My initial diagnosis: Secondary Nocturnal Enuresis

[zzyzx]

My initial incontinence adult onset was secondary nocturnal enuresis that came about due to illness and the set of medications used to deal with the illness.  The medication "tweaked" how I sensed things.  Years ago, most doctors didn't give slight changes in how you sense things much thought.  With covid-19, I notice a change in this area is now more noted.  Two weeks on the medication left me never waking up each night when the full bladder hit.  After getting off the medication and the illness cleared, it had changed what had been pre-illness occasional nocturia into occasional nocturnal enuresis.

Years later, with early onset BPH, playing the watch and wait game, then finally having Rezūm procedure, my bladder capacity has decreased (from the bladder wall thickening, and the muscle strengthening).  This has shifted the nocturnal enuresis to nightly (assuming I stay normally (or better) hydrated and also get a good nights sleep) and added a daytime light leaking component, which means I'm now wearing protection all the time (outside of the bathroom).  I still normally make it during the day to the toilet, but I now have a slight pre and/or post leak that will leave some dampness I have to deal with.

[John Davis]

Keep making it to the toilet as long as you can.  It helps to exercise those muscles and nerves.  Thanks for sharing.

[zzyzx]

13 hours ago, John Davis said:

Keep making it to the toilet as long as you can.  It helps to exercise those muscles and nerves.  Thanks for sharing.

@John Davis: Thanks for the comments.  

My daytime "fun" is telling the difference between an urge because I'm full and needing to make it to the bathroom, and an urge for other reasons.  I know sudden temperature deltas are one of those issues.  I need to treat the two types of urges differently, but that catch is knowing which is which all the time.  And I'm not "aware" of how full the bladder is when the urge hits.  At least I have reasonable "holding" power still.  Just leak some on (very?) strong urges on (nearly?) full bladder.  I figure eventually I'll loose more control, but I'm trying to keep that from happening for as long as I can...  Unfortunately, I think the day time situation (over the last few weeks) is some times worse than it was....  (i.e. damper in the evening when I'm preparing for bed.)

Urologist wasn't completely in agreement with my attempts to regain bladder capacity after the rezume procedure.  I lost about 1/2 to 2/3's of my functional capacity before getting the prostate reduced around the urethra while running with "watch and wait" protocol concerning early onset BPH and related (slightly high) PSA / Free PSA numbers.  Urologist says my prostate size supports my PSA numbers.. 

I think I managed to get back to about 2/3's of my previous capacity, and that may be dropping back down to about 1/2....  Part of the reason is my previous  maximum functional capacity meant I had an oversized bladder....  So, the urologist doesn't want to have me go too far with trying to hold and increase capacity back to what it was and the potential issues if I succeeded in getting closer to the old functional capacity.....  And that's why the occasional nocturnal enuresis is now basically nightly when I get good sleep and am at least properly hydrated.....