Urinary incontinence in adults - signs, treatment. How to cure nocturnal or daytime enuresis in an adult man

Enuresis is uncontrolled urination during the day or at night. When this pathology appears, the quality of life of patients decreases significantly. Adult patients long time hide their problem from relatives and doctors. Enuresis in adult men occurs due to pathology prostate gland.

Therapeutic measures for enuresis give positive results thanks to an integrated approach. This allows the patient to return to normal life.

Etiology of enuresis in adults

The causes of enuresis in adults differ from those in children.

IN childhood Enuresis is provoked stressful situations(divorce of parents, death of relatives, severe fear).

In adults they secrete following reasons diseases:

  • operations in the pelvic organs;
  • injuries;
  • endocrine diseases ( diabetes and obesity);
  • sexually transmitted infections;
  • nervous tension;
  • medications that can cause enuresis;
  • muscle weakness pelvic floor;
  • neoplasms of the prostate gland in men;
  • postpartum period, menopause in women;
  • hereditary predisposition;
  • alcoholism.

Elderly patients are more susceptible to enuresis, as there is a decrease in the concentration of sex hormones and the contractile function of the pelvic floor sphincters. In elderly patients it is provoked by brain tumors and Alzheimer's disease. And also the causes of pathology are diseases of the central nervous system.

Men are more likely to suffer from enuresis. Scientists have proven the existence of a causal relationship between children and adult forms enuresis.

Types and symptoms of enuresis

Doctors distinguish three classifications of enuresis:

Symptoms of enuresis

The disease is manifested by the presence of urinary incontinence in the patient at night or during the day. The patient becomes less sociable and secretive. Patients experience urine leakage before urge and pain in the lower abdomen.

Associated symptoms:

  • heart rhythm disturbance (bradycardia);
  • bluish, cold extremities;
  • hypothermia or hyperthermia;
  • weakness, drowsiness;
  • cloudy urine, presence of blood clots in it.

Nocturnal enuresis in adults it manifests itself as uncontrolled night urination. With this type of pathology, the patient loses the awakening reflex when the bladder is full.

Diagnostic measures

The first step in diagnosing urinary incontinence is an examination by a general practitioner, gynecologist or urologist. The doctor collects a detailed history of the disease. He specifies the time, frequency, nature of urination, and the presence of pain. It also determines the amount of fluid you drink during the day and before bedtime.

The doctor writes down information about heredity and childhood diseases, and also palpates the prostate gland in men. The gynecologist performs an examination on the chair, takes smears from the vagina and. The patient passes general analysis blood and urine, keeps a diary of urination.

The next step in examining the patient is uroflowmetry. During the procedure, the rate, time of excretion and volume of urine are recorded.

The patient is given ultrasonography to determine the amount of residual volume in bladder, provoking spontaneous urination during the next urge. The doctor recommends an ultrasound scan of the kidneys and prostate gland (for men).

If necessary, the doctor prescribes x-ray examination kidneys, bladder with contrast agent to determine their excretory function.

To assess the condition of the mucosa and identify formations in the bladder, ureters and pelvis, use endoscopic method diagnostics

Treatment of enuresis

Treatment measures include conservative and surgical methods. TO conservative treatment include drug therapy, psychological assistance, medicinal physical culture, diet therapy, healthy lifestyle, physiotherapy.

Diet therapy and healthy lifestyle

In order to improve general condition The doctor recommends that the patient follow a diet. The patient is required to drink at least 2 liters of water per day, and not before going to bed or before going for a walk.

You should exclude drinks that stimulate urine excretion: tea, coffee, sweet carbonated drinks, and also avoid alcohol (especially beer).

Do not get carried away with salty foods, spicy, fatty, fried foods. Nutritionists recommend consuming more fruits, vegetables, herbs, bran bread, and cereals.

General principles of treatment and patient care

The patient needs to change behavioral habits. Treatment of enuresis in adults, the causes of which non-patients cannot immediately determine, involves the practice of controlled urination. The patient must empty the bladder forcibly every hour, if necessary every half hour. Gradually, the intervals between urinations increase to 3–4 hours.

