Nurse-led Paediatric Continence Service - Daytime wetting, Referral Criteria

Children with daytime wetting or combined daytime wetting and enuresis should be referred to the Nurse-led Continence Service via SCI gateway or New Appointments Office at RHC for Vetting for non-invasive bladder assessment.

A child will be referred into the nurse led Continence Service if they possess the following criteria:

• Have primary or secondary daytime wetting
• Are age four years or above
• Significant urinary frequency and/or urgency
• Dysfunctional voiding

Referrals from UTI Service with daytime wetting – Patients should be free from urinary tract infections and off prophylaxis for a period of 6 months prior to referral.

Referrals from Nurse-led Enuresis/Constipation Service - Patients who have daytime wetting or urinary symptoms which are significant or predominant.

• Prior to referral patients should have a period of urotherapy for a minimum of 2 months to normalise daytime drinking and toileting habits
• Underlying constipation has been treated for a minimum period of 2 months and any soiling has resolved
• Daytime symptoms have been re-assessed following a period of urotherapy and bowel management prior to referral. If applicable if a Dysfunctional Voiding Score has been completed please upload information with the referral.

Referrals through SCI –

• Patients who have secondary daytime wetting following a recent UTI should defer referral until 3 months after treatment for UTI to see if symptoms resolve spontaneously. If wetting or urinary symptoms are long standing and precede patient having a UTI the referral will be considered.
• As a service we are unable to offer toilet training. For patients under 5 years who have not achieved daytime continence we would advise to seek advice from the Health Visiting Team in the first instance. If not progressing please ensure patient has tried a period without nappies (8-12weeks) prior to referral.