Bed-wetting: Are you an adult suffering silently?
Apr 19, 2009
MAYBE doctors can tell but a small local survey on bed-wetting in adults did not yield much as everyone could not freely talk about it.
By Irene Nabusoba
MAYBE doctors can tell but a small local survey on bed-wetting in adults did not yield much as everyone could not freely talk about it.
“Who will say I wet the bed,†says Mikel Mukasa, a marketing executive. “May be doctors can reveal. We tend to tell them everything but this is something one will not divulge even to a doctor,†Mukasa says.
Dr Stephen Watya, the head of Mulago Hospital’s urology department says that bed-wetting happens in adults although they see only a few patients.
Medically known as nocturnal enuresis, bed-wetting, is involuntary urination while asleep after the age at which bladder control would normally be anticipated about the age of three years.
A US survey shows that although many think of bed-wetting as a childhood problem, about 26 million American adults are affected by urinary incontinence and experts believe the number is low because many of those with urinary incontinence are too ashamed to seek help.
The study conducted by the Simon Foundation for Continence says one to two percent of those experience bed-wetting, either as an issue carried over from childhood (primary enuresis) or a secondary condition that is developed in adulthood.
Causes
Watya attributes the condition to a neurological disorder, prostate obstruction, diabetes, overactive bladder, complications from childbirth or other medical issues.
“There are many causes. It could be just a urological disease that needs medical attention like the ones mentioned above,†he says.
“It could be due to small or loose membranes around the bladder or an obstruction on the bladder.
Conditions, such as expansion of the prostate gland and neurological problems can obstruct the bladder and result in bed-wetting,†Watya says.
He adds that the problem is more common in women because there are more conditions exclusive to women that make them more susceptible like childbirth.
An Internet site on bedwetting, www.doctordvt.com, explains that lack of necessary muscle and nerve control is a common cause of bed-wetting in adults.
“Your bladder may not have developed the necessary nerve and muscle control, so the bladder muscle contracts and empties the bladder when it is only half full of urine,†it says.
“Or you could be simply producing a lot of urine at night because the mechanisms that reduce urine production at night have not developed,†it argues.
The urine infection can irritate the bladder and make it more difficult to hold urine causing bed-wetting in adults.
Gaston Byamugisha, a marriage therapist and lecturer at Kyambogo University’s department of psychology says alcohol consumption, stress, and anxiety are also associated with bed-wetting.
“Alcohol, coffee or diuretic medicines encourage the kidney to make more urine. It is best not to take a diuretic at bedtime, because you will need to pass urine in the night and, if your bladder control is poor, this could cause bed-wetting.
While some experts point at old age or a genetical condition. “In ladies who have crossed the age of menopause, the most common reason for bed-wetting is called the female urethral syndrome,†says the online encyclopaedia.
“After menopause, there is a lack of hormonal influence and the urethra becomes less compliant.
It sometime becomes more rigid and narrow and women begin to retain water the same way as men do when their prostate gets enlarged resulting into increasing obstruction to the flow of urine leading to retention of water in the urinary bladder,†it says.
Effects of adult bed-wetting
Psychologists say the habit has a significant downward impact on self esteem, social and economic outcomes.
“You may worry about staying away for the night, going on holiday, business trips, college or moving away from home.
You may not want to get into a relationship in case your new partner finds out,†says Dr. Jennifer Anger, an assistant professor of urology.
Anger says that many adults are loath to bring up the “b†word with anyone including a doctor and hide their night-time incontinence, “managing†their condition by limiting their life.
“Some end relationships rather than spill the beans about their bladder trouble; others simply avoid them altogether,†Anger says.
Byamugisha says adult bed-wetting can be a big blow to marriage.
“Bed-wetting kills self esteem and this kills marriage. You hate yourself and even those around you, including your spouse whose every comment may be interpreted as getting at you.
“But it can be treated medically or with lifestyle changes. We need to just open up,†Byamugisha says.
Watya says people should break out of their shells and seek expert advice because the problem could be much bigger than imagined.
“We advise people to confide in a doctor. We diagnose the condition and treat it accordingly,†he says.
He says no treatment option has a 100% success rate and those suffering from enuresis may have to experiment with different options to see what works best.
Deidre’s story
WHILE many tease Deidre 32, for taking forever to get married, it is only her who understands her problem-“Bed wetting,†she says, in what seems like a whisper. I have not told anyone. Not even my family.
Well, as a child, I was often spanked for wetting the bed but I am sure my parents plus siblings now think that I have outgrown the habit,†she reveals.
This fear has clouded Deidre’s life for as long as she remembers. It lowered her selfesteem as an adolescent and kept her out of ‘top socialites’ in high school because the ‘good preferred company’ often shunned her. It caused her first heartbreak and she has since developed a ‘dating phobia’.