Before walking and going to bed, you need to empty your bladder. Urological swimming trunks and pads are actively used. In bedridden patients, these products cannot be used constantly, as this can lead to skin irritation, which is quite difficult to cure.

Methyluracil ointment and Bepanten cream help with diaper rash.

To protect the mattress from getting wet, special moisture-resistant mattress covers are available for sale.

Physiotherapy

Exercise therapy is necessary to strengthen the pelvic floor muscles. For this purpose, a special set of exercises was created - Kegel gymnastics. The essence of the technique is rhythmic contractions of the sphincters of the pelvic floor (10 seconds for contraction, 10 seconds for relaxation, 10–15 repetitions).

And also in an attempt to stop the flow of urine during urination. These exercises do not require much effort from the patient.

Physiotherapy

Physiotherapy for enuresis in an adult is intended to reduce the intensity of bladder contractions during overflow, as well as strengthen the pelvic floor muscles.

Actively used:

  • electromagnetic effects on the pelvic floor;
  • darsonvalization of the bladder walls;
  • mud therapy.

Electrical stimulation of the pelvic floor muscles is used, which simulates Kegel exercises.

Drug therapy

Includes use medicines. These include a group of anticholinergics and M-cholinergic blockers. These medications have a positive effect only in conjunction with general measures.

The drug Oxybutynin, Tolterodine, Solifenacin, Darifenacin are widely used in the treatment of enuresis. They have long-term action, apply 1–2 times a day.

Oxybutynin is available in both tablet and patch form. The patch requires changing every two weeks. These drugs relax the detrusor muscle (the muscle lining of the bladder that contracts when you urinate).

Gynecologists and urologists prescribe the following drugs:

  • Minirin;
  • Driptan;
  • Vizikar.

For nocturnal enuresis in adult women and men, Miridin and Driptan are suitable. The presence of persistent enuresis requires the use of a group of drugs.

Other treatments

If treatment measures are ineffective, doctors move on to invasive techniques: operative method treatment and stimulation of the sacral and tibial nerve.

Surgical treatment is indicated for patients with tumor-like formations urinary system, hypertrophy of the prostate gland, preventing the passage of urine.

If it is not possible to remove the tumor, a stent is placed inside the urethra, which prevents the walls of the urethra from closing. In most patients after surgical intervention enuresis is eliminated almost immediately.

At severe course diseases, a minimally invasive method of stimulation is used through injections at the level of the 3rd sacral vertebra and into the area of ​​the tibial nerve.

These methods also strengthen the bladder sphincter. Sessions are held once a week. The course of treatment must be followed for 3–4 months. Additionally, the patient is given a neurostimulating implant.

Enuresis in adults is treated successfully thanks to an integrated approach. Great importance the patient's behavior plays a role in treatment. Training urination and Kegel exercises significantly increase the likelihood of cure. If all doctors' recommendations are followed, patients can completely get rid of the disease.

There are many things that a person, as a rule, gets rid of in childhood. However, it is very bad when similar diseases and disorders begin to haunt adults as well. Enuresis is not common in adults, but it does occur, and symptoms can occur in anyone. This is quite unpleasant for many reasons. Also because a person can suffer greatly from it emotionally: the emergence of new complexes, shyness, a decrease in the level of self-esteem - this is all exactly what enuresis can lead to in adults (children, of course, are not immune from this either, although they experience it more easily).

What is the reason for this and what are the reasons?

The described disorder refers to a disorder of the human body, the most important symptom of which is something that occurs, usually during sleep. Many children suffer from it, but adults also often become victims (about two percent of all living people).

In adults it is very complex problem. Because of this, people become irritable, nervous, hysterical and often withdraw into themselves. Making family and friends can be very, very difficult for them.

This should not be confused with a frequent urge to urinate at night, as this is completely different problems.

The causes of enuresis can be both psychological and medical. IN medical cases usually everything is associated with some kind of infectious disease urinary tract, prostate enlargement, diabetes, bladder cancer or alcoholism.

TO psychological reasons may include stress, poor nutrition, childhood mental trauma, various kinds emotional problems.

It is also worth noting that enuresis in adults can also occur due to certain genetic abnormalities.

