What Happens In Enuresis
There are two kinds of enuresis:
- Someone with primary nocturnal enuresis has wet the bed since he or she was a baby. This is the most common type of enuresis.
- Secondary enuresis is a condition that develops at least 6 months or even several years after a person has learned to control their bladder.
The bladder is a muscular receptacle, or holding container, for pee . It expands as pee enters and then contracts to push the pee out.
In a person with normal bladder control:
- Nerves in the bladder wall send a message to the brain when the bladder is full.
- The brain then sends a message back to the bladder to keep it from automatically emptying until the person is ready to go to the bathroom.
But people with nocturnal enuresis have a problem that causes them to pee involuntarily at night.
Find Out Why Your Bladder Wont Stop Leaking
Urine leakage is inconvenient and embarrassing. Involuntary bladder leaking is called urinary incontinence , and it is a common problem for adult males. UI is not a disease but rather a symptom that something is going on with your bladder or urinary tract.
While the signs and symptoms of male incontinence are pretty similar for most men, you need to know whats causing your bladder incontinence to formulate a plan to treat it. In this article, we delve into five common causes of bladder incontinence in males so you can find out whats causing unexpected dribbling.
Fast Facts On Urinary Incontinence
- Urinary incontinence is more common in females than in males.
- There are a number of reasons why urinary incontinence can occur.
- Obesity and smoking are both risk factors for urinary incontinence.
Urinary incontinence is when a person cannot prevent urine from leaking out.
It can be due to stress factors, such as coughing, it can happen during and after pregnancy, and it is more common with conditions such as obesity.
The chances of it happening increase with age.
Bladder control and pelvic floor, or Kegel, exercises can help prevent or reduce it.
Treatment will depend on several factors, such as the type of incontinence, the patients age, general health, and their mental state.
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Surgical Treatments For Ui
Bladder control surgery to treat stress incontinence is available and works by giving more support to the urethra. The support keeps you from leaking when pressure is put on your bladder or your urethra, putting you in control of when its time to go. There are also procedures available to treat urge incontinence.
Our doctors will help to decide if a procedure or surgery is the best option for you and will walk you through how it works as well as answer any questions you may have.
Urinary Incontinence In Men
Urinary incontinence is not purely a womens issue. Statistics may indicate that this condition affects women more often, but it is a symptom that affects millions of men around the world.
Sometimes, stress incontinence and urge incontinence are related to prostate hyperplasia or its treatments.
Of course, many male patients who have undergone definitive prostatectomy or cystectomy experience the problem of urinary incontinence. In particular, according to a study published in the journal of the American Medical Association, urinary incontinence after removal of the prostate can last from a few weeks to 18 months.
In addition, nocturnal enuresis is a phenomenon that particularly concerns men after 45 years. It is most often due to hormonal changes, benign prostatic hyperplasia and heart disease. However, because some elderly men are unable to wake up, even when there is an urgent need to urinate, due to various poreparations, they urinate in their bed, hence the term urinary incontinence.
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What To Think About
Many men who have urge incontinence or overflow incontinence also have an enlarged prostate gland . They may want to talk to a doctor about medicine, surgery, or other treatment to relieve their symptoms. For more information, see the topic Benign Prostatic Hyperplasia .
Urinary incontinence can be a problem following treatment for prostate cancer, including radiation therapy and removal of the prostate.
Treatment will be different for men who have total incontinence or who cannot comply with or tolerate specific treatments because of a serious illness or disease.
Urinary Incontinence In Women
It is estimated that at least 1 in 10 women between the ages of 40-65 and 3 in 10 women over the age of 65 experience the specific symptom of urinary incontinence.
It is often caused by specific changes in the bodys function that may result from the use of drugs and/or the onset of an illness. Most of the time it is the first symptom of a urinary tract infection. In addition, women are more likely to develop urinary incontinence during pregnancy, where the increasing weight of the fetus can lead to stress urinary incontinence.
Also, childbirth may bring about a series of changes in the muscles, nerves and supporting tissues of the bladder, eventually leading the woman to an inability to control the bladder, resulting in involuntary loss of urine.
Finally, the hormonal changes observed during the menopause and the general reduction of estrogen in the body result in the abnormal retention of the bladder and urethra resulting in progressive urinary incontinence.
It is worth noting that some women also experience urinary incontinence duringintercourse, due to pressure exerted on the urethra and bladder, as well as due to weakness of the muscles of the pelvic region.
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What Are The Variations Of Male Incontinence
There are six different types of urinary incontinence that can affect men.
Urgency incontinence: you feel a sudden urge to urinate that is followed by accidental leakage
Stress incontinence: leakage occurs as a result of quick movements or pressure like coughing or sneezing.
