Urinary Tract Disorders : Enuresis – Causes and Treatment

Urinary Tract Disorders

One of main disorder of the urinary tract is enuresis. Enuresis means “bed wetting”.

Enuresis or Bed Wetting

Enuresis (Bed wetting) is normal in young children of age below 10 years and persists in about 5 % of the children. Disordered micturition (passing of urine) is also common in adults of either sex and may persist even with increasing age.

Causes for Enuresius

This may be due to structural problems like prostatic hypertrophy, uterine prolapse and also may be due to urinary infections. The structural problems may require surgical procedures for correcting the problem and urinary infections can be treated by administering antibiotics.

Many cases of incontinence are functional and the drugs have to act on the urinary tract smooth muscles and the nerves that control the passage of urine. But the current treatment is unable to prevent incontinence without causing urinary retention.

Drugs used for the treatment of Enuresis (Urinary Tract Disorders)

Nocturnal enuresis in children aged 10 and above may take desmopressin. The drug is administered either orally or as nasal spray. Steps should also be taken to restrict fluid intake in addition to keeping enuresis alarm.

Tricyclic antidepressants like amitryptyline can be prescribed for a duration of 3 months. But this may lead to the behavioural disturbances and relapse is common after completion of the treatment.

Symptoms of the benign prostatic hypertrophy can be improved by alpha 1(a1) adrenoceptor antagonists like doxazosin and tamsulosin. Other drugs like 5-a-reductase inhibitors such as finasteride can be prescribed.

Incontinence in adults that is caused by neurogenic detrusor muscle instability can be managed by following some conservative measures like pelvic floor exercises. The drug treatment may include muscarinic receptor antagonists like oxybutinin, tolterodine, propiverine or trospium with limited doses only as they give rise to adverse effects in large doses.