Enuresis guidance for GPs

Guidelines for the management of enuresis in primary care have been published in the British Journal of General Practice (2017;67:328–9). The practical guidelines and tools are based on the guidelines of the International Children’s Continence Society (ICCS) and follow the new ICCS standardisation and subtyping of patients.

According to the international panel of authors, around 10% of 6–7-year-olds suffer from enuresis. Enuresis is therefore highly prevalent, but its impact is often underestimated.

Training for GPs rarely includes specific guidance on enuresis, and the default approach is often to wait for spontaneous resolution, they say. Despite comprehensive enuresis guidelines in specialist journals for secondary and tertiary care, versions for use in primary care are scarce and often confusing because of outdated terminology.

The guidance starts by saying that bedwetting in the under fives does not need treating. In the over fives the first stage of diagnosis is to determine if the problem is simple enuresis or involves more complex bladder dysfunction requiring specialist referral.

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