The Whittington Health (WH) CYP Bladder and Bowel Service is a nurse-led bedwetting (nocturnal enuresis) and constipation service that runs across Northern Health Centre, Tynemouth Road Medical Centre and Noah's Ark Hospice.

There are many underlying causes to bedwetting and in most children, there is no specific, single cause. Bedwetting occurs because the volume of urine produced at night time is more than your child's bladder can hold.

The service offers advice and support for children and their carers, as well as self-help measures and other treatments including bedwetting alarms and medicine if required.

The bedwetting service accepts referrals from all health professionals including GPs, health visitors and school nurses.

The service covers Islington, Haringey, Camden and North Barnet areas. Children are seen from the age of 5 years up to 18 years for nocturnal enuresis and from 2 years for constipation. Clinic appointments are offered for new referrals, as well as regular telephone support.

Please note: patients' non-attendance/reschedule on two consecutive appointments will be discharged and referrer informed.

Eligibility Criteria

Inclusions

• be aged 5 to 18 years for nocturnal enuresis
• be aged 2 years for constipation
• be a resident or have a GP in the borough of:
  • Islington
  • Haringey
  • Camden
  • North Barnet (current postcodes: EN4, EN5, N10, N12, N14, N20, part NW3)
• Must have complete minimum 3 months tier 1 input from either GP/school nurse/Health visitor
  • initial health assessment
  • health education
  • education
  • GP to complete physical examination of the spine and lower limbs, checking tone, strength and reflexes, inspection of perianal area and to exclude red flags

Exclusions

Patients should not be referred to us if any of the following apply.

• complex or severe medical conditions /complex health needs such as moderate to severe ADHD and ASD
• already under secondary or tertiary care
• product provisions – refer to School Nursing/Special School Nursing teams
• day time symptoms including frequency, urgency, day wetting

Exclusion criteria: Red flags
Patients should not be referred to us if any of the following apply.

• child (particularly girls) reported to always be wet during the day (continuous incontinence)
• any reported straining to void or weak stream
• recurrent UTIs
• safeguarding concerns
• any known neurological problem
• reported weight loss/failure to thrive or excessive thirst – (GP to check urinalysis and blood sugar)
• abnormal spine/neurology
• delay in passing meconium >48 hours after birth
• ribbon stools from birth
• history of constipation pre weaning
• abdominal distention with vomiting
• unexplained persistent vomiting or any bile-stained vomit
• recent leg weakness
• blood in stools

How to Refer

Referrals accepted from health professionals including GPs, health visitors and school nurses.

Locations

Northern Health Centre

Tynemouth Road Medical Centre

Noah’s Ark Hospice

Camden location TBC