Transcript Document

Nocturnal Enuresis in Children
GREEN
AMBER
If under 7 years old and no
amber flags
Reassure patients that it is
common (1 in 5 children
aged 4 – 5 wet bed once a
week)
Advise parent / carer of
eric.org.uk for further
support
If 7 years old and over with
no suspicion of underlying
cause
History and examination
If started in last few days / weeks or
secondary enuresis (previously dry at
night for > 6 months)
Or
Severe daytime symptoms
Carry out urinalysis if:
Assess for
systemic cause
or trigger
New onset
Daytime symptoms
Ill health
?UTI
?Diabetes
RMS
Interventions:
Advise toilet training if not
been attempted
UTI
Constipation
Diabetes
Advise parents or carers to
take child to toilet if wakes
up at night
Suggest a trial of 2 nights in
a row without nappies or
pull-ups for child who has
been toilet trained during
day for at least 6 months
Version Draft April 2013
Treat as per
local
guidance.
Refer to
appropriate
local pathway
Behavioural or
emotional
problems
RMS
Referral to
Paediatrician
Consider
referral to
CAMHS
Referral to
Enuresis Clinic
(Vale Drive
Clinic, Vale
Drive, EN5 2ED)