Bed-Wetting in Adults

A lot of folks think bed-wetting is something that only happens to kids, but it's a problem that can hit grown-ups, too. You may feel embarrassed to wake up to wet sheets, but it's not your fault. It could be due to a medical condition, medicine, or a problem with your bladder. You've got lots of ways to fix it.

Causes

If you start wetting the bed as an adult, see your doctor. You may hear him call your problem nocturnal enuresis, which is the medical name of the condition. Some of the reasons it may be happening to you:

Your kidneys make more pee than normal. A hormone called ADH tells your kidneys to make less urine, and you normally make less of this hormone at night. When you have bed-wetting issues, you may not make enough of this hormone or your kidneys might not respond well to it.

A form of diabetes called diabetes insipidus also affects ADH levels, causing you to make more urine.

Your bladder can't hold enough urine. When there isn't enough room in your bladder, pee can leak.

Overactive bladder (OAB). Your bladder muscles normally squeeze when you're ready to pee. In OAB, these muscles squeeze too often or at the wrong times.

Medicine. Some drugs you take can irritate your bladder, such as sleeping pills or antipsychotics like:

Your bed-wetting may also be due to conditions that affect your body's ability to store and hold urine. For instance, bladder cancer and prostate cancer can cause it. So can diseases of the brain and spine, such as a seizure disorder, multiple sclerosis, or Parkinson's disease.

Some other possible causes are:

How Is Bed-Wetting Diagnosed?

Your doctor will do an exam and ask about your symptoms and health history. Keep a diary so you'll have the answers to his questions. Write down things like:

  • How often and what time your bed-wetting happens
  • How much urine comes out (a lot or a little)
  • What and how much you drank before bed
  • Any other symptoms you've had

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Your doctor will do tests to diagnose the problem, such as:

Urinalysis. It checks a sample of your urine to look for an infection or other conditions of the urinary tract -- the collection of organs that are involved with urine like the kidneys, ureters, bladder, and urethra.

Urine culture. Your doctor sends a small sample of your urine to a lab, where technicians put it in a special dish with nutrients. This test looks for bacteria or yeast in your urine. It can diagnose a urinary tract infection.

Uroflowmetry. You pee into a special funnel to measure how much urine you make and how quickly it flows out.

Post-void residual urine measurement. This test measures how much urine is left in your bladder after you pee.

How Do You Treat Bed-Wetting?

Your doctor may suggest you start by making a few changes to your daily and nightly routines:

Try bladder retraining. Go to the bathroom at set times during the day and night. Slowly increase the amount of time between bathroom visits -- for example, by 15 minutes at a time. This will train your bladder to hold more fluid.

Don't drink right before bed. That way, you won't make as much urine. Avoid caffeine and alcohol, which can stimulate your bladder.

Use an alarm clock. Set it to wake you up at regular times during the night so you can use the bathroom.

Try a bed-wetting alarm system. You attach it to your underwear or a pad on your bed. It will alert you as soon as you start to wet the bed.

Take medicines. Several can help with bed-wetting. Desmopressin (DDAVP) reduces the amount of urine your kidneys make.

Other drugs calm overactive bladder muscles, such as:

If medicines and other treatments don't work, your doctor might recommend one of these procedures:

Bladder augmentation. It's an operation that makes your bladder larger, which raises the amount of urine it can hold.

Sacral nerve stimulation. It helps control an overactive bladder. Your doctor puts a small device into your body that sends signals to nerves in your lower back that help control the flow of urine.

Detrusor myectomy. It's a major operation that treats an overactive bladder. Your surgeon removes part or all of the muscles around your bladder to stop them from contracting at the wrong times.

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Tips to Deal With Wetness

Until you can get bed-wetting under control, take some simple steps to manage the situation:

  • Put a waterproof cover or pad over your mattress or sheets to keep them dry.
  • Wear absorbent underwear or pads to bed.
  • Use special skin cleansing cloths and lotions to prevent your skin from getting irritated.

If you try one treatment and it doesn't work, go back to your doctor. Sometimes it takes a few tries to find the right solution to bed-wetting.

WebMD Medical Reference Reviewed by Jennifer Robinson, MD on January 31, 2019

Sources

SOURCES:

American Association for Clinical Chemistry: "Urine culture," "Urinalysis."

Bladder and Bowel Foundation: "Detrusor Myectomy."

Dartmouth-Hitchcock: "Sacral Nerve Stimulation Therapy."

Journal of Urology: "Long-term followup of children with nocturnal enuresis: increased frequency of nocturia in adulthood."

Mayo Clinic: "Bed-wetting: Definition," "Diabetes insipidus: Symptoms and causes," "My 24-year-old husband has started to wet the bed at night. What causes adult bed-wetting? Should we be concerned about this?"

National Association for Continence: "Adult Bedwetting," "OAB Prescription List."

UCSF Health: "Bladder Training."

Urology Care Foundation: "What is Bladder Augmentation?"

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