Why Some Women Grow Up Bed-Wetting

Some women will need help to
correct the problem of bed-wetting.Bed-wetting is more rampant among children, but in some instances, it is carried into womanhood. Reports by Sade Oguntola.

TO many people, bed-wetting is more of a problem in children. The fact that some women while coughing, sneezing or laughing have urine seeping into their underwear(s) or that they always feel a strong uncontrollable desire to urinate is never associated with the problem.

However, for adults that experience urinary loss, a team of Turkish researchers is suggesting that the problem could have started much earlier because such people might have also bed-wet as children.

In a study of more than 1,000 Turkish women seen at one gynaecology clinic, researchers found that those with urinary incontinence were more likely than other women to have had bed-wetting problems as children.

Among the 1,021 women seen at their centre’s gynaecology clinic, 229 women said they wet the bed after the age of five years, and the childhood problem was more common among those who currently had urinary incontinence – 30 per cent reported a history of bed-wetting, versus 21 per cent of those with no bladder control problems.

When the researchers focused on the different types of urinary incontinence, they found that childhood bed-wetting is specifically linked to stress incontinence, in which urine leaks from the bladder during exercise, heavy weight lifting or other activities that put stress on the organ. More than 35 per cent of women with stress incontinence wet the bed as a child. In addition, nearly six per cent of women with a history of bed-wetting had fecal incontinence, versus just over two per cent of those with no such history.

According to the study led by Dr Ayse Gurbuz, of the Zeynep Kamil Women and Children Disease Education and Research Hospital in Istanbul, the potential causes could include some flaw in the nerve pathway between the bladder and the brain, or a developmental defect in the pelvic muscles or ligaments that help control the flow of urine.

They suggested in a report in the British Journal of Urology International that in some cases, a common cause might underlie both childhood and adult bladder problems.

Awareness of the association between childhood bed-wetting and adult urinary incontinence, they said, might make the medical practitioners and patients both cognisant of the risk factors that can lead to urinary incontinence from stress.

A previous study in the 1999 edition of the Journal of Epidemiology Community Health involving 1,333 women, aged 48 years, that were drawn from England, Scotland and Wales recorded, similarly, 50 per cent reported symptoms of stress incontinence and 22 per cent reported symptoms of urge incontinence in the previous year, while eight per cent had severe symptoms.

Women who at age six had wet in the day or several nights a week, were more likely to suffer severe incontinence and urge symptoms, but occasional bed-wetting was not associated with an increased risk in adult life. Those who were older at the birth of their children and who had vaginal deliveries had an excess risk of stress symptoms.

The cause of chronic bed-wetting in school-age children is not fully clear, but it’s thought to have a genetic component, according to Dr. Adekola Adebayo, an urologist formerly at the Ring Road State Hospital, Ibadan.

The expert declared that in children, less than 15 per cent bed-wet beyond age five and after age 10 less than five per cent will still be bed-wetting, adding that some conditions that make a child to bed-wet can also be carried into adulthood and people take it as just bed-wetting. “A child that has problems with the nerve supply to the bladder may first be noticed to be bed-wetting and this can later progress to incontinence in adulthood because the individual may not be able to control urine release,” he stated. “It’s not an illness, but a condition that can be treated effectively and permanently.”

In urinary incontinence, there is involuntary passage of urine. The person may just start to see urine flowing and even when such is noticed, the person may not be able to get to the toilet before it starts to come out. It could be a situation that is associated with sleep, or one that happens when the individual is fully awake.

Dr Adebayo explained that when urinary incontinence or the inability to control bladder discharge is seen in women, it can arise from a number of causes, including weak or over-active bladder muscles. For some women, incontinence is related to childbirth or menopause.

While urine leakage is a problem that, at least, one out of 10 women in the age group of 15 to 64 suffers from. He said most of the time, the sufferer never approaches a medical practitioner, though it is curable, using several treatment options that are available today.

There are several well-established risk factors for urine leakage; they include the woman’s age. The problem increases progressively with age; the frequency roughly doubling between 45 and 85 years of age. It is common in pregnant women but it usually gets better after delivery.

Some cases occur after the delivery of a child because of slacked pelvic floor muscles occassioned by weakening and stretching. This may be worse if any of the nerves is damaged, as these control the muscles that can close up the flow of urine. Sometimes, tears in the vagina or an episiotomy (a deliberate cut) during childbirth may be responsible. The number of pregnancies is sometimes thought to increase the risk for incontinence, but this is not proven.

In individuals that are obese, the excess weight can bear down on pelvic tissues, causing a chronic strain, with stretching and weakening of the pelvic floor muscles. Some bladder infections are responsible in some individuals. Other unproven factors such as constipation, certain drugs, prolapse of the uterus, and cigarette smoking have all been accused of being related to incontinence. However, good evidence is lacking for most of these.

Meanwhile, some cases of bed-wetting, a study said, had some genetic basis. It was shown that a child of two bed-wetting parents has a 77 per cent chance of becoming a bed -wetter. When one parent wets the bed as a child, his son or daughter was found to have a 44 per cent chance of becoming a bedwetter. While little scientific support exists, many hold the “deep-sleep” theory, which maintains that an exceptional deep sleep in some children is the cause of wetting the bed. Because a child is so deep in sleep, his brain and body ignore the signals of a full bladder.