This Tuesday marks national ‘Make Your Bed’ day, which for some is an easy process. But, just how easy is making your bed when you’ve got to wash your covers every other day?
Stereotypically, we associate bedwetting with small children, yet it can affect adults too.
Don’t be tempted to hide under the covers if you suffer from bedwetting, 1 in 100 adults are affected by bedwetting at some point during their lifetime, so you’re not the only one who’s suffering.
However, the embarrassing nature of the topic can prevent you from seeking advice. If you don’t treat the problem you can miss out of life's opportunities as you are likely to worry about staying away from home, going on holiday, or going to university. It can also thwart social opportunities, such as establishing a new relationship, or cause financial problems due to consistent washing and drying of bedding and buying disposable incontinence products. Yet, in most cases, something can be done to improve your situation.
That’s why, here at Kegel8, we’re raising awareness of the problem, so you can keep your confidence high and your bed dry!
What is Nocturnal Enuresis?
Bedwetting is known as nocturnal enuresis and can occur in two ways. Primary nocturnal enuresis is the involuntary release of urine at night that develops during childhood, when bladder control has never been achieved. Secondary enuresis is determined when incontinence reoccurs after at least six months of continence (staying dry).
Nocturnal enuresis as an adult is different to experiencing it as a child, however that doesn’t stop the embarrassment of it. It’s important to remember that it is involuntary and not your fault.
What causes Nocturnal Enuresis?
Both physical and psychological conditions can lead to wetting the bed. The most common causes include:
- Hormones – The antidiuretic hormone (ADH) signals the kidneys to reduce the amount of urine produced during the evening and at night. The body normally produces more ADH to avoid nocturnal enuresis, but some people do not create the appropriate amount of this hormone at night, which leads to high urine production. In other cases, ADH is not acted upon by the kidneys, as they continue to produce the same amount of urine no matter what time of day.
- A small bladder – The physical size of the bladder isn’t actually small, instead the bladder can only hold a smaller volume of urine. This can be because the detrusor muscles (bladder muscles) are overactive and not allowing the bladder to fill fully before giving you the urge to empty. This is the case in 70-80% of patients with primary nocturnal enuresis.
- Hereditary – Bedwetting as an adult can often be a hereditary issue. There is a 77% chance of you becoming a bedwetter if both of your parents were too. If just one parents was a bedwetter, you have a 40% chance of becoming one; and these probabilities continue into adulthood. It's worth starting a conversation with your parents to see if this may be the case for you.
Other issues that can cause bedwetting in adults include:
- Pelvic organ prolapse
- Urinary tract infection
- Bladder irritants, such as caffeine and alcohol
- Prostate problems
- Obstructive sleep apnoea
- Bladder cancer
- Neurological disorders
How is the cause of Nocturnal Enuresis Diagnosed?
In most cases of nocturnal enuresis, treatment can improve or even cure the condition. Before deciding on an appropriate treatment, your doctor will want to discover what is the cause of your nocturnal enuresis. To this you will be asked to complete a bladder diary to note your symptoms. Including:
- When accidents occur - Day or night.
- Amount of urine voided - You won'e be expected to give an exact measurement, but an indication of what is little or lots for you.
- Drinking patterns (is there an influx of fluids in the late afternoon/evening?)
- What you drink - Sugary, caffeinated, artificially sweetened, carbonated and alcoholic drinks can be stimulating your need to wee more often.
- Nature of the urinary stream - Is it strong and constant, or is there difficulty initiating a void or continuous dribbling?
- Any existing recurrent urinary tract infections
- The number of wet versus dry nights - And the consistency or this to see if there is a pattern.
- Any other symptoms - Such as night sweats.
You may also be required to undergo a physical examination or a neurological evaluation for further investigation. Your urine may also be analysed to determine its contents, possibly signifying a cause for your nocturnal enuresis.
What is the Treatment for Nocturnal Enuresis?
Short-term management of nocturnal enuresis may include buying absorbent pads and underwear, or mattress covers and protectors. However, these should not be relied on for long-term relief as they do not solve the problem.
Recommended lifestyle modifications to improve or cure your nocturnal enuresis include:
- Kegel exercises – Pelvic floor exercises are often a first-line recommended treatment to prevent and treat bedwetting in adults. Strengthening your pelvic floor can increase your bladder control, preventing bedwetting episodes and allowing you to get to the bathroom in time. If you find it hard to perform manual pelvic floor exercises, try an electronic toner. The Kegel8 range of Electronic Pelvic Toners stimulate 90% of the pelvic floor muscles. Even the best manual exercises only stimulate 40%! Plus, a stronger pelvic floor can also reduce your risk of developing a pelvic floor disorder and lead to an improved sex life
- Monitoring your fluid intake – By limiting fluids in the late afternoon and evening, you can decrease the amount of urine that is produced at night.
- Waking – Randomly setting an alarm to go off during the night to wake yourself to go and urinate can help nocturnal enuresis. Keep the times random to ensure that you don't inadvertently train the bladder to empty at a certain time.
Surgical treatments for nocturnal enuresis are only considered when all other less invasive treatments have been tried for at least 6 months and have been proven unsuccessful. Some medications can be prescribed by your GP to support your treatment. Visit your GP for more advice if you are suffering.
So, rather than making your bed with frustration and nervousness about leaking, make it with excitement at the amazing orgasms you'll have with a stronger pelvic floor.
 Bladder and Bowel Community (2018) Nocturnal Enuresis [online]. Bladder and Bowel Support [viewed 03/09/2018]. Available from https://www.bladderandbowel.org/bladder/bladder-conditions-and-symptoms/nocturnal-enuresis/
 Continence NZ (2015) Adults and Bedwetting [online]. Continence New Zealand [viewed 03/09/2018]. Available from https://www.continence.org.nz/pages/Adults-and-Bedwetting/52/
 Feldman, M. (2005) Management of Primary Nocturnal Enuresis. Paediatrics & Child Health. 10(10), pp. 611-614.
 Mayo Clinic (2017) Bed-Wetting [online]. Mayo Clinic [viewed 03/09/2018]. Available from https://www.mayoclinic.org/diseases-conditions/bed-wetting/symptoms-causes/syc-20366685
 NAFC (2018) Adult Bedwetting [online]. National Association for Continence [viewed 03/09/2018]. Available from https://www.nafc.org/adult-bedwetting/
 Pruneau, C. (2016) Causes of Adult Bedwetting and How to Manage it [online]. National Association for Continence [viewed 03/09/2018]. Available from https://www.nafc.org/bhealth-blog/causes-of-adult-bedwetting-and-how-to-manage-it
 Sinha, R. et al. (2016). Management of Nocturnal Enuresis. World Journal of Nephrology. 5(4), pp. 328-338.