Overflow incontinence: leakage occurs because of a full bladder
Transient incontinence: this is usually the result of a temporary infection in the urinary tract or a side effect of medication
Functional incontinence: obstacles or physical disabilities keep you from getting to the bathroom in time, and accidental leakage occurs
Mixed incontinence: when the cause of your incontinence falls under two or more of the above types
Dementia And Changes To The Lower Urinary Tract
Dementia is an umbrella of neurodegenerative disorders which cause degeneration of the CNS. The Alzheimers Disease Association estimated that currently, there are 46.8 million people living with dementia worldwide and this number will double every 20 years to 74.7 million in 2030 and 131.5 million in 2050. Much of this increase will be in the developing world.
Central control of detrusor activities includes the frontal cortex, basal ganglia, Pontine Micturition Centre. The central control provides an inhibitory input on the detrusor to reduce contractions during the bladder filling phase. Dementia, particularly vascular dementia, normal pressure hydrocephalus, Frontotemporal lobe dementia, Alzheimers Disease present with features of detrusor over-activity where urgency is the main symptom. Among the elderly with Alzheimers disease, urge incontinence is the commonest presentation and UI is proportional to the dementia severity and impairment of ADLs .
Diffuse Lewy Body Dementia , Multisystem atrophy, Parkinsons Disease Dementia and AD have additional component of autonomic dysfunction, in addition to the central causes. The autonomic dysfunction presents with detrusor over-activity as the main type of UI. The synuclein deposition in PDD and DLBD is present in central nervous system and postganglionic sympathetic nerves .
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Bladder Anatomy And Physiology
The anatomy and physiology of the bladder are complex, but a basic understanding of these topics is essential in order to appreciate the various types of UI and their management., illustrates the basic anatomic structures and nervous system wiring involved in bladder function, including the detrusor muscle, the internal and external sphincters , and their neurological components.
Bladder anatomy and physiology.
Reduced activation of the sympathetic nervous system results in relaxation of the detrusor muscle, closure of the sphincter, and bladder filling. When the volume of urine in the bladder reaches 200 to 400 mL, the sensation of urge to void is relayed via the spinal cord to the brain centers. Voluntary voiding involves the parasympathetic nervous system and the voluntary somatic nervous system. Influences from these systems cause contractions of the detrusor muscle and corresponding somatic nervous activity, leading to sphincter relaxation.
Incontinence Support Treatment And Education
Bladder or bowel leaks won’t get better on their own, and if ignored, they might even get worse. But the good news is there are a number of relatively easy things you can do to treat or manage the condition and improve your quality of life. And the first step is consulting your healthcare provider for an assessment and plan of action.
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Reach Out For Support
If you’re always anxious about leaking, you can start to feel worn down. Your social life may suffer. You may not even want to leave the house. If this is what your life has become, you can change that. Look for a support group or a therapist. Or go back to the doctor and see if there’s something different you can try. Remember, incontinence is almost always treatable.
Things You Can Buy To Help
If you find that you still have trouble throughout the night, it might be time for some professional help. We can examine you and prescribe medication to help you release all your urine prior to bed. We can also prescribe medication to relax your bladder compressions. If you are wetting the bed, a bedwetting alarm will wake you up at the first drop so you can hop out of bed and head to the bathroom.
If you still have trouble, its time to take a deep breath and, without feeling ashamed because you are not alone, purchase a plastic mattress cover and urinary incontinence briefs or pads. Dont be embarrassed. Millions of Americans suffer from urinary incontinence. Its normal for us to lose control of our bladders as we age and these products protect our mattresses and night clothing from urination.
Eagles Landing OB/GYN would be happy to discuss your concerns over urinary incontinence. Call our medical facility in Stockbridge, GA, at 770-474-1919 to set up an appointment with one of our medical professionals. Well help you stay dry throughout the day and at night.
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Causes Of Stress Incontinence
Stress incontinence is when the pressure inside your bladder as it fills with urine becomes greater than the strength of your urethra to stay closed. Your urethra is the tube that urine passes through to leave the body.
Any sudden extra pressure on your bladder, such as laughing or sneezing, can cause urine to leak out of your urethra if you have stress incontinence.
Your urethra may not be able to stay closed if the muscles in your pelvis are weak or damaged, or if your urethral sphincter the ring of muscle that keeps the urethra closed is damaged.
Problems with these muscles may be caused by:
- damage during childbirth particularly if your baby was born vaginally, rather than by caesarean section
- increased pressure on your tummy for example, because you are pregnant or obese
- damage to the bladder or nearby area during surgery such as the removal of the womb , or removal of the prostate gland
- neurological conditions that affect the brain and spinal cord, such as Parkinson’s disease or multiple sclerosis
- certain connective tissue disorders such as Ehlers-Danlos syndrome
- certain medicines
Causes Of Urinary Incontinence
Stress incontinence is usually the result of the weakening of or damage to the muscles used to prevent urination, such as the pelvic floor muscles and the urethral sphincter.
Urge incontinence is usually the result of overactivity of the detrusor muscles, which control the bladder.
Overflow incontinence is often caused by an obstruction or blockage in your bladder, which prevents it from emptying fully.
