Enuresis Referrals Dr Rick Fulton 09/06/2014. Enuresis Diurnal vs nocturnal NICE guidance on Bed-wetting Referrals.

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Presentation transcript:

Enuresis Referrals Dr Rick Fulton 09/06/2014

Enuresis Diurnal vs nocturnal NICE guidance on Bed-wetting Referrals

Daytime Enuresis Daytime wetting more likely to represent an underlying secondary cause of enuresis – consider: Recurrent UTI Constipation Diabetes Adequate fluid intake Underlying bladder control issues Emotional/Psychological factors (safeguarding)

Bedwetting NICE Guidance 1 in 6 5yo children wet the bed once per week 1 in 15 children aged 10y still wet the bed Inadequate or excessive fluid intake still most common cause

NICE guidance Fluid intake, diet and toileting patterns Rewards (for behaviours not dry nights) Lifting and waking (short term solution only) Trial without nappies

NICE guidance Consider alarm (not appropriate for all families) Desmomelt (Desmopressin dissolvable tablets) – 120mcg at bedtime (up to 240mcg) Rules: No drinking after tablet. Stop if D and V. Wean off when stopping drug.

Referrals Nurse-led nocturnal enuresis clinic: The Jarvis Centre, Stoughton Road, GU1 1LJ. Accept referrals direct from GPs. Refer to paediatrics if other cause suspected.

References Ferring pharmaceuticals resource pack Nocturnal Enuresis. NICE Guidance. CG (see NICE pathway) ERIC – Enuresis Resource and Information Centre.