This disease may be chronic or appear completely unexpectedly. Some suffer from it since childhood: the symptoms either disappear or reappear completely unpredictably, while others discover it completely unexpectedly. Of course, those who are most surprised by him are those who did not encounter this trouble even in childhood. In both cases, urination can occur every night, and from time to time (for example, when a person is too tired during the day or drinks before bed a large number of liquids).

Enuresis in adults: treatment

Some people who suffer from it have, in addition to symptoms and other things, another a big problem- they are so embarrassed about their illness that they cannot even bring themselves to see a doctor. In fact, you shouldn’t be afraid of the doctor, since you won’t surprise him with anything, and the treatment he prescribes can be completed without anyone knowing any details. Is it really better to wake up every night, realizing that everything has happened again?

Of course, before starting treatment, you need to establish the reasons for its occurrence, and for this you will need to undergo special examination. You will have to visit a urologist (gynecologist), as well as a neurologist. It is worth noting that the treatment process can be quite lengthy, and magic remedy, which would help to heal immediately, does not exist.

During treatment, the patient takes medications that are needed to reduce or restore the bladder. It is also mandatory to take all kinds of sedatives, which can normalize the functioning of the nervous system.

Some in adults folk remedies. This treatment can also be very effective, but it is also recommended to carry it out under the supervision of a doctor.

Enuresis is a disease characterized by the inability to hold urine. Often in patients, the main symptom manifests itself at night, but cases also occur during wakefulness.

ICD 10 code is F98.0 Enuresis of inorganic origin and R32 Urinary incontinence, unspecified.

Classification and symptoms of the disease

There are 2 types of classification of the disease.

According to the factors that provoked it, the pathology differs into:

  • – and active secretion of urine;
  • – separation of urine due to, or crying;
  • incontinence due to bladder fullness.

Depending on the time of symptom onset, the pathology is the following types:

The main symptoms of enuresis are frequent urination with the inability to hold urine. In addition, other signs of pathology are noted:

  • appears in the lower abdomen pain syndrome(genital area);
  • body temperature rises, in rare cases fever appears;
  • Blood clots appear in the urine, and;
  • drowsiness and malaise.

Causes of the disease

Pathology can develop due to many factors:


Other factors may also cause the pathology:

Modern diagnostic methods

The effectiveness of treatment depends on the correct diagnosis and causes of the disease. First of all, the patient is examined and interviewed. During this, the genitals are examined and the abdomen is palpated.

The patient must be sent for 2 sessions of pelvic ultrasound (full and empty bladder) and abdominal cavity.

Other diagnostic methods are also carried out:

  • consultation Laura (excludes chronic diseases);
  • (intravenous);
  • urofluometry;
  • the rhythm and volume of bowel movements at night and daytime days.

Treatment of pathology

Various methods are used in the treatment of pathology:

  1. Changing mode. Adults diagnosed with enuresis must avoid stress. Caffeine, alcoholic drinks and foods that have a diuretic effect are completely excluded from the diet. After lunch, you need to reduce the volume of liquids you drink, and a few hours before bedtime, do not drink at all. To prevent embarrassment, you should develop a schedule for emptying your bladder, including at night.
  2. Psychotherapy. Psychological therapy is used regardless of the type of disease. The most powerful factors are hypnotic, indirect, post-hypnotic and self-hypnosis.
  3. Abdominal muscle training. During urination, it is necessary to hold the flow of the stream for a while (30 - 60 seconds is enough) each time. If weakness of the pelvis and pelvic floor is noted, then it is additionally used.
  4. Acupressure . In this case, pressure is applied to reflex zones, which helps to activate important processes in the body.
  5. Healing mud. They are used every other day on the kidney area and lower abdomen before bed. The course of using mud is no more than 8 procedures.
  6. Hydrotherapy. Involves taking pine or nitrogen baths to improve blood circulation and relaxation. And also the use of showers with pressure of different intensity. The procedures also help restore nervous balance.
  7. Animal therapy. The use of animals for treatment, in particular horses, dolphins and dogs, helps to get rid of diseases based on mental disorders.

