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Nocturnal Enuresis Clinical Management Tool

Why this management tool?

  1. The aim of this tool is to use a simple questionnaire and non-invasive screening, leading to a rational approach to diagnosis.
  2. This tool is designed to help ensure that treatment choice is informed by robust information on the underlying pattern and cause of wetting, as this influences the probability of success with a given treatment.
  3. The tool is meant to complement, not replace, good clinical practice whereby the child's and family's views, attitudes, circumstances and preferences are central to agreeing a management strategy.
  4. By selecting treatments based on a correct diagnosis and categorisation, treatment failures should be reduced.

Please download your copy of the Nocturnal Enuresis Clinical Management Tool and Fluid Chart using the links on the right hand side.

NICE Algorithm

In June 2014, Ferring hosted a consensus steering meeting with a panel of experts whom have a special interest in paediatric continence. They were tasked to review the current 2010 NICE guidelines and evaluate their pragmatic use within primary care service. Following their critique as a group, the chair June Rogers MBE, PromoCon Paediatric Continence Specialist challenged them to compose a succinct management algorithm if a child (5-19) presents with bedwetting in primary care. In addition, were there any top tips that the group as experts could share with non-specialists.

The objective of this document once composed is to:

  1. Facilitate early intervention, assessment and diagnosis in the patient cohort
  2. Improve treatment outcomes for children with NE
  3. Ensure consistency and alignment to NICE Quality Standards across services
  4. Promote and emphasise the need for integrated bladder and bowel services nationally

After development and review by the committee plus a practicing GP and commissioning manager, the algorithm and top tips is now available for use by healthcare professionals.

The Algorithm was released following the publication of the NICE Quality Standards to verify commonality and consistency across both documents.

The steering committee consisted of the following specialists:

  • June Rogers MBE (PromoCon Paediatric Continence Specialist)
  • Brenda Cheer (Paediatric Specialist Continence Nurse and ERIC Nurse)
  • Dr Sameena Shakoor (Consultant Paediatrician and Clinical Director)
  • Davina Richardson (Children’s continence Nurse)
  • Alison Wardley RGN/RSCN,BSc(Hons) SpCN(Children), Team manager Children’s Community Nursing Team)
  • Dr Chinnaiah Yemula (Consultant Community Paediatrician)

Reviewed and commented by:

  • Dr Zoe Rawlinson (GP)
  • Sheena Hennell (Commissioning Manager)

This document has been made available to be downloaded as a PDF should you require further copies, please contact Ferring Pharmaceutics at

The Clinical Management Tool and the NICE Algorithm can be found in the CCG Commissioning Tool Kit

Find out more on our NICE Implementation page