Paediatric Continence Service

 

The Paediatric Continence Service helps children who have long standing issues with soiling (encopresis) or wetting (enuresis). These issues are not uncommon and can occur alone or in combination.

Soiling and wetting can be extremely frustrating and embarrassing for children and their family. It can lead to struggles at home, in school, in friendships and with emotions, behavior and mental health. Children experiencing issues with continence can be more active, social, happy and independent when they have a management plan that works for them.


About Encopresis / Enuresis

Encopresis or soiling problems usually build up over a period of time and may be associated with constipation or apparent diarrhea. Most children have no control over the soiling.

Constipation is when your child’s stool is hard, painful or difficult to pass.

  • A hard, painful stool can make a child scared and reluctant to use the toilet.
  • Constipation can occur around the time of toilet training.

Soiling is when smears of their stool can appear on your child’s underwear.

  • It can mean that the bowel could be overloaded and overflow is occuring.
  • Your child may not feel the urge to go to the toilet because to them the rectum always feels stretched.
  • Soiling can happen without your child knowing.

Management consists of:

  • dietary advice
  • a good water intake
  • a stool diary
  • laxative regime
  • a toileting program

Further information is available in the Resources section below.

Bedwetting is known in medical terms as nocturnal enuresis (roughly meaning ‘urinate in the night’), and sometimes is just referred to as enuresis.

How common is bedwetting?

Bedwetting is common in school age children. It affects:

  • 1 in 5 children at 5 years.
  • 1 in 10 children at 10 years.
  • 1 in 30 to 100 teenagers at 15 to 17 years.

Are there different types of bedwetting?
  • Mono-symptomatic enuresis – is when bedwetting at nightime is the only symptom
  • Non-mono-symptomatic enuresis – children can have nightime and daytime bladder symptoms
    For example:
    - needing to wee as soon as they feel the urge (urgency)
    - wetting while they’re awake
    - needing to wee more often than usual

The Paediatric Urologist team will conduct a thorough assessment to distinguish between these two conditions and discuss appropriate treatment.

You may be referred initially to the Paediatric Urology team at John Hunter Children’s Hospital for an initial assessment and then to the Paediatric Continence Service Nurse.


Accessing the Paediatric Continence Service

Your child's GP is able to make the referral. The referral can be made out to Professor Trish Davidson (Encopresis) or Dr Ani Deshpande (Enuresis).

Your child's GP can find out the appropriate referral pathway by visiting our Primary Healthcare Practitioners Referrals page.


Encopresis / Enuresis Information and Resources

The Paediatric Continence Service Team
  • Professor Trish Davidson – Paediatric Surgeon
  • Dr Ani Deshpande – Paediatric Urologist
  • Sharyn Duffy – Paediatric Continence Nurse
  • David Porter – Clinical Psychologist

Location