I remember when I had to join boarding school in S.1. My mother protested and almost settled for a day school for fear that I would immensely be teased for wetting the bed. But my dad insisted on the borading school.
It helped me, but only for a while. I could hardly sleep. I starved myself took little fluids, so I could minimise the dreaded chance that I could wet the bed.
I got used to the environment, the habit returned. It was terrible carrying out my dripping mattress out of the crowded room. The first time, it was excusable.
But with time, I became a source of gossip and chose to stay my mattress while devising measures of a comfortable sleep. I would put a kaveera under my bed so it could not drip on the person sleeping below me.
However, this meant the mattress sucked all the urine and while she piled the soaked area with dry clothing for a comfortable night’s sleep, disguising the smell of urea was difficult.
She chose to share her ordeal with her friend who luckily was understanding and offered her the lower bed on the Decker.
She also helped to routinely wake her up in the night for a visit to the bathroom and the habit became an occasional torment.
But it did not exit her memory. Neither did it exit her daily life save for the fact that she mastered a way to get around it, especially when visiting; which she rarely did courtesy of the ‘night habit’.
Nonetheless, I guess it is hard to run away from ghosts.
I once had a boyfriend I loved so much. We went to a night club and stayed out late.
When we left the disco at about 3:30am, it was quite obvious that I had to spend the night over at his place because they close the campus gates at midnight. she narrates.
Since I had been to his apartment a couple of times, it was no problem. But with some alcohol and fatigue, my ‘habitual ghost lingered’ and made a comeback. I peed on the bed.
While he took it lightly the first time, he chucked me when it happened again, giving no reasons only for me to hear it from his friends. I have never recovered.
How to kick the Habit
Talk to your family doctor. Some people feel too embarrassed to talk about bedwetting. Take this article with you if you think it may help to start the conversation.
Consider alarms designed to wake you up when you start to wet which may be preferable if you are sharing a bedroom.
Practice retention control training by postponing urination during the day, first by a few minutes and then by gradually increased amounts of time.
Avoid taking liquids before bedtime and make sure you empty the bladder before sleeping.
Some parents have been known to spank their children for this habit but careful counsel and support has been found to be more helpful.
Drinks with caffeine such as coffee, tea and alcohol irritate the bladder. Cutting on their consumption will improve the situation.
Regular exercise like running will help strenghten thepelvic floor.
Diabetes has been found to be a common cause of bedwetting in adults. The kidneys try to lower the sugar by making lots of sugary urine, so you pass more urine in the day and during the night.
If your bladder control is poor, this could cause bed-wetting. The problem goes away when the diabetes is treated.
MAYBE doctors can tell but a small local survey on bed-wetting in adults did not yield much as everyone could not freely talk about it.
“Who will say I wet the bed,†says Mikel Mukasa, a marketing executive. “May be doctors can reveal. We tend to tell them everything but this is something one will not divulge even to a doctor,†Mukasa says.
Dr Stephen Watya, the head of Mulago Hospital’s urology department says that bed-wetting happens in adults although they see only a few patients.
Medically known as nocturnal enuresis, bed-wetting, is involuntary urination while asleep after the age at which bladder control would normally be anticipated about the age of three years.
A US survey shows that although many think of bed-wetting as a childhood problem, about 26 million American adults are affected by urinary incontinence and experts believe the number is low because many of those with urinary incontinence are too ashamed to seek help.
The study conducted by the Simon Foundation for Continence says one to two percent of those experience bed-wetting, either as an issue carried over from childhood (primary enuresis) or a secondary condition that is developed in adulthood.
Causes
Watya attributes the condition to a neurological disorder, prostate obstruction, diabetes, overactive bladder, complications from childbirth or other medical issues.
“There are many causes. It could be just a urological disease that needs medical attention like the ones mentioned above,†he says.
“It could be due to small or loose membranes around the bladder or an obstruction on the bladder.
Conditions, such as expansion of the prostate gland and neurological problems can obstruct the bladder and result in bed-wetting,†Watya says.
He adds that the problem is more common in women because there are more conditions exclusive to women that make them more susceptible like childbirth.
An Internet site on bedwetting, www.doctordvt.com, explains that lack of necessary muscle and nerve control is a common cause of bed-wetting in adults.
“Your bladder may not have developed the necessary nerve and muscle control, so the bladder muscle contracts and empties the bladder when it is only half full of urine,†it says.
“Or you could be simply producing a lot of urine at night because the mechanisms that reduce urine production at night have not developed,†it argues.
The urine infection can irritate the bladder and make it more difficult to hold urine causing bed-wetting in adults.
Gaston Byamugisha, a marriage therapist and lecturer at Kyambogo University’s department of psychology says alcohol consumption, stress, and anxiety are also associated with bed-wetting.
“Alcohol, coffee or diuretic medicines encourage the kidney to make more urine. It is best not to take a diuretic at bedtime, because you will need to pass urine in the night and, if your bladder control is poor, this could cause bed-wetting.
