Excessive Pee

Also Called Enuresis, Urinary/Stress Incontinence, Bed-wetting

• Enuresis is a repeated inability to control urination.  Use of the term is usually limited to describing people old enough to be expected to exercise such control.  Involuntary urination is also known as urinary incontinence.

• Urinary/stress incontinence, also known as involuntary urination, is any uncontrolled leakage of urine.

• Bedwetting, also called nocturnal enuresis, is involuntary urination while asleep after the age at which bladder control usually begins. Bedwetting in children and adults can result in emotional stress.

Detection of excessive pee is sometimes difficult or not timely with people with special needs:

• People with Disability

• Postoperative Patients

• Bedridden Patients

• Nursing Home Patients

• Children

• Babies

Detection provides care givers the ability to take appropriate action.

Urinary/Stress Incontinence

Overview
Urinary incontinence is the unintentional loss of urine. Stress incontinence happens when physical movement or activity — such as coughing, sneezing, running or heavy lifting — puts pressure (stress) on your bladder. Stress incontinence is not related to psychological stress.

Stress incontinence differs from urge incontinence, which is the unintentional loss of urine caused by the bladder muscle contracting, usually associated with a sense of urgency. Stress incontinence is much more common in women than men.

If you have stress incontinence, you may feel embarrassed, isolate yourself, or limit your work and social life, especially exercise and leisure activities. With treatment, you'll likely be able to manage stress incontinence and improve your overall well-being.

Symptoms
If you have stress incontinence, you may experience urine leakage when you:

• Cough

• Sneeze

• Laugh

• Stand up

• Get out of a car

• Lift something heavy

• Exercise

• Have sex

You may not experience incontinence every time you do one of these things, but any pressure-increasing activity can make you more vulnerable to unintentional urine loss, particularly when your bladder is full.

When to see a doctor
Talk to your doctor if your symptoms interfere with daily activities, such as work, hobbies and social life.

Causes
Stress incontinence occurs when the muscles and other tissues that support the bladder (pelvic floor muscles) and the muscles that regulate the release of urine (urinary sphincter) weaken.

The bladder expands as it fills with urine. Normally, valve-like muscles in the urethra — the short tube that carries urine out of your body — stay closed as the bladder expands, preventing urine leakage until you reach a bathroom. But when those muscles weaken, anything that exerts force on the abdominal and pelvic muscles — sneezing, bending over, lifting, laughing hard, for instance — can put pressure on your bladder and cause urine leakage.

Your pelvic floor muscles and urinary sphincter may lose strength because of:

• Childbirth. In women, poor function of pelvic floor muscles or the sphincter may occur because of tissue or nerve damage during delivery of a child. Stress incontinence from this damage may begin soon after delivery or occur years later.

• Prostate surgery. In men, the most common factor leading to stress incontinence is the surgical removal of the prostate gland (prostatectomy) to treat prostate cancer. Because the sphincter lies directly below the prostate gland and encircles the urethra, a prostatectomy may result in a weakened sphincter.

Contributing factors
Other factors that may worsen stress incontinence include:

• Illnesses that cause chronic coughing or sneezing

• Obesity

• Smoking, which can cause frequent coughing

• High-impact activities, such as running and jumping, over many years

Risk factors
Factors that increase the risk of developing stress incontinence include:

• Age. Although stress incontinence isn't a normal part of aging, physical changes associated with aging, such as the weakening of muscles, may make you more susceptible to stress incontinence. However, occasional stress incontinence can occur at any age.

• Type of childbirth delivery. Women who've had a vaginal delivery are more likely to develop urinary incontinence than women who've delivered via a cesarean section. Women who've had a forceps delivery to more rapidly deliver a healthy baby may also have a greater risk of stress incontinence. Women who've had a vacuum-assisted delivery don't appear to have a higher risk for stress incontinence.

• Body weight. People who are overweight or obese have a much higher risk of stress incontinence. Excess weight increases pressure on the abdominal and pelvic organs.

• Previous pelvic surgery. Hysterectomy in women and particularly surgery for prostate cancer in men can alter the function and support of the bladder and urethra, making it much more likely for a person to develop stress incontinence.

