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Adult Bedwetting

Question:

Hi,I was wondering if you could give us an idea of where to go next ,out son has been a bed wetter all his life and is now 18,we have tried a few different things to help him but nothing has worked,the latest thing we tried was an alarm which worked for a while but now It doesn't seam to do the trick.
now that he is 18 it is very awkward for us to talk to him about it as it is very embarrassing for him we were thinking we might try hypnosis  next .

Any ideas would be great many thanks 

Answer(s):

That must be very distressing for your son, and very distressing for you to see him going through this.   Bedwetting occurs for a number of reasons.  The main three are failure to wake to a full bladder signal, Producing large volumes of urine while asleep, or a small functional bladder capacity.  To offer  the best advice the reason it is happening to him needs to be ascertained.

Firstly, get him to take a urine specimen to the doctor to rule out urinary tract infection as a contributing factor to his wetting.  It is also a good idea to get the GP to test for diabetes, just to rule it out as a cause of wetting.

Ensure he is not constipated – motions should be easy to pass, smooth, and formed.  70% of young people who are bedwetters have a great reduction in wetting once they have constipation resolved.

Does he drink regularly during the day? – this allows the bladder to fill up regularly during the day and exercise the bladder muscle thus making it work more efficiently.  Also, some drinks have an irritative effect on the bladder, making it want to empty more frequently.  Main drinks that do this are fizzy (particularly Coke and energy drinks), concentrated fruit juices, coffee, alcohol.

Is he able to delay the urge to void for two to three hours through the day? – urgency and frequency are symptoms of an overactive bladder which the GP can prescribe a medication for a time.

Can he measure how much urine he passes, not after “holding on” but with a feeling of needing to go to the toilet.  He should measure about 400 – 500ml.  If well below this, get him to do some bladder retraining – full drink 2 hourly throughout the day, and toilet two – three hourly.  It is common in young people to wait until they are thirsty before drinking, so the bladder just doesn’t get the exercise it needs and shrinks.

Enuresis alarms are great,  but there can be a relapse rate.  Perhaps after he has done some bladder retraining and gotten his bladder to hold the right amount, it may be worth reintroducing the alarm.

Hypnosis does work for some people, but not a lot.

Resolving the bedwetting can take some months, but the more committed he is to trying the abovementioned the sooner he will be on track with becoming dry.  If no changes (ie. Volume of wetting decreasing, unable to delay toileting during the day) contact your local continence service.  They are generally run through the DHB and are free.  They will be able to offer more advice.