Manifestations of enuresis (or incontinence) are predominantly nocturnal in nature: 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 one often has to 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 varieties of male enuresis, there are also mixed forms.
This type is typical for daytime incontinence. On the background of stress, overwork, or anatomical features (deformation of the sphincter of the bladder), during physical stress, a small amount of urine is released. The attack can be triggered by coughing, weight lifting, laughter.
A distinctive feature is the strong urge to precede uncontrolled emptying of the bladder. Spasms appear even with a slight filling, and the role of a provoking factor is usually played by the sound of flowing water. This type of dysfunction is observed in infections of the urinary tract, bladder hyperactivity, and benign neoplasms.
The nervous system partially or completely loses control over the functioning of the sphincter and bladder muscles. At night, the patient does not wake up even when overflowed, can not control the process of urination.
Enuresis on the background of ischuria
An enlarged prostate gland in adenoma blocks the urethra, preventing complete emptying. The prostate becomes inflamed, the urge to urinate becomes painful, and urine is involuntarily released in a small volume.
Causes of urinary incontinence
Persons older than 40 years usually fall into the risk group, but cases of nocturnal incontinence and in men of younger age are recorded. Causes of enuresis are associated with disorders of the central nervous system, the development of prostatitis, organic and infectious diseases of the urinary organs:
- bladder hyperactivity;
- infections of the pelvic organs, including sexually transmitted infections;
- organic lesions of the central nervous system as a result of injury or infectious and inflammatory processes;
- age-related anatomical changes (weak pelvic and sphincter muscles);
- stress, overwork, incontinence with alcohol intoxication;
- malignant and benign tumors of the prostate gland;
- deformation of the ducts or urethra due to surgery, injury or pathology;
- endocrine diseases (diabetes).
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.
The diagnosis of enuresis in adult men is made on the basis of a comprehensive examination. During the survey, the nature and frequency of urination, the volume in which the urine is released, the presence of concomitant pathologies is specified. Laboratory tests of blood and urine, including bacposev, urinolysis are appointed.
An ultrasound, uroflowmetry (determination of the speed and nature of the discharge). After the initial treatment to the therapist, the diagnosis is carried out by such specialized specialists as a urologist, nephrologist, endocrinologist, and neuropathologist.
Therapy depends on the causes of the disease. If nocturnal uncontrolled urination caused nerves or stress, the help of a psychotherapist would be required.
Treatment of alcoholic enuresis in men, when urine excretion during the night is observed after alcohol, is to abandon the bad habit. In other cases, the following methods are used.
Often combined with medical treatment, includes the use of electrical discharges, magnetic field, warming and blood circulation-stimulating procedures. Electrophoresis, Darsonval and the electrics help restore the transmission of nerve impulses.
Magnetotherapy on the device Almag and vacuum banks contribute to the normalization of 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.
The range of drugs used for drug treatment is very wide. In the case of an infectious disease, antibiotic medications are prescribed, and soothing pills (tranquilizers, antidepressants) are used to relieve stress.
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Piracetam-type nootropics normalize the activity of the central nervous system, M-anticholinergics relieve muscle spasm of the bladder. Of the hormonal agents used Adiuretin-DM, reducing the secretion of urine.
Treatment of enuresis in adults caused by prostatic hyperplasia, spinal cord injuries, neoplasms, or ductal deformity requires surgery. The installation of an artificial sphincter, collagen injections, a sling operation (implantation of a special support mesh) have proven themselves well.
Any adult can be confronted with urination disorder. Modern medicine has a wide arsenal of methods for treating enuresis, therefore it is necessary to consult a doctor at the first signs of indisposition. Along with the traditional methods allowed the use of traditional methods of therapy at home. Various decoctions and infusions help to get rid of unpleasant symptoms, but they can be used only with the approval of the urologist.