Bed Wetting in the Elderly

Nocturnal enuresis (NE) is the involuntary voiding of urine during sleep. This condition is more commonly known as bed wetting.

Causes could include: diabetes, urinary tract infection, urinary tract stones, neurological disorders, anatomical abnormalities, urinary tract calculi, prostate cancer, prostate enlargement, bladder cancer, and obstructive sleep apnea. In very rare cases, acute anxiety or emotional disorder may cause adult bed wetting.

One of the most useful tools for a healthcare provider is to have a great deal of information about your parent's symptoms and general habits. Consider keeping a symptom diary of daily habits and routines for at least two days prior to a medical appointment. These details will assist your healthcare provider when determining the cause and severity.

  • Note when and how many times your parents urinates during the day and night
  • When accidents occur (time of day or night)
  • Amount of urine voided
  • Drinking patterns (does your parent drink a lot of fluids in the later afternoon/evening?)
  • What they drink (sugary, caffeinated, artificially sweetened, carbonated, alcoholic drinks, etc.)
  • Nature of the urinary stream (is the urinary stream strong and constant or is there difficulty initiating a void or continuous dribbling?)
  • Any existing recurrent urinary tract infections
  • The number of wet versus dry nights
  • In addition, note any other symptoms associated with nocturnal enuresis such as night sweats. This information can help a healthcare provider determine the cause of the problem and the appropriate treatment.

At the time of the appointment, be prepared to supply such information and details related to personal and family medical history as well as medication usage. In addition to helping you find options to help cure bed wetting, it is also important to see a healthcare provider to rule out any other serious problems that may cause nocturnal enuresis as a side effect.

At the appointment you can expect:

  • A physical examination
  • Neurological evaluation
  • Urinalysis and urine culture: The urinalysis and urine culture are different tests that determine the contents of the urine.

Further tests include:

  • Uroflowometry: involves urinating into a specialized funnel that measures the flow rate, amount of urine, and time required for urination
  • Post-void residual urine measurements: require an ultrasound and are non-invasive procedures that determine the volume of urine left in the bladder after voiding

If other problems are suspected, you can expect further tests for diagnosis.

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