Complications
Complications of stress incontinence may include:

• Personal distress. If you experience stress incontinence with your daily activities, you may feel embarrassed and distressed by the condition. It can disrupt your work, social activities, relationships and even your sex life. Some people are embarrassed that they need pads or incontinence garments.

• Mixed urinary incontinence. Mixed incontinence is common and means that you have both stress incontinence and urge incontinence — the loss of urine resulting from an involuntary contraction of bladder muscles (overactive bladder).
   

•  Skin rash or irritation. Skin that is constantly in contact with urine is likely to be irritated or sore and can break down. This happens with severe incontinence if you don't take precautions, such as using moisture barriers or incontinence pads.
   

Bedwetting

Overview
Bed-wetting — also called nighttime incontinence or nocturnal enuresis — is involuntary urination while asleep after the age at which staying dry at night can be reasonably expected.

Soggy sheets and pajamas — and an embarrassed child — are a familiar scene in many homes. But don't despair. Bed-wetting isn't a sign of toilet training gone bad. It's often just a normal part of a child's development.

Generally, bed-wetting before age 7 isn't a concern. At this age, your child may still be developing nighttime bladder control.

If bed-wetting continues, treat the problem with patience and understanding. Lifestyle changes, bladder training, moisture alarms and sometimes medication may help reduce bed-wetting.

Symptoms
Most kids are fully toilet trained by age 5, but there's really no target date for developing complete bladder control. Between the ages of 5 and 7, bed-wetting remains a problem for some children. After 7 years of age, a small number of children still wet the bed.

When to see a doctor
Most children outgrow bed-wetting on their own — but some need a little help. In other cases, bed-wetting may be a sign of an underlying condition that needs medical attention.

Consult your child's doctor if:

•  Your child still wets the bed after age 7

•  Your child starts to wet the bed after a few months of being dry at night

•  Bed-wetting is accompanied by painful urination, unusual thirst, pink or red urine, hard stools, or snoring

Causes
No one knows for sure what causes bed-wetting, but various factors may play a role:

• A small bladder. Your child's bladder may not be developed enough to hold urine produced during the night.

• Inability to recognize a full bladder. If the nerves that control the bladder are slow to mature, a full bladder may not wake your child — especially if your child is a deep sleeper.

• A hormone imbalance. During childhood, some kids don't produce enough anti-diuretic hormone (ADH) to slow nighttime urine production.

• Urinary tract infection. This infection can make it difficult for your child to control urination. Signs and symptoms may include bed-wetting, daytime accidents, frequent urination, red or pink urine, and pain during urination.

• Sleep apnea. Sometimes bed-wetting is a sign of obstructive sleep apnea, a condition in which the child's breathing is interrupted during sleep — often due to inflamed or enlarged tonsils or adenoids. Other signs and symptoms may include snoring and daytime drowsiness.

• Diabetes. For a child who's usually dry at night, bed-wetting may be the first sign of diabetes. Other signs and symptoms may include passing large amounts of urine at once, increased thirst, fatigue and weight loss in spite of a good appetite.

• Chronic constipation. The same muscles are used to control urine and stool elimination. When constipation is long term, these muscles can become dysfunctional and contribute to bed-wetting at night.

• A structural problem in the urinary tract or nervous system. Rarely, bed-wetting is related to a defect in the child's neurological system or urinary system.

Risk factors
Bed-wetting can affect anyone, but it's twice as common in boys as in girls. Several factors have been associated with an increased risk of bed-wetting, including:

• Stress and anxiety. Stressful events — such as becoming a big brother or sister, starting a new school, or sleeping away from home — may trigger bed-wetting.

• Family history. If one or both of a child's parents wet the bed as children, their child has a significant chance of wetting the bed, too.

• Attention-deficit/hyperactivity disorder (ADHD). Bed-wetting is more common in children who have ADHD.

Complications
Although frustrating, bed-wetting without a physical cause doesn't pose any health risks. However, bed-wetting can create some issues for your child, including:

• Guilt and embarrassment, which can lead to low self-esteem

• Loss of opportunities for social activities, such as sleepovers and camp

• Rashes on the child's bottom and genital area — especially if your child sleeps in wet underwear.

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