Differential Diagnosis for Nocturnal Enuresis in an Adult
Single Most Likely Diagnosis
- Overactive Bladder: This condition is characterized by a sudden, intense urge to urinate, often resulting in involuntary loss of urine. It is a common cause of nocturnal enuresis in adults due to its prevalence and the fact that symptoms can worsen at night.
Other Likely Diagnoses
- Diabetes Mellitus: High blood sugar levels can lead to increased urine production, making it difficult to stay dry throughout the night. Adults with uncontrolled diabetes are at a higher risk of developing nocturnal enuresis.
- Sleep Disorders: Conditions like sleep apnea can increase the likelihood of nocturnal enuresis by disrupting normal sleep patterns and leading to increased urine production.
- Neurogenic Bladder: Damage to the nerves that control the bladder can result in loss of bladder control, leading to nocturnal enuresis.
- Polyuria: Excessive urine production, often due to conditions like diabetes insipidus or primary polydipsia, can overwhelm the bladder's capacity, leading to nocturnal enuresis.
Do Not Miss Diagnoses
- Urinary Tract Infections (UTIs): While not the most common cause, UTIs can lead to severe consequences if left untreated, such as sepsis or kidney damage. Nocturnal enuresis can be a symptom of a UTI, especially in older adults.
- Bladder Cancer: Although rare, bladder cancer can cause nocturnal enuresis, especially if the tumor obstructs the flow of urine or irritates the bladder.
- Spinal Cord Injury or Disease: Conditions affecting the spinal cord, such as multiple sclerosis or spinal cord injuries, can disrupt communication between the brain and bladder, leading to loss of bladder control.
Rare Diagnoses
- Nocturnal Polyuria Syndrome: A rare condition characterized by excessive urine production at night, often without an underlying medical condition.
- Epilepsy: Certain types of seizures, such as nocturnal frontal lobe epilepsy, can cause loss of bladder control during sleep.
- Multiple System Atrophy: A rare neurodegenerative disorder that can affect bladder control, leading to nocturnal enuresis.