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Bedwetting Solutions: Comprehensive Care for Enuresis Patients in General Practice

Explore how GP practices address bedwetting issues with a detailed examination and treatment guidelines. Learn about specialist referrals, potential risks, and effective treatment options to cure bedwetting. Discover the importance of a collaborative approach and the role of healthcare professionals in managing enuresis effectively.

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Bedwetting Solutions: Comprehensive Care for Enuresis Patients in General Practice

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  1. Bedwetting inGeneral Practice Rex Browne Anne Street Medical Centre

  2. Is bedwetting still a GP issue? PHOs and capitation based funding wencourage GPs to adopt a broader view of health that includes: • Health screening and prevention. • Increased funding for children

  3. Is there an Enuresis Specialist? Bedwetting is an orphan specialty falling between: • Urology • Paediatrics • Psychology • General Practice

  4. Who to Cure?

  5. How to Cure Start with listening first .

  6. Examination A minimal examination would be • Observation of body habitus and nutritional state • Observation of self confidence, posture, and gait

  7. Complex Enuresis • Psychosocial issues • Polyuria secondary to other illness • Neurological causes • Bladder based problems

  8. Detailed examination Where there is suspicion of underlying problems • Abdominal palpation of bowel, bladder and kidneys. • Genital check, spine, neurological • Nose and throat check. • Urinalysis • Ultrasound

  9. Bedwetting Guidelines Bedwetting Assessment Urinary Infection Treat as per UTI guidelines Bedwetting persists Constipation Treat Refer to Urologist or Paediatrician Complex Enuresis failed Repeat Mono symptomatic Nocturnal Enuresis Enuresis Alarm with support program Relapse Cure! Spontaneous Child less than 7 yrs Inform, Advise and Reassure Not motivated Episodic Needs (6 yrs or older) Offer Desmopressin enuresis

  10. Risks of Not treating • Persisting bedwetting • Incontinence in later life • Infertility in boys In association with the use of pull-ups

  11. Treatment Options • Taking away the trainer wheels. • Scheduled waking. • Alarm training and variations thereof.

  12. The rest of the team • Enuresis consultant. • Practice Nurse with an interest

  13. Is there a void in your life?

  14. My personal interest

  15. Early Days

  16. Trying Harder

  17. Really Advanced

  18. Another happy punter

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