Enuresis: practical guidelines for primary care

INTRODUCTION Worldwide, around 10% of 6–7-yearolds suffer from enuresis. Enuresis is therefore highly prevalent, but its impact is often underestimated. Training for family doctors rarely includes specific guidance on enuresis, and the default approach is often to wait for spontaneous resolution. Despite comprehensive enuresis guidelines in specialist journals for secondary and tertiary care, versions for use in primary care are scarce (for example, https://pathways.nice. org.uk/pathways/bedwetting-in-childrenand-young-people), and often confusing because of outdated terminology. This article provides practical guidelines and tools to manage enuresis in primary care in children of ≥5 years based on the guidelines of the International Children’s Continence Society (ICCS), following the new ICCS standardisation and subtyping of patients.1–3 The document was developed by the steering committee of World Bedwetting Day 2017 representing the American Academy of Pediatrics (AAP), the North American Paediatric Urology Societies, the European Society for Paediatric Nephrology (ESPN), the European Society for Paediatric Urology (ESPU), the Asia Pacific Association of Paediatric Urology (APAPU), the Sociedad Iberoamericana de Urologia Paediatrica (SIUP), the International Pediatric Nephrology Association (IPNA), and the ICCS. It should be highlighted that this guideline differs to some extent from previous guidelines, based on historical studies, in which there was no differentiation between NMNE and MNE, contrary to current understanding.