(Disclaimer: This article is only for popular science purposes, in order to protect the patient’s privacy, the relevant information in the following content has been processed) Abstract: Bedwetting is generally considered to be a condition that occurs only in children, but the patient in this article is an elderly person who still suffers from the phenomenon of bedwetting. After detailed consultation and examination, the patient was diagnosed with prostatic hyperplasia with overflow incontinence. After medication, the nighttime bedwetting has been controlled, but due to the seriousness of the condition, the patient will have to undergo minimally invasive transurethral prostate surgery to solve the urination problem at root. 【Basic information】 Male, 73 years old 【Disease type】 Congestive incontinence 【Hospital】 Shijiazhuang People’s Hospital 【Date of consultation】 June 2021 【Treatment plan】 Oral medication (tamsulosin hydrochloride extended-release capsule, finasteride tablets) 【Treatment cycle】 2 weeks 【Treatment effect】 Bedwetting symptoms disappeared A. Initial interview The patient, Mr. Wang, who is already 73 years old, came to us with a complaint of recurrent nocturnal bedwetting for 6 months, and complained that he had no ability to urinate for several years before. He complained that in the past few years, he had weakness in urination, and the number of times he went to the toilet at night increased, almost 4-6 times per night, which seriously affected his rest and caused insomnia. After taking oral sleeping pills, sleep was slightly improved, but bedwetting occurred. Body temperature was 35.9℃, and rectal examination revealed the presence of hyperplasia of the prostate gland, which was tough and no obvious nodules were palpable. Physical examination report did not find other internal chronic diseases, perfect urinary ultrasound as well as bladder residual urine measurement, suggesting prostatic hyperplasia, bladder urinary retention, residual urine 239ml, bilateral renal cysts, preliminary diagnosis of prostatic hyperplasia, congestive urinary incontinence bilateral renal cysts. After repeated communication with the patient, the patient was told that the main reason for nighttime bedwetting was that there was too much residual urine in the bladder, the real effective bladder capacity became small, and the bladder became full of urine and overflowed at night, which then led to bedwetting. After 2 weeks of retaining the urinary catheter, oral tamsulosin hydrochloride extended-release capsules, finasteride tablets for 2 weeks, the patient removed the urinary catheter, the patient urinated more fluently, rechecked the residual urine in the bladder 110 ml, and the nighttime bedwetting disappeared. Figure Patient’s urological ultrasound + bladder residual urine measurement report III. Treatment effect After 2 weeks of retaining the ureter to drain urine, the patient was rechecked for urological ultrasound as well as bladder residual urine measurement, and the results suggested prostate hyperplasia, 110ml of bladder residual urine, and bedwetting at night did not occur again. However, due to the patient’s prostatic hyperplasia is more serious, the current drug treatment bladder residual urine 110ml is still greater than 50ml, and the patient is older, so it is recommended to wait until the bladder contraction function is restored, and then come to perform transurethral plasma electrocution of the prostate, in order to solve the problem at the root. After active treatment, the patient did not experience bedwetting again and his condition was significantly relieved. It is important to note that patients still need to pay attention to the following points after discharge: 1, daily life should try not to eat spicy, stimulating food, do not drink alcohol, and develop a good work and rest habits; 2, do not ride a bike for a long time or riding across the movement, in order to prevent pressure on the prostate, resulting in aggravation of the condition; 3, when the weather becomes cold, should pay attention to keep warm. And regularly review the urinary ultrasound + bladder residual urine measurement, according to the amount of bladder residual urine, to determine whether the condition is progressing. Fifth, personal perception of the patient prostate hyperplasia symptoms of lower urinary tract obstruction, there has been a nighttime bedwetting and other symptoms suggesting that the bladder is in the stage of loss of compensation, it is imperative to retain the urinary catheter, drainage of urine, imaging tests to assess the damage to the upper urinary tract, blood biochemistry to assess the renal function, the degree of anemia. In this case, the patient was suffering from overflow incontinence due to prostatic hyperplasia and was old enough to undergo retention of the urinary catheter to drain out the urine, and medications for prostatic hyperplasia were given to manage the patient’s symptoms to the maximum extent that the patient’s body was able to tolerate them. For the evaluation of bladder contraction function, often at 2 weeks or even 3 months of retention of urinary catheter, to ensure maximum recovery of bladder contraction, urodynamic examination to determine the recovery of bladder function, if the bladder contraction force is roughly normal, the patient is generally recommended to surgical treatment, such as minimally invasive treatments such as transurethral plasma electrocision of the prostate gland, and often postoperative results are more satisfactory, for the poor contraction of the bladder, unable to tolerate major For patients with poor bladder contraction who cannot tolerate major surgery, it is generally recommended to perform cystostomy to try to avoid further aggravation of upper urinary tract injury and protect renal function.