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Suggest Treatment For Night Sweats, Sleeping Trouble And Urination Issues

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Posted on Sat, 22 Aug 2015
Question: I am a 60 year old woman who has had no previous history of bed wetting ..EVER. About a year ago doctor took me off of natural hormones and I have gained weight, have night sweats, have trouble getting to sleep and get up 3 or 4 times a night to urinate. I do not have constant urination issues during day. Since May I have woken up 4 times and have been soaked with no idea what has happened. The fluid is colorless and odorless. Tonight I literally had been up a 1/2 hour before gone back to bed, woke up from some strange dream (nothing to do with going bathroom) and I am wet. My new doctor is putting back on my hormones which I should pick up tomorrow. My urinalysis was good. I do have high blood pressure and have gained some weight. I am finding this extremely humiliating and disturbing and I don't know what to do to keep it from happening when traveling, visiting other's homes for the night, etc. I don't know why it is happening. I am to visit family this weekend and I have not been able to bring myself to tell my domestic partner about my issues or anyone else for that matter. My doctor has given me the name of a urogynecologist but I am so upset by these episodes I don't know what to do. First one was in Mid May, then another about a week later and then another week later on 6/13. Went over a month then 7/26 woke up damp like leakage from sneezing or coughing, then again on 7/29 same thing. Now next night I wake up soaked. I have had a full vaginal hysterectomy 12 years ago. What is going on? Why is this happening and what can I do to eliminate this humiliating problem?
doctor
Answered by Dr. Ravi Bansal (3 hours later)
Brief Answer:
Bladder dysfunction

Detailed Answer:
Hi XXXX,

Passage of urine in bed at night time can be because of various problems-

1. urine infections- but then there should be symptoms in daytime also, you may have burning sensation and fever.

2. urge incontinence- this occurs when you feel that you now want to pass urine but when you go towards the loo you are not able to hold it and you wet yourself. Here, you come to know that urine is going to come and you can try to holdit. This is because of bladder irritability. there are medicines to help you

3. stress incontinence- Here whenever you cough or jump or shout a little bit of urine may come out.- this is generally due to weakness of pelvic musculature. which can occur with increasing age and in patients with prior gynec surgury -like your case. exercises help you

4. But some times people do bedwetting like in children, where during sleep they pass urine and come to know only when they get up. in day time they remain normal. they can be helped by medicines.

By your description i think it is the last type of problem which i have described ( please correct me if any other type of problem)

In that case you may be benefitid by MINIRIN ( Desmopressin) tablets which are a hormone used only fof this specific problem. But since you have high BP you should take them only under guidence of your doctor.

We should get a serum creatinine, electrolytes, urine routine, Ultrasound KUB with post void residue estimation also done before we start treatment.

If any query please write in,
Best wishes
Above answer was peer-reviewed by : Dr. Vinay Bhardwaj
doctor
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Follow up: Dr. Ravi Bansal (1 hour later)
I have had the blood work and urinalysis done and everything was normal. I don't understand why I produce more urine once I go to bed vs all day when I am up. Secondly, I had been to the bathroom 1/2 hr before last night's incident. I don't have bed wetting issues multiple times during night so why after getting up several times prior did this happen? Secondly, it just seems so weird, like fluid is storing up over period of time then dumps. This has happened occasionally, (thank goodness) and doesn't happen nightly. I feel like I have mild vaginal cramps after one of these episodes but that doesn't make any sense since I have had a full hysterectomy that removed my ovaries also.

Lastly I will have to get up 3-4 times usually before 3 in the morning and then after that I will sleep fine and not have to get up to use the loo.
doctor
Answered by Dr. Ravi Bansal (21 hours later)
Brief Answer:
urine incontinence

Detailed Answer:

More urine at bed time occurs due to mobilization of water from Exracellularcompartment to intravascular compartment. It is common in patients with swelling and water excess in body.

Second cause is lack of Antidiuretic hormone which is normally secreted at night in normal individuals.

If large amount of urine comes out together without your control it is a type of 'bed wetting' only. It may not occur daily. and most likely cause is lack of central brain control and again lack of ADH hormone.

when you get up recurrently at light , do not drink water that time. also avoid liquids for 1-2 hrs before you go to sleep.

as for medication as i told previously , under guidence of your treating doctor you can try desmopresin.

Best wishes
Note: Consult a Urologist online for consultation about prostate and bladder problems, sexual dysfunction, kidney stones, prostate enlargement, urinary incontinence, impotence and erectile dysfunction - Click here.

Above answer was peer-reviewed by : Dr. Shanthi.E
doctor
Answered by
Dr.
Dr. Ravi Bansal

Nephrologist

Practicing since :1996

Answered : 359 Questions

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Suggest Treatment For Night Sweats, Sleeping Trouble And Urination Issues

Brief Answer: Bladder dysfunction Detailed Answer: Hi XXXX, Passage of urine in bed at night time can be because of various problems- 1. urine infections- but then there should be symptoms in daytime also, you may have burning sensation and fever. 2. urge incontinence- this occurs when you feel that you now want to pass urine but when you go towards the loo you are not able to hold it and you wet yourself. Here, you come to know that urine is going to come and you can try to holdit. This is because of bladder irritability. there are medicines to help you 3. stress incontinence- Here whenever you cough or jump or shout a little bit of urine may come out.- this is generally due to weakness of pelvic musculature. which can occur with increasing age and in patients with prior gynec surgury -like your case. exercises help you 4. But some times people do bedwetting like in children, where during sleep they pass urine and come to know only when they get up. in day time they remain normal. they can be helped by medicines. By your description i think it is the last type of problem which i have described ( please correct me if any other type of problem) In that case you may be benefitid by MINIRIN ( Desmopressin) tablets which are a hormone used only fof this specific problem. But since you have high BP you should take them only under guidence of your doctor. We should get a serum creatinine, electrolytes, urine routine, Ultrasound KUB with post void residue estimation also done before we start treatment. If any query please write in, Best wishes