Total incontinence may be caused by a problem with the bladder from birth, a spinal injury, or a small, tunnel like hole that can form between the bladder and a nearby area .
Certain things can increase the chances of urinary incontinence, including:
- pregnancy and vaginal birth
Find out more about the causes of urinary incontinence.
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Pad And Underwear Options
The product you choose should depend on your symptoms. For severe urinary incontinence, the ideal choice may be highly absorbent guards or disposable underwear. Guys with milder symptoms may need less protection. Drip collectors are disposable padded sheaths that go around the penis they’re good for slight leaking or dribbling. Pads can be tucked into underwear and attached with adhesive tabs. They’re designed for light to moderate leaking.
We Heard You Incontinence Affects Men Too Heres What You Need To Know
- By Matthew Solan, Executive Editor, Harvard Men’s Health Watch
As men age, the simple act of urinating can get complicated. Prostate surgery often leaves men vulnerable to leakage when they cough, sneeze, or just rise from a chair. Or the bladder may become impatient, suddenly demanding that you find a bathroom right now. Thousands of years ago, it was not as much of an issue, observes Dr. Anurag Das, a urologist at Harvard-affiliated Beth Israel Deaconess Medical Center. There were lots of trees, and you could just find one and go.
But tricky bladders can be whipped into shape. The first step is a careful assessment of what triggers those difficult moments. Often your doctor can suggest helpful strategies and possibly medication to improve urinary control.
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Prevalence And Type Of Urinary Incontinence
The prevalence of UI according to age is shown in . The overall prevalence of UI was 14.8%, increasing from 12.0% for the men aged 7074 years old to 26.3% among men 8589 years old but reduced to 16.3% for those aged 90 years old .
Urgency incontinence was the most frequent type of urinary incontinence, with 20% of men reporting leaking urine before getting to the toilet . About 10% of men experienced post-micturition dribbling and 5% of men reported leaking urine for no obvious reason. Three percent of men reported using pads or other incontinence aids.
Analysis of the data from the ICIQ showed that the frequency of urine leakage was strongly correlated with the quantity of urine leaked . Both frequency and quantity of urine leakage were strongly correlated with the self-perceived impact on daily life rating in the ICIQ. Among those defined with UI, 12.6% reported a score over 5 on the self-perceived impact on life scale . The overall ICIQ summed score in all men in CHAMP ranged from 0 to 18 , with a median score of zero, the first quantile was zero and the third quantile was three.
When Is Enuresis A Problem
Many children may have enuresis from time to time. It can take some children longer than others to learn to control their bladder. Girls often have bladder control before boys. Because of this, enuresis is diagnosed in girls earlier than in boys. Girls may be diagnosed as young as age 5. Boys are not diagnosed until at least age 6.
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Finding Help For Male Incontinence Starts With You
Learning how to treat male incontinence starts by taking care of yourself as you age. Men in different stages of life are prone to certain health issues that can be prevented if you are proactive now. Know how to take charge of your own health with our Mens Guide to Healthy Aging.
This blog post was originally published in 2015 and was refreshed in 2020.
Medications For Urinary Incontinence
If medications are used, this is usually in combination with other techniques or exercises.
The following medications are prescribed to treat urinary incontinence:
- Anticholinergics calm overactive bladders and may help patients with urge incontinence.
- Topical estrogen may reinforce tissue in the urethra and vaginal areas and lessen some of the symptoms.
- Imipramine is a tricyclic antidepressant.
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What Are The Treatments For Urinary Incontinence
Treatment depends on the type and cause of your UI. You may need a combination of treatments. Your provider may first suggest self-care treatments, including:
- Lifestyle changes to reduce leaks:
- Drinking the right amount of liquid at the right time
- Being physically active
- Staying at a healthy weigh
- Avoiding constipation
- Not smoking
If these treatments do not work, your provider may suggest other options such as:
- Medicines, which can be used to
- Relax the bladder muscles, to help prevent bladder spasms
- Block nerve signals that cause urinary frequency and urgency
- In men, shrink the prostate and improve urine flow
How Urinary Incontinence Works In Men
Urinary incontinence means the accidental or involuntary loss of urine from the bladder. Many cases involve slight dribbling. The most common types are urge incontinence and stress incontinence. The usual causes of urge incontinence in men are involuntary contractions of the bladder muscles . This is sometimes related to long-term blockage from an enlarged prostate. You feel the urge to go but you start leaking before you make it, Dr. Das says. It could be a few drips, or it could be a larger amount if you cant find the bathroom in time. Many men notice that certain triggers set off their urge incontinence, such as hearing running water, entering a cold room, rising after sitting, or even just inserting the key in your homes door lock.
Stress incontinence refers to urine leakage that occurs when coughing, sneezing, lifting a heavy object, or other activity. In men, this is usually caused by problems in the rings of muscle, or sphincters, that squeeze closed to seal off the bladder.
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