Hypertonic bladder, or uncontrollable urination in adults, can be caused by various diseases or conditions. Symptoms include regular urges to urinate and incontinence. Diagnosis may involve tests such as cystoscopy and treatment options include medication, pelvic exercises, and surgery.
When enuresis, or uncontrollable urination, occurs in adults, it’s known as having an overactive or hypertonic bladder. Caused by any number of diseases or conditions that cause an improperly sized or functioning bladder, this condition leads to regular urges to urinate which, if not met, can cause incontinence, the inability to stifle urination. A diagnosis of hypertonic bladder could provide any number of treatment options, from prescribing a bladder relaxant or pelvic exercises to catheterization or surgery.
While it is possible for a tumor, excessive fluid intake, certain medications, or even advanced age to cause a hypertonic bladder, this is usually the result of various diseases or conditions. Inflammation caused by infection or bladder stones are the regular culprits. Other causes include an enlarged prostate, a condition called benign prostatic hypertrophy, and various neurological disorders, from Parkinson’s disease to multiple sclerosis. It is widely believed that heredity is a factor.
Aside from an oddly recurring need to empty their bladder, those with a hypertonic bladder will often experience regular incontinence as a result of it. The Mayo Clinic defines an excessive need to urinate eight or more times a day. Another sign of this disorder is called nocturia, when a patient wakes up a few times or more each night to urinate. Often, older adults find the condition to be untreatable and simply start wearing adult diapers.
Doctors have a number of options for determining why a person has this disorder. You may need a procedure known as a cystoscopy to see how your bladder is working. Other tests might include radiology, urinalysis, or a postvoid residual volume test to measure how much urine is passed and how much remains in the bladder after each urination.
However, incontinence resulting from a hypertonic bladder is usually treatable. Doctors have a number of non-invasive therapies at their disposal such as training the bladder to hold more urine for longer periods. Doctors will also prescribe a drug known to relax the bladder or regulate its function. Called anticholinergic drugs, these go by names like darifenacin, oxybutynin or tolterodine. Another regular treatment includes so-called pelvic floor exercises to strengthen the muscles associated with urination.
Surgery is a last resort for sufferers of this condition. One route is known as a bladder augmentation procedure, which involves creating an additional buildup of bladder by altering part of the bowel. Another procedure requires implanting a device that sends the correct set of electrical impulses to the bladder.
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