Nocturia – Can it be Cured?

Many studies have been made about man’s capability to sleep through the night without waking up and going to the toilet to urinate. Some people wake up once in the middle of the night with the urge to empty their bladder and to some people, waking up more than twice in the night to use the toilet is more than enough reason to be anxious.

Nocturia is an excessive urination at night. Also called nocturnal enuresis or bedwetting or urinary incontinence, a condition that is often a cause of embarrassment and anxiety for the person suffering from it and inconvenience and stress for the family who car for the affected person. It is involuntary and uncontrollable.

This condition is a normal occurrence for children from age 0 to 4 when their bladder is still immature and cannot hold urine for a long time. This stage is called primary bedwetting that goes away with time, usually when the child is already potty trained and their bladder muscles and nervous system have acquired some degree of maturity.

Secondary bedwetting on the other hand is when the child is bedwetting again after more than 6 months of being dry. This can be a symptom of an underlying medical problem like urinary infection, rare tumours in the urinary tract, bladder or urethral sphincter. Psychological trauma can also play a part in losing urinary continence.

In adults, Nocturia is more prevalent in older people and more common in men than in women. Age has nothing to do with this problem even though more elderly people are afflicted than the younger population. Although bedwetting seems to be a hereditary trait, there are reasons that may aggravate this condition including:

  • Enlarged prostate gland (benign prostatic hyperplasia) that may block the urethra or the urinary tracts
  • Spinal cord injuries that may render paralysis of the lower extremities
  • Dementia caused by Alzheimer’s disease, Parkinson’s disease, Multiple Sclerosis
  • Diabetes and other debilitating illness like arthritis
  • Post-operation recuperation period
  • Depleted supply of hormone that slows down urine production at night

This urinary incontinence may be a serious medical condition but it is not totally incurable. Treating nocturnal enuresis starts at finding the underlying cause and treating it. A professional health care provider (GP or Urologist) can determine the probable cause through a series of tests and checkups to rule out other complications.

Medication

Your doctor may prescribe certain drugs such as anti-depressants and anti-cholinergics to relax the bladder. Anti-inflammatory drugs help to ease the swelling of the prostate gland and medications to manage Diabetes and other medical problems.

Physical Therapy

Temporary paralysis can be helped with physical therapy with focus on the range of motion (ROM) exercises to rehabilitate atrophied muscles of the lower extremities. Exercise also helps ease the pain and stiffness of arthritic joints. Kegel exercises help in strengthening the pelvic floor muscles and improve muscle tone.

Psychological Counseling

This is an important and integral part of treatment for people suffering from incontinence. It is necessary to be aware that incontinence is not an isolated case, in fact it is a very common problem and many people are affected with it. Attending support group meetings help in restoring self-esteem and self-confidence.

Behavioural Modification

Bladder re-training is re-learning the toilet patterns one has learned during the toilet training in childhood. Using the toilet to void at regular intervals, voiding completely and not stopping in midstream, urinating when the urge gets urgent and observing proper hygiene after using the toilet are the patterns that the patient must learn again.

Proper Diet and Nutrition

Food and beverages play an important part in the occurrence of bedwetting. Caffeine and carbonated drinks stimulate the bladder causing frequent urination. Eating healthy and fibre-rich foods instead of processed and spicy foods that can aggravate the condition help maintain proper metabolism.

Semi-invasive Treatment

Injectable bulking agents are used to give the urethral sphincter more bulk and improve closure. The bladder is injected with certain drugs to temporarily paralyse the muscles and prevent overactive bladder. Laparoscopic sling procedures help women with prolapsed uterus to ease the compression on the bladder. Open surgery is a last option.

Incontinence Products

While undergoing treatments, using incontinence products such as incontinence pads, pants, bed pads, mattress protection covers and urine collectors help in managing nocturia. There is no need for drastic changes in your lifestyle. These products can help you lead a normal life and pursue your goals unhampered by incontinence.

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