It was a really embarrassing situation for my friend. Someone that does not drink nor party, slept for the first time in my house and here we are at early dawn spreading the mattress in anticipation of the sun. A really strange thing happened overnight, my long time friend bed-wetted, that is, he involuntarily urinated on the bed overnight! What could have happened that a 20 year old man bed wets? It was really awkward for me to ask him such question. So I secretly did a little research and what I found was absolutely eye opening for me. I became medically more enlightened and this is what I wish to share with my readers tonight (it's 9:52pm here by the way).

Enuresis: The science of bed-wetting

Enuresis is medically simplified as the inability to hold urine, otherwise known as involuntary urination. It could be diurnal when this inability happens during the day or nocturnal when the involuntary urination happens during the night while the subject is sleeping. In order to fully understand enuresis, it is essential to have a little understanding of how the bladder works.

The bladder is an organ that is primarily responsible for storing urine in the body. It stores urine until the body system signals its release into the urethra, a tube-like structure that leads to the outside of the body. When the body signals, the bladder contracts and the muscle of the bladder holding the urine in place relaxes and opens up for the urine to pass out of the body. Any disruption to the signal processing can make urination to become mistimed or difficult, a situation that can lead to enuresis.

Types and causes of enuresis.

Basically, there are two types of enuresis - the one that follows infancy when the baby is yet to learn the art of controlling its bladder, which is also known as primary enuresis and the ones that develops after six months or several years of birth during which the subject would have learned to control his/her bladder, known as secondary enuresis. I am sure my friend was suffering from the latter.

There are many known causes of enuresis which include medical, hormonal, sleeping pattern and psychological causes. In the case of secondary enuresis, the first place to check is family history. Statistics have shown that adult enuresis could be heritable. A patient suffering from medical disorders or diseases such as diabetes, constipation and urinary tract infections also have a higher chance of developing secondary enuresis. The antidiuretic hormones (ADH) helps in the concentration of urine during the night to reduce the chances of filled bladder and hence, an uninterrupted sleep. An inability to produce enough of this antidiuretic hormones can lead to the bladder becoming filled at intervals during sleeps and hence a higher chance of wetting the bed before dawn. In addition, a very deep sleeper might find waking up to empty his/her bladder too demanding and resort to bed wetting while psychological disorders such as stress from being bullied, death of close ones or family tension among many others have also been recorded to cause the phenomenon.

Treatment/management of enuresis

The disorder has a wide variety of management/treatment. Some of the management methods include wearing absorbent briefs and using water proof mattress covers and behavioural modifications such as monitoring fluid intakes, using a bedwetting alarm system and randomly waking up the individual to go and empty his/her bladder in the case of nocturnal enuresis. Treatment include surgical procedures as well as pharmaceutical prescription such as demopressin that works by making the kidney to produce less urine, oxybutynin, tolterodine, trospium chloride and solifenacin.

Trivial: The friend of mine in this write up happens to be someone that is quite promiscuous with multiple sex partners. Can you guess what caused his own enuresis and how we were able to get solution to it?
Hint: He got completely cured of the disorder!

References

nafc
reflexology
science20
medical news
medicinenet
mayoclinic
bedwettingstore

Image Credit

reflexology
webmd
flickr