The most common causes of enuresis in men are urinary tract infections, tumors, neurological and psychological factors. Treatment is prescribed complex, combining physiotherapy methods with taking medications. Surgery is sometimes necessary. About 3% of patients are followed up from childhood.
Classification
Manifestations of enuresis (or incontinence ) are predominantly nocturnal: more than 85% of patients complain of uncontrolled urination during sleep. Sometimes pathology is confused with nocturia – the predominance of nocturnal diuresis, due to which you have to often get up to empty the bladder.
The main difference is the lack of awakening and the ability to control the process. There are 4 main types of male enuresis , there are also mixed forms.
Stressful
This type is characteristic of daytime incontinence. Against the background of stress, overwork, or peculiarities of the anatomical structure (deformation of the sphincter of the bladder), a small amount of urine is released during physical exertion. An attack can be triggered by coughing, lifting weights, or laughing.
Imperative
A distinctive feature is the strong urge preceding uncontrolled emptying of the bladder. Spasms appear even with an insignificant filling, and the noise of pouring water usually plays the role of a provoking factor. This type of dysfunction is observed with MEP infections, overactive bladder, and benign neoplasms.
Violation of urge
The nervous system partially or completely loses control over the functioning of the sphincter and the muscles of the bladder. At night, the patient does not wake up even when overflowing, he cannot control the urination process.
Enuresis on the background of ishuria
An enlarged prostate gland with adenoma blocks the urethra, preventing complete emptying. The prostate becomes inflamed, the urge to urinate becomes painful, and urine is involuntarily excreted in a small amount.
Causes of urinary incontinence
The risk group usually includes persons over 40 years old, but cases of bedwetting are recorded in younger men. The causes of enuresis are associated with disturbances in the work of the central nervous system, the development of prostatitis, organic and infectious diseases of the urinary organs :
- overactive bladder;
- infections of the pelvic organs, including sexually transmitted infections;
- organic lesions of the central nervous system as a result of trauma or infectious and inflammatory processes;
- age-related anatomical changes (weakened pelvic and sphincter muscles);
- stress, overwork, incontinence with alcohol intoxication;
- malignant and benign neoplasms of the prostate gland;
- deformation of the ducts or urethra due to surgery, injury or pathology;
- endocrine diseases (diabetes mellitus).
The factor of heredity matters: in the presence of enuresis in one of the parents, the disease develops in a child in 45% of cases, often recurs in adulthood.
Diagnostics
The diagnosis of bedwetting in adult men is based on a comprehensive examination. During the survey, the nature and frequency of urination, the volume in which urine is excreted, and the presence of concomitant pathologies are specified. Laboratory tests of blood and urine are prescribed , including bacterial culture , urinolysis .
Ultrasound examination, uroflowmetry (determination of the speed and nature of emptying) are carried out . After the initial appeal to a therapist, diagnostics is carried out by such specialized specialists as a urologist, nephrologist, endocrinologist, and neuropathologist.
Treatment
Therapy directly depends on the causes of the disease. If nighttime uncontrolled urination caused nervous feelings or stress, the help of a psychotherapist will be required.
Treatment of alcoholic enuresis in men, when the discharge of urine at night is noted after alcohol, consists in giving up the bad habit. In other cases, the following techniques are used.
Physiotherapy
Often combined with drug treatment, it includes the use of electrical discharges, magnetic fields, procedures that warm and stimulate blood circulation. Electrophoresis, Darsonval and electrosleep help restore the transmission of nerve impulses .
Magnetotherapy on the Almag apparatus and vacuum cups help to normalize the muscle tone of the bladder. Paraffin, therapeutic mud and acupuncture have a beneficial effect on the functioning of the nervous system and blood vessels.
Medications
The range of drugs used for drug treatment is very wide. With an infectious origin of the disease, drugs are prescribed for antibiotic therapy, to relieve stress – sedative pills (tranquilizers, antidepressants).
Nootropics such as Piracetam normalize the activity of the central nervous system, M- anticholinergics relieve spasm of the muscles of the bladder. From hormonal agents, Adiuretin- SD is used, which reduces the secretion of urine.
Surgical intervention
Treatment of bedwetting in adults caused by prostatic hyperplasia, spinal injuries, neoplasms, or duct deformities requires surgery. The installation of an artificial sphincter, collagen injections, and sling surgery (implantation of a special supporting mesh) have proven themselves well .
Conclusion
Any adult can face a urinary disorder. Modern medicine has a wide arsenal of methods for treating enuresis , so you should consult a doctor at the first sign of illness. Along with traditional methods, the use of traditional methods of therapy at home is allowed. Various decoctions and infusions help to get rid of unpleasant symptoms, but they can be used only with the approval of a urologist.