Physiotherapy

Physiotherapy helps with urinary incontinence in adults, such as:

  • exposure to pulsed alternating current on the affected area (Darsonval apparatus is used) to strengthen the sphincter;
  • low-frequency alternating current directed to the brain area (normalizes sleep);
  • acupuncture by introducing thin needles into special points responsible for reflexes to improve sleep, the functioning of the nervous system and normalize the emotional state;
  • magnetic therapy to reduce the urge to urinate, which is achieved by relaxing the muscles of the bladder walls;
  • electrophoresis with anticholinergics, which helps to increase the muscle tone of the sphincter, relax the walls of the bladder and increase its filling.

Drug treatment

Proper nutrition during illness involves multiple meals (4-5 times a day), but you need to have dinner no later than 19.30 or 3 hours before rest. During this period, the use of dry crumbly cereals, eggs, cheese, bread and tea is allowed.

Personal hygiene rules

Enuresis somewhat complicates personal hygiene in adults. Therefore, careful preparation is required:


People with this diagnosis need to pay more attention to hygiene, so they need to wash themselves several times a day. In this case, it is better to use a solution of manganese, chlorhexidine or a decoction of medicinal herbs.

For bedridden patients, the use of lotions and liquids for bedsores is additionally required.

Enuresis is a pathology that occurs at any age. Moreover, the causes of the disease are not always determined by physiology; it often depends on psychological state. Treatment requires the support of specialists, regardless of the nature of the disease. Self-medication in in this case can only significantly complicate the situation.

Enuresis is involuntary urination in a child over 4-5 years old. In rare cases, enuresis occurs in adults; it is more often diagnosed in men. Involuntary urination occurs mainly at night.

Nocturnal enuresis in adults is a rather complex problem. In fact, a person suffering from urinary incontinence becomes very nervous, irritable and upset. It is very difficult for him to live among the people around him, as he is afraid all the time.

There are actually quite a few reasons for this phenomenon. For example, it can be transmitted to a person along with the genetic material of the parents. Sometimes enuresis occurs as a result of hormonal imbalance, during which the urine formation regime is disrupted.

Causes of enuresis in adults

In adults, the main causes of enuresis are diseases or degenerative changes in the genitourinary system, abnormal development of the bladder or urethra, stone formation. It becomes relevant for women hormonal imbalance with degenerative changes in the muscles in the urethral area.

Experienced emotional or physical stress also becomes the reason why enuresis very often appears in adults. In old age, degenerative changes in the brain area come first, which impair control between spinal cord and head.

Separately in Lately neurotic and neurosis-like forms of urinary incontinence began to be identified.

Causes of enuresis in adult men

In adult men, enuresis can occur for a number of reasons:

  1. If the prostate adenoma has been operated on, there may be postoperative consequences, including nocturnal enuresis, requiring immediate treatment in this case.
  2. The prostate gland undergoes with age hormonal changes, and the pelvic muscles weaken. Amenable to conservative treatment.
  3. Neurological diseases, Parkinson's disease and multiple sclerosis, as well as some other diseases.
  4. Mental problems, stress, alcohol and other reasons.

Any type of enuresis in men requires comprehensive therapeutic treatment, at home you will have to try to persistently do a set of exercises and take prescribed medications. It is not recommended to self-medicate without consulting a doctor.

Diseases of the genitourinary system

And - all these infectious diseases have one thing in common: general symptom, as a violation of the urination process. Often nocturnal enuresis in adult men and women is associated with a concomitant disease that patients are not even aware of.

In this situation, it is necessary to undergo a thorough examination by specialized specialists for the presence of any genitourinary infections. This will not only cure concomitant disease, but also get rid of urinary incontinence.

Types of enuresis

There are three types of enuresis in adults.

  1. Nocturnal enuresis is spontaneous urination during sleep, unrelated to how deep the sleep is.
  2. Daytime enuresis is the inability to control the urgent urge to urinate while awake.
  3. Mixed enuresis - complex problem, combining the first two points.

Of course main symptom Enuresis in adults: inability to control urination, but there are also secondary symptoms as a consequence of the main thing.

How to treat enuresis in adults

Treatment of nocturnal enuresis is complex and a long process, which requires systematic and integrated approach. Adults are usually prescribed medications and behavioral methods. If for some reason they are not effective, surgical methods are used.

