From September 1, 2012, children with bedwetting have access to diagnostics and treatment in accordance with European standards.
Out of concern for the welfare of children, the Minister of Health appointed a Group of Experts that developed Guidelines for diagnostic and therapeutic management of a child wetting at night. They consist of several parts describing the current medical terminology of bedwetting, its causes, diagnosis and treatment, and indications for referral to a specialist center.
The introduction of uniform terminology, in addition to the medical aspect, will allow the assessment of the frequency of this phenomenon in the children’s population in Poland, which we can only estimate at present. A uniform standard of dealing with a child wetting at night will facilitate diagnosis and therapy at the level of a primary care physician, which will undoubtedly improve patients’ access to treatment.
The developed diagnostic procedure allows for rational conduct of tests enabling the diagnosis of the type of enuresis at the level of primary health care, and leaves the decisions on invasive tests in the hands of specialists.
The guidelines indicate standard, equivalent first-line therapies such as pharmacotherapy with desmopressin or conditioning treatment using the nocturnal alarm. They can be used by a general practitioner after excluding other important pathologies underlying the enuresis. It is worth noting that pharmacological treatment or an alarm should be preceded by a three-month period of standard urotherapy.
The introduction by the Minister of Health of the reimbursement of first-line pharmacological treatment (desmopressin) from September 1, 2012, will undoubtedly improve the availability of treatment to a wide group of children who so far could not be treated for economic reasons.
For the needs of pediatricians, general practitioners, specialists and parents of children with enuresis problems, an online educational website was created, www.moczeudzieci.pl, containing a compendium of knowledge and advice on bedwetting in children.
Text: Barbara Skrzypińska