function. While waiting for the re-education to be completed, night-time protection can be used.

Incontinence is not inevitable. It is a symptom of physical or psychological problems, and can be treated in a variety of ways. The first step is to discuss the problem with your doctor.