  1. First of all, you need to completely avoid drinks that contain caffeine (coffee, cola, tea). This component contributes to bladder irritation. If a person suffers from enuresis, he needs to minimize his fluid intake at night. In addition, you should completely avoid beer.
  2. You can use preventive measures - artificial awakening. But it’s worth changing the time you get up at night so that your bladder doesn’t get used to urinating at the same time.
  3. If you have problems with involuntary urination, bladder training will be helpful. This will help strengthen the muscles and elasticity of its walls. When full, the bladder holds about 0.5 liters. If you feel that your volume is less, hold back during the day and visit the toilet less often. Divide the immediate process of urination into parts with breaks of 10–15 seconds. This exercise strengthens the pelvic floor muscles.
  4. Before going to bed, you need to make sure your bladder is empty.
  5. You can protect your mattress and pillows from getting wet using special waterproof covers. However, it is best to sleep on a cotton sheet, in linen made from natural fabric. They absorb odor and moisture.

Today, very effective way Minimally invasive sling operations are the only way to get rid of this disease in women. Used to treat enuresis in adults behavioral therapy, physical therapy, and the use of medicines. Don't hesitate, contact a specialist.

Representatives of the stronger sex prefer to remain silent about the problem associated with urinary incontinence. This problem especially often affects older men.

However, it is important to know that bedwetting in adults is treatable.

Features of enuresis in men

Enuresis is characterized uncontrolled release of urine from the urethra. This causes significant discomfort, causing not only physical, but also psychological inconvenience.

For older men, a diagnosis of enuresis will not be life-threatening, but will affect the nervous system, and can subsequently lead to withdrawal from society due to the embarrassment of being awkward. Precursors of the disease in older men are problems with the nervous system, vessels and organs of the urinary system.

Men are often silent about their illness and do not want to talk about it not only to the doctor, but also to their loved ones. Therefore there are various complications, many times aggravating the course of the disease and the implementation of medication measures.

IN International classification disease, which is used by doctors all over the world, this ailment is referred to as F98.0 and refers to enuresis of inorganic nature.

After the patient suffered a stroke, he experiences urinary incontinence. This becomes an unpleasant phenomenon not only for the person himself, but also for those who care for him. In addition to urine, a person in this state experiences fecal incontinence, which also negatively affects the psychological state and interferes with a speedy recovery.

In this case, urine may leak drop by drop, and sometimes is released in portions. Therefore, it is important to pay attention to this symptom in the first days after a stroke and tell your doctor about the problem. Enuresis in this case occurs due to loss of control over certain areas of the brain.

Diagnosis of the disease

Success lies not only in making a diagnosis for an adult man, but also in correctly identifying the cause of urinary incontinence. Man addressing medical specialist, comes with certain complaints, on the basis of which the doctor can assume a particular condition.

Diagnostic measures are carried out using the following types of research:

  • Studies related to urodynamic and endoscopic methods.
  • Carrying out cough tests. The doctor prescribes this test when the bladder is full.
  • Collecting anamnesis, that is, complaints from the man.
  • Conducting a daily pad test. This method consists of wearing a pad during the day, which can show the level of urine output from the urinary tract, and after that it will help make a correct diagnosis.
  • Ultrasound examination aimed at examining the bladder and organs of the urinary system.
  • General urological examination.

Most effective method, capable of identifying a disease, is combined urodynamic study. It is characterized by cystometry and profilometry, as well as uroflowmetry. These methods are most effective in identifying the cause of the disease and determining the condition of the excretory tract for urine.

After comprehensive survey The patient's doctor will decide whether to diagnose enuresis or refute it. If a man’s urinary incontinence is confirmed, then he will be prescribed a competent treatment regimen, which he must adhere to until he completely forgets about the uncontrolled release of urine.

How to get rid of an illness - therapeutic measures

Therapeutic measures will depend on what degree of neglect of the disease, as well as from previous treatment methods, if the patient has already experienced problems with this disease. The cause of enuresis is also important for the correct treatment regimen.

