When enuresis, or uncontrollable urination, occurs in adults, it is known as having an overactive or hypertonic bladder. Caused by any number of diseases or conditions that cause an improperly sized or operating bladder, this condition leads to regular urges to urinate that, if not satisfied, can cause incontinence — the inability to stifle urination. A diagnosis of hypertonic bladder could yield any number of treatment options, from a prescription for a bladder relaxant or pelvic exercises to catheterization or surgery.
Though it is possible that a tumor, excessive fluid intake, certain medications or even advanced age is causing a hypertonic bladder, this is typically a result of various diseases or conditions. Inflammation caused by infection or bladder stones are 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 recurrent urge to void the bladder, those with a hypertonic bladder will often experience regular incontinence as a result of it. The Mayo Clinic characterizes an excessive urge to urinate as happening eight or more times a day. Another sign of this disorder is called nocturia, when a patient wakes up a few times or more every night to urinate. Often, older adults assume the condition is untreatable and merely begin to wear adult diapers.
Doctors have a range of options available to determine why a person is suffering from this disorder. It may require a procedure known as a cystoscopy to view the operation of the bladder. Other tests might include radiology, urinalysis or a post-void residual volume test to gauge how much urine is voided and how much remains in the bladder after each urination.
Incontinence resulting from a hypertonic bladder is usually treatable though. Doctors have a range of non-invasive therapies at their disposal like training the bladder to hold more urine for longer periods. Doctors also will prescribe a medication known to relax the bladder or regulate its function. Called anticholinergis drugs, these go by names like darifenacin, oxybutynin or tolterodine. Another regular treatment includes what is known as pelvic-floor exercises to strengthen the muscles associated with urination.
Surgery is a last resort for those with this condition. One route is known as a bladder augmentation procedure, which involves creating extra bladder storage by altering a part of the bowels. Another procedure requires the implantation of a device that sends the correct array of electrical impulses to the bladder.