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27-10-2010 | General practice | Article

New guidance on bedwetting

Abstract

NICE Guidance: Nocturnal enuresis – the management of bedwetting in children and young people

Children under the age of seven years can now be considered for treatment for bedwetting, according to new guidance issued by the National Institute for Health and Clinical Excellence (NICE).

Currently treatment for bedwetting (nocturnal enuresis) is only considered once a child reaches the age of seven, but the new NICE guidance does not specify a minimum age limit.

Over a fifth of children aged between four and five years regularly experiences nocturnal enuresis. Most grow out of it as they learn to control their bladder at night, but for some it can continue into late childhood.

The guidance advises GPs and practice nurses to encourage parents or carers to reward their children for agreed behaviour, such as going to the toilet before bed or helping to change the sheets, rather than for dry nights.

It suggests an alarm as first-line treatment, unless considered unsuitable or the child is only wetting the bed once or twice a week, while treatment with desmopressin is a second-line option. Children who do not respond to either treatment should be referred to a specialist, to help identify any underlying disease or social or emotional causes.

Dr Mark MacKenzie, a GP who helped develop the guidance, said: "The guideline from NICE outlines the variety of ways that the NHS can help families cope with this condition. It also provides advice on when bedwetting may be a symptom of an underlying condition - such as a urinary tract infection, diabetes, or emotional troubles like bullying or maltreatment.

"I hope that this guideline reassures GPs and other healthcare professionals that they are treating these patients in the most effective ways possible."

GP News is an independent clinical news service provided by Springer Healthcare Limited. © Springer Healthcare Ltd; 2010

By Caroline Price