You can get rid of incontinence by undergoing treatment or surgical intervention, if other methods are not able to cope with the pathological condition.

Conservative methods

TO conservative methods eliminating the disease include:

  • Drug-related therapy. These include drugs that can eliminate problems with the central nervous system, as well as those that improve microcirculation in the circulatory system.

    • Antispasmodics eliminate tone in the bladder and significantly improve its functionality. Effective are the drugs that have an effect on hormonal background person. If a person develops nervous system disorders, they are eliminated by using antidepressants.

  • Physiotherapeutic activities. These include extracorporeal exposure to a magnet and the method of electrical stimulation.
  • Compliance with a certain program that can improve many systems of the human body.
  • Exercises that improve the patient’s psychological state and strengthen the pelvic floor muscles. Such exercises include the method.

During treatment, in order to eliminate psychological discomfort, the man is prescribed to wear special gaskets that hide systematic leaks.

If an adult male produces a large amount of urine, then he is prescribed to wear special panties designed to absorb urine. They eliminate urine and are not visible under clothing.

Many people are recommended to exercise, avoid alcoholic beverages and other bad habits. Muscles need to be strengthened both at home and outside; for this, experts recommend training them through gradual tension and then relaxation.

This method helps in many cases, especially in those where the muscles have weakened and this is due to age characteristics patient.

Surgical intervention

Conservative methods are carried out within six months. If during this period no improvement has occurred in the body and urine continues to be excreted without the control of the brain, then the doctor decides to perform surgical intervention.

Surgical treatment is often carried out with the installation of an artificial sphincter, a special valve made in the form of a ring. This method is effective when removing the prostate or after surgical intervention to eliminate tumors in the pelvic organs.

This method has particular disadvantages, characterized by frequent erosions and periprosthetic infections.

Another method to eliminate incontinence is in collagen injections. This method is successful in almost half of the cases, especially when the patient suffers from tumors in the urinary tract.

The disadvantage of this method is the gradual resorption of the substance and, as a result, loss of effect and new signs of uncontrolled urination.

The third method used in modern medicine, consists of creating a male loop implantation or, as this method is also called, "sling operation".


The essence of the method is to wrap the urethral area with a special mesh made of synthetic fiber. The edges of such a mesh are strengthened to the pelvic bones. This method provides support to the urethra and prevents premature leakage of fluid.

This method becomes more advanced and effective for many patients every year. Positive effect with such an operation there is almost in ninety percent of cases.

Modern medicine has more than a hundred different implants that can eliminate specific problem in adult men.

Traditional methods

Many urologists recommend that patients, in addition to drug therapy carry out treatment with folk remedies. It is especially important to carry out such therapeutic measures using traditional medicine after acute period diseases, or for the treatment of elderly people.

An effective method for treating leakage is to take infusions prepared from rosehip. This is due to the fact that it contains an excess amount of vitamin C, which can normalize protective forces body and strengthen immune system. Oxidizing agents included in the product and flavonoids normalize the pH balance in urine.

To eliminate urinary incontinence, the following recipes will be effective:

  1. One teaspoon of plantain is brewed with 250 milliliters of water, after which the infusion sits for an hour, wrapped in a towel. This decoction is taken three times a day, one tablespoon, preferably before meals;
  2. five tablespoons of sage are poured into one liter of boiling water, then infused and taken one teaspoon once a day;
  3. tea made from St. John's wort copes with the symptoms of incontinence. They drink it several spoons a day.

Traditional medicine recommends eating vegetables and fruits that fill the body with vitamins and useful microelements. Not recommended abuse diuretic products and fruit drinks. This can make your incontinence problem worse.

What to do to prevent enuresis?

After the disease has subsided, we must not forget about preventive measures aimed at strengthening the muscles and psychological state of the patient. TO preventive measures include:

  • Maintaining healthy image life accompanied by moderate physical activity on the body.
  • Quitting smoking and alcohol.
  • Do exercises to strengthen your pelvic floor muscles on a daily basis.
  • Examinations by a urologist (about once a year).
  • Preventing diseases such as stroke or Parkinson's disease.
  • Consumption of vitamins and microelements.

A doctor will tell us about the problem of enuresis in adults in a video clip: