Help! My husband wets the bed

May 23, 2012

Tomorrow, my husband and I will mark our fifth anniversary. Our marriage is good and I love him so much. However, sometimes he wets the bed and when this happens, he holds back and does not want to talk about it

Tomorrow, my husband and I will mark our fifth anniversary. Our marriage is good and I love him so much. However, sometimes he wets the bed and when this happens, he holds back and does not want to talk about it. Every time this happens, I fear to take the mattress out to dry because I will give the neighbours something to talk about. I want to help him overcome the problem without embarrassing him. What can I do?   
 
By Joyce Nyakato
 
Occasionally adults sleep soundly at night, only to wake up soaked in urine. When this becomes frequent, it is cause for concern.
 
Bed-wetting which starts in adulthood is rare, but requires medical evaluation, experts say. For obvious reasons, adult bed-wetting is not a subject that invites open discussion. It is more of a skeleton-in-the-closet condition, which means many sufferers could be missing out on treatment. 
 
“When an adult constantly wets the bed, he is likely to feel embarrassed about it and, therefore, miss out on help,” says Dr. Wilberforce Kabweru, a general practitioner. “Few adults will admit they have the problem.”
 
Categories
Bed-wetting, also termed as nocturnal enuresis, can be categorised as primary and secondary, Kabweru explains. 
In the primary stage, a person has never been dry (has always wet the bed), while for secondary, an adult starts all over again after having stayed dry. 
 
Whether adult bed-wetting occurs suddenly or develops gradually, it is something that should not be taken lightly. It could be a symptom of an underlying medical condition. 
 
Cause
If bed-wetting begins suddenly in adulthood, it is normally a result of an underlying condition such as diabetes or heart failure, Kabweru warns. 
 
Adult bed-wetting can also result from weakness of the sphincter, the muscles that control the exit of urine in the urinary bladder through the urethra. In rare circumstances, a problem in the prostate, the gland surrounding the neck of the bladder, or bladder, can spark off bed-wetting. If a man has an infection in the prostate, he may end up leaking urine because the biggest sphincter control in that area is impaired.
 
In addition, if someone has a spinal cord injury, his nervous system is likely to be damaged. 
Usually, a message is sent from the brain when the bladder needs emptying. However, when the spine is damaged, one may not feel the urge to urinate, yet once the bladder is full, it empties itself.  
 
Majority of patients have very loose sphincter muscles. The muscles may not be able to hold urine for a long time, thereby causing incontinence (leaking), Kabweru, clarifies.
 
Women, who have been victims of obstructed labour, or developed a fistula (a severe medical condition in which a hole develops between either the rectum or the bladder and vagina), are likely to wet the bed because they tend to suffer from sphincter muscle damage due to vaginal birth. 
 
Also, after childbirth, some women, are likely to have their sphincter muscles weakened and may not be able to hold in urine for long, says Dr. Eve Nabunya, a gynaecologist at Mulago Hospital. 
 
Urinary tract infections too, are known to cause urge incontinence, a condition where one leaks urine immediately they feel the urge, but cannot empty the bladder. 
 
In cases where the victim, is a heavy sleeper and cannot immediately satisfy the urge to empty the bladder immediately, they will also leak. 
 
Deep sleepers also lose control of the muscles that would normally prevent them from passing urine during the night because they do not respond to the normal mental triggers that wake most adults when the bladder is full.
 
The pituitary gland produces an antidiuretic hormone. Normally, this hormone is produced in vast amounts at night to reduce the amount of urine produced, so that we are not woken by the urge to use the toilet. “Without an adequate amount of this hormone, urine production continues as normal, increasing  the risk of bed-wetting,” Kabweru adds.
 
Abnormally large production of urine can also cause bed-wetting. Increase in fluid intake, especially water, diuretic foods and beverages (containing caffeine) and diabetes mellitus increase urine production.
 
Diuretic drugs, usually prescribed for treatment of heart failure, liver cirrhosis, hypertension and certain kidney diseases, lead to high doses of urine production, increasing chances of bed-wetting.
 
Too much alcohol intake also increases urine production, which inhibits the anti-diuretic hormone from functioning fully. And since one is likely to be unconscious, he is likely to pass a lot of urine.
 
Treatment
Because people who wet their beds may suffer emotional stress or psychological injury, they should seek counselling.
Without diagnosis, drugs are unlikely to be beneficial, therefore, it is important for a doctor to know the cause.
 
One can also exercise. Nabunya recommends kegel exercises to aid bladder control. Pelvic muscle exercises can decrease urine leakage, urine urgency and frequency.
 
Prevention/coping tips
-Avoid sugary, caffeinated, artificially sweetened and carbonated drinks
 
-Limit alcohol intake
 
-Deal with urinary tract infections as soon as possible
 
-Time your drinks
 
-Set an alarm to wake you up in intervals so you can empty your bladder.
 
 

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