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Managing Enuresis - a guide for professionals

Professionals can find out more about our enuresis service on this page including how we work in partnership with you to to support families in managing enuresis. 

Our 0-19 team including health visitors, school nurses and the continence service support children and families in managing enuresis.

Only children aged 5 years and over can be referred to the Early Toileting team.

Parents/carers of children are under 5 years can contact the Advice Line for advice (this is because the bladder is not fully developed until at least 5 years old) or call the ERIC Helpline.

The Health Visiting team provides early toileting advice and support for parents/carers. This advice covers good toileting routines, fluid intake and constipation management and families are given  details of the ERIC website.

The School Nursing team provides early toileting advice if needed. This is identified in a questionnaire completed by parents/carers before children start school. If support is required, families are directed to the 'Boss of your bladder' leaflet and ERIC website.

Enuresis clinics are available for children who have not achieved night time continence by the age of 5 years.

GPs should refer children needing Enuresis support through the One Stop Referral Service. Persistent day time and nocturnal enuresis will be referred to the Continence Service and back to the GP for further support

The continence service will assess the requirement for containment products for children with persistent Enuresis over the age of 4 years, after revisiting all toileting advice.

Please visit the Continence page for more information about this service. 

What happens in the nocturnal enuresis clinic?

Surrey Clinics are run in line with NICE guidance (2010) and the three systems approach. Clinics are child-focused and planned interventions are made in partnership with parents/carers and the child.

Children are seen for up to six months in the clinic and will be referred back to GPs or other relevant health professionals if continence is not achieved.

  • Clinics are run weekly, fortnightly or monthly.
  • First appointment is 1 hour to allow for holistic assessment of the situation.
  • NICE guidance will direct whether support is needed with drinking, toileting advice or interventions are needed with Desmopressin or a nocturnal enuresis alarm.
  • Interventions are trialled for 4 weeks and then reviewed.
  • Nocturnal enuresis alarms or medication are not issued without completion of a full holistic assessment.
  • Desmopressin will not be prescribed at the clinic. If desmopressin is required the GP will receive a letter requesting their support prescribing the desmopressin.
  • Children with signs of bladder instability will be referred back to GPs for further assessment and bladder scanned.

Please refer through the One Stop Referral Service. This is the centralised referral and triage service for Surrey's specialist children's services

Photograph of a child potty training