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Dr. Arun Phophalia
Dr. Arun Phophalia, Doctor (MD)
Category: Health
Satisfied Customers: 29874
Experience:  MBBS, MS (General Surgery), Fellowship in Sports Medicine
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Is there treatment or a cure for adult bedwetting? The bedwetting

Resolved Question:

Is there treatment or a cure for adult bedwetting? The bedwetting that continues on from childhood? What are the causes of continued bedwetting and is it permanent? If the person has been traumatized over and over throughout childhood and teenage years and early adulthood, will the bedwetting stay permanently with that person as a psychological disorder? Also to add, the person has chiropractic issues. The spine is 19 degrees to the right and 10 degrees extra concaved, and the neck has a curvature of only 3 degrees instead of normal 35 degrees. The said person is a 25 year old female, me.
Submitted: 2 years ago.
Category: Health
Expert:  Dr. Arun Phophalia replied 2 years ago.

Hello Isabella,

 

I am sorry that your question was not unanswered for long.

 

Despite the long traumatic experience in childhood and early adulthood, a proper treatment is likely to resolve the issue. Thus it is not permanent. The causative factors are not much different than the childhood bed wetting.

 

Following are the causes for bed wetting termed as enuresis;

 

1) constipation

2) night time increased frequency (termed nocturnal polyuria)

3) nocturnal decreased capacity of the bladder

4) diabetes mellitus; if there is a family history

5) idiopathic; when no cause is ascertained

 

Two major intervention can be done;

 

1) practicing the increased urine holding time in the day.

2) limiting the fluid 3 hours before bed time and voiding immediately before going to the bed (which you are already doing).

 

You may also be given a trial with Flavoxate (Urispas), which is an oral medicine. This decreases the bladder spasm. If this is not effective than the trial is given to Desmopressin and alarm system with the above measure. If these medications / measures too are not effective; an examination by a urologist and following investigations may be contemplated;

 

Voiding cystourethrography

Urodynamic studies and cystoscopy

MRI of the spine

Uroflowmetry
The urodynamic studies needs to be performed during sleep, if not done already. This can demonstrate whether there is abnormal pelvic floor activity during the sleep. Usually this is diagnostic. Urodynamic studies during sleep demonstrate a relationship between nocturnal enuresis and pelvic floor activity. When pelvic floor activity increases in association with detrusor (bladder muscle) contractions, wetting is usually avoided, and the individual would often awaken subsequently to void. In contrast, when pelvic floor activity did not increase, the detrusor contraction (bladder muscle) usually is associated with a wetting episode. Whether abnormally deep sleep contributes to enuresis is not substantiated. Unrecognized underlying medical disorders like, sickle cell disease, diabetes mellitus, diabetes insipidus, hyperthyroidism also needs to be looked for by the blood investigations. Delayed bladder maturation, small functional bladder capacity, diminished vasopressin release, and poor arousal from sleep (alone or in combination) may contribute to nocturnal enuresis (bed wetting).

 

Please feel free for your follow up questions.

I would be happy to assist you further, if you need any more information.

 

We have recently implemented a new rating and feedback system. Please be aware that you are rating my courtesy and service as a professional. If you have any questions whatsoever, or there is anything I can clarify for you, please temporarily bypass the rating system by clicking “Continue the Conversation” or "Reply."

Clicking either of the lowest two options reflects poorly on me so please reply to me if there is anything else I can do to help before choosing those options. I appreciate your patience while we work out the kinks. It's important to me that you are 100% satisfied with the service I have provided you. Thank you.

Customer: replied 2 years ago.

Hi, thank you for your feedback. I am very impressed with your knowledge. I sometimes drink fluids before bed. But i think my problem too is i rarely take in fluids during the day. Sometimes going a few days without water. I take in typically less than half gallon of fluids a day, usually a glass a day. I have not tried any medicine or went to a doctor about it aside from chiropractor. I also suffer from nightmares every night. Maybe that is also contributing to the problem, but lately i feel like i don't dream anyore because i recently stopped remembering my dreams. I aso lately have a hard time falling asleep, taking me 1-2 hours to fall asleep. So i end up sleeping heavy on those nights.and sometimes i sleep light and feel when i have to go. Also i experience frequent day time urination only to pee a few drops and feel sensation to go after just using toilet. I've only had a UTI twice in my life, last time was this past spring and year before.

Expert:  Dr. Arun Phophalia replied 2 years ago.
You are very welcome, Isabella. Thanks for your kind words.

The traumatic experiences in past sometimes may cause a condition called as post traumatic stress disorder, which may be responsible for nightmares or sleep issue. Most important in your case would be relaxation techniques, drinking more water in day time and training your bladder for increased voiding time and not drinking water in evening. These should be able to resolve your symptoms.

It is privilege assisting you.

Dr. Arun
Customer: replied 2 years ago.

Dear doctor Arun,


Just wanted to say how truly pleased i am with your help and knowledge. I wish you were my pcp. From all the doctors ive had over the years, they never really seem to know how to help me or tell me what the problem is when i have told them about my other issues like piercing chest pain where the heart is, sometimes getting pain on other side of chest, spasms in my limbs and stomach, trouble remembering what i did the day before or even that day. I even feel like im getting early signs of arthritis most likely because of my atlas bone being crooked and compressing my nervous system. But what scares me the most is i fear i might get Alzheimer's at a young age. I heard symptoms can start as early as 30 years before the actual diagnosis. I'm a car wreck. And I'm very certain with all my health problems i will die at a young age, maybe 50 or 40. I can't see myself reaching old age when since the age of 11 i felt very old. I feel like an 80 year old. Plus to boot ihave horrible vision, and have a hard time hearing out of my left ear. Hurts to stand sometimes, can't stand for long period of time. Any advice doctor? You are the best in the world.

Expert:  Dr. Arun Phophalia replied 2 years ago.
Thanks Isabella for your kind words.

Some of your symptoms are likely due to post traumatic stress disorder. Some may be due to organic cause and will warrant following investigations;

1) Complete blood count,

2) Erythrocyte sedimentation rate,

3) Thyroid function tests,

4) Muscle enzymes;

5) Anti-nuclear antibodies (ANA)

6) Adrenal function test

7) Anti-dsDNA

8) Anti-Sm

9) Anti-SSA (Ro) or Anti-SSB (La)

10) Coombs test

11) Anti-histone

 

A consultation with either a rheumatologist or a clinical immunologist and an endocrinologist would be prudent. Fibromyalgia, autoimmune arthritis, hypothyroidism can be responsible for your symptoms. None of them decrease the life span, and have good treatment available.

 

Dr. Arun

Customer: replied 2 years ago.

Hi doctor, i just have one short final question, probably stupid question but, once i give you awesome feedback, will i still be able to see your replies and feedback to have and look at whenever i need to?


 


Thank you again doctor. You have my ultimate respect. You truly are a doctor.

Expert:  Dr. Arun Phophalia replied 2 years ago.
Sure, Isabella, this thread would be open for you always. So you can ask follow up questions anytime.
Dr. Arun Phophalia, Doctor (MD)
Category: Health
Satisfied Customers: 29874
Experience: MBBS, MS (General Surgery), Fellowship in Sports Medicine
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