Bed-wetting (also known as sleep enuresis and urinary incontinence) is a fairly common condition in young children and is seen as a sign of an immature, developing bladder. It is estimated that 15% of children over three, and 10% over five wet the bed occasionally. In fact, most doctors don't consider bed-wetting in children to be a sign of a problem unless the child is older than seven years old, or the child has begun wetting the bed again after six months of maintaining overnight bladder control.

However, when adults wet the bed it is often an indication of an underlying illness, disease, or a symptom of other untreated medical conditions.Studies shows that 1 to 2 percent of adults wet the bed, though researchers think that statistic is underreported due to the embarrassing nature of the problem. Rather than hiding your secret, you should explore effective treatments that can help lessen the likelihood of bedwetting and reduce the anxiety of going to sleep at night.

 What causes Enuresis?

• HORMONAL CAUSES: The body produces an antidiuretic hormone at night called ADH, which slows the kidney's production of urine while you sleep. In people with enuresis, this hormone is not produced in significant enough quantities to slow the production of urine, which often leads to bedwetting. This can be a symptom of both Type I and Type II Diabetes.
• NEUROLOGICAL CAUSES: People who suffer enuresis can also have a smaller functional bladder capacity, meaning the amount of urine they can hold before the bladder sends a signal to the brain that it's full is smaller than average. Coupled with overactive bladder or bladder instability, this can lead to bedwetting.
• STRUCTURAL CAUSES: Enuresis can also be a symptom of problems in the urethra, prostate or pelvis, including urinary tract infection, urinary tract stones, enlarged prostate, prostate cancer and bladder cancer.
• MEDICATION AND DIET: Bedwetting can be a side effect of certain insomnia medications and drugs taken for psychiatric purposes like Thioridazine, Clozapine and Risperidone. Bladder irritants such as alcohol and caffeine can also contribute to bladder instability and act as diuretics to increase the production of urine.

How can Enuresis be treated?

Many treatments for enuresis have been effective. Consult your doctor before trying any treatment on your own.

BEHAVIORAL TREATMENT

• Monitoring Fluid Intake: The first step towards preventing bedwetting is limiting the intake of fluids in the afternoon and evening, which creates a decrease in the amount of urine produced at night. Reduce or avoid caffeine and alcohol intake, which act as diuretics and increase the likelihood of accidents.
• Bladder Volume Control: This technique attempts to increase bladder capacity in those with smaller functional bladders. Training involves drinking large amounts of fluid during the day and refraining from urinating for as long as possible to increase functional bladder capacity.
• Bedwetting Alarm System: Wet-detection alarms can be used in underwear or on the bed itself to vibrate or give off sound when bedwetting occurs. This wakes you and allows you to stop the flow of urine and finish in the restroom. Eventually, the body conditions itself to wake before the urge to urinate gets too strong.
• Waking: Setting a random alarm each night to get up and urinate may be helpful in preventing bedwetting. Avoid setting an alarm at the same time each evening in case your body becomes accustomed to emptying at a set time each night.

MEDICATION

Medication can be an effective treatment for enuresis, but only for as long as it is taken. Medication only deals with the symptoms rather than the underlying causes of bedwetting, so it's recommended that you try behavioral treatments as well. The most common medications mimic the hormone ADH, slowing production of urine in the kidneys and lessening the instances of bedwetting.

 SURGERY

Surgery should only be considered once other non-invasive options have been exhausted.

 Talk to your health care professional about other options before choosing surgery.

•  Sacral Nerve Stimulation: Sacral nerve roots are stimulated, causing decreased activity in the bladder muscles, which helps the muscle to relax and not contract constantly. This form of surgery is recommended if you also have moderate to severe urge incontinence.
• Clam Cytoplasty: The bladder is cut open and a patch of intestine added to increase bladder capacity and reduce bladder instability.
• Detrusor Myectomy: A portion of the exterior muscle surrounding the bladder is removed, strengthening bladder contractions and reducing the number of them.

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.

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