21 December 2001
Bedwetting in Adults in Hong Kong:
Fact & Fiction
Although it is
now well known that bed-wetting is a very common problem in childhood, with
about 10% of local children by age 7 being frequent bed-wetters, until recently
nobody knew whether the problem also occurred in Hong Kong adults.
Researchers from the Division of Paediatric
Surgery at the Faculty of Medicine, The Chinese University of Hong Kong explored
this question by surveying over 8,500 adults aged between 16 - 40 years over
the telephone. Nearly 3% of all men and 2% of women admitted to having
bed-wetting whilst asleep. This amounts to over 60,000 adults in Hong
Kong in that age range being affected by this embarrassing problem.
Of these, over half of the affected adults were wet for 3 or more nights
a week, and one quarter of the sufferers experienced bed-wetting every night.
The study also compared people who
have night bladder problems with the adults who didn’t and found that sufferers
were significantly more likely to be depressed and have a lower self-esteem.
Up to 40% of adults with bed-wetting felt that the problem affected their
employment performance and social and family interactions. In addition,
significantly less of the affected individuals achieved tertiary education
as compared to normal controls. People in the affected group also reported
more difficulty with falling asleep and woke up more often during the night
or very early in the morning. Despite all the negative effects of this
disorder it seems that very few people knew how to manage the problem, and
less than half of the affected individuals have tried some form of therapy
or seeked medical assistance.
Through ongoing medical research both
the pathophysiology and therapeutic approach for bed-wetting has become far
better understood over the past few years. It is currently believed
that 3 main factors interact to decide whether a person can be dry during
the night. Firstly the bladder must have the ability to rest during
the night and store all the urine made by the kidneys during sleep.
Secondly the brain needs to be able to respond to messages to wake when the
bladder is near its limit of storage. Thirdly the amount of urine produced
by the kidneys should not exceed the holding capacity of the bladder.
Detailed assessment of each affected individual, considering the above factors,
has allowed us to accurately determine which specific treatment or combination
of treatments would be mostly effective to improve the problem, thereby achieving
a complete cure in the great majority (over 90%) of patients.
Since these new approaches
to helping bed-wetters are relatively recent, it is likely that sufferers
who have sought medical help 3-4 years ago or longer may not have the access
to, or even the knowledge of, recent therapies. In view of this the
Faculty of Medicine, CUHK, has established the Hong Kong Enuresis Research
and Information Centre (HKERIC). The aims of the centre are to
promote public understanding of bed-wetting and to help health professionals
improve their assessment and treatment skills. The services provided
by HKERIC include: telephone hotline, fax and letter advice service, homepage
and e-mail with Q & A sections for professional advice, and regular seminars
for public and health professionals.