While some experts point at old age or a genetical condition. “In ladies who have crossed the age of menopause, the most common reason for bed-wetting is called the female urethral syndrome,†says the online encyclopaedia.
“After menopause, there is a lack of hormonal influence and the urethra becomes less compliant.
It sometime becomes more rigid and narrow and women begin to retain water the same way as men do when their prostate gets enlarged resulting into increasing obstruction to the flow of urine leading to retention of water in the urinary bladder,†it says.
Effects of adult bed-wetting
Psychologists say the habit has a significant downward impact on self esteem, social and economic outcomes.
“You may worry about staying away for the night, going on holiday, business trips, college or moving away from home.
You may not want to get into a relationship in case your new partner finds out,†says Dr. Jennifer Anger, an assistant professor of urology.
Anger says that many adults are loath to bring up the “b†word with anyone including a doctor and hide their night-time incontinence, “managing†their condition by limiting their life.
“Some end relationships rather than spill the beans about their bladder trouble; others simply avoid them altogether,†Anger says.
Byamugisha says adult bed-wetting can be a big blow to marriage.
“Bed-wetting kills self esteem and this kills marriage. You hate yourself and even those around you, including your spouse whose every comment may be interpreted as getting at you.
“But it can be treated medically or with lifestyle changes. We need to just open up,†Byamugisha says.
Watya says people should break out of their shells and seek expert advice because the problem could be much bigger than imagined.
“We advise people to confide in a doctor. We diagnose the condition and treat it accordingly,†he says.
He says no treatment option has a 100% success rate and those suffering from enuresis may have to experiment with different options to see what works best.
Deidre’s story
WHILE many tease Deidre 32, for taking forever to get married, it is only her who understands her problem-“Bed wetting,†she says, in what seems like a whisper. I have not told anyone. Not even my family.
Well, as a child, I was often spanked for wetting the bed but I am sure my parents plus siblings now think that I have outgrown the habit,†she reveals.
This fear has clouded Deidre’s life for as long as she remembers. It lowered her selfesteem as an adolescent and kept her out of ‘top socialites’ in high school because the ‘good preferred company’ often shunned her. It caused her first heartbreak and she has since developed a ‘dating phobia’.
I remember when I had to join boarding school in S.1. My mother protested and almost settled for a day school for fear that I would immensely be teased for wetting the bed. But my dad insisted on the borading school.
It helped me, but only for a while. I could hardly sleep. I starved myself took little fluids, so I could minimise the dreaded chance that I could wet the bed.
I got used to the environment, the habit returned. It was terrible carrying out my dripping mattress out of the crowded room. The first time, it was excusable.
But with time, I became a source of gossip and chose to stay my mattress while devising measures of a comfortable sleep. I would put a kaveera under my bed so it could not drip on the person sleeping below me.
However, this meant the mattress sucked all the urine and while she piled the soaked area with dry clothing for a comfortable night’s sleep, disguising the smell of urea was difficult.
She chose to share her ordeal with her friend who luckily was understanding and offered her the lower bed on the Decker.
She also helped to routinely wake her up in the night for a visit to the bathroom and the habit became an occasional torment.
But it did not exit her memory. Neither did it exit her daily life save for the fact that she mastered a way to get around it, especially when visiting; which she rarely did courtesy of the ‘night habit’.
Nonetheless, I guess it is hard to run away from ghosts.
I once had a boyfriend I loved so much. We went to a night club and stayed out late.
When we left the disco at about 3:30am, it was quite obvious that I had to spend the night over at his place because they close the campus gates at midnight. she narrates.
Since I had been to his apartment a couple of times, it was no problem. But with some alcohol and fatigue, my ‘habitual ghost lingered’ and made a comeback. I peed on the bed.
While he took it lightly the first time, he chucked me when it happened again, giving no reasons only for me to hear it from his friends. I have never recovered.
How to kick the Habit
Talk to your family doctor. Some people feel too embarrassed to talk about bedwetting. Take this article with you if you think it may help to start the conversation.
Consider alarms designed to wake you up when you start to wet which may be preferable if you are sharing a bedroom.
Practice retention control training by postponing urination during the day, first by a few minutes and then by gradually increased amounts of time.
Avoid taking liquids before bedtime and make sure you empty the bladder before sleeping.
Some parents have been known to spank their children for this habit but careful counsel and support has been found to be more helpful.
Drinks with caffeine such as coffee, tea and alcohol irritate the bladder. Cutting on their consumption will improve the situation.
Regular exercise like running will help strenghten thepelvic floor.
Diabetes has been found to be a common cause of bedwetting in adults. The kidneys try to lower the sugar by making lots of sugary urine, so you pass more urine in the day and during the night.
If your bladder control is poor, this could cause bed-wetting. The problem goes away when the diabetes is treated.