Urinary incontinence and enuresis
-
If any of the following are present or suspected, please refer the patient to the emergency department (via ambulance if necessary) or follow local emergency care protocols or seek emergent medical advice if in a remote region.
- Recent onset of polyuria/polydipsia that might suggest diabetes (mellitus or insipidus)
-
| Category 1 (appointment within 30 calendar days) |
|
| Category 2 (appointment within 90 calendar days) |
NB: Refer to general paediatrics if there are no structural abnormalities. |
| Category 3 (appointment within 365 calendar days) |
NB: Refer to general paediatrics if there are no structural abnormalities. |
Please insert the below information and minimum referral criteria into referral
1. Reason for request Indicate on the referral
- To establish a diagnosis
- For treatment or intervention
- For advice and management
- For specialist to take over management
- Reassurance for GP/second opinion
- For a specified test/investigation the GP can't order, or the patient can't afford or access
- Reassurance for the patient/family
- For other reason (e.g. rapidly accelerating disease progression)
- Clinical judgement indicates a referral for specialist review is necessary
2. Essential referral information Referral will be returned without this
- Is there daytime incontinence of urine?
- Is there nocturnal enuresis?
- Report presence or absence of concerning features
- poor urinary stream in a boy
- Physical examination, including abdominal examination, spine and lower limbs
- Serial weight measurements
- Confirmation of OOHC (where appropriate)
- Urinalysis (dipstick)
- Fingerpick blood glucose if recent onset of symptoms
- Renal tract ultrasound
3. Additional referral information Useful for processing the referral
Highly desirable information – may change triage category.
- What is the impact on the child? (teasing or social exclusion at school, family conflict over wetting, anxiety or distress about incontinence)
- Description of the pattern incontinence:
- is there daytime incontinence? How frequent is the incontinence? Is the incontinence new?
- primary or secondary (>6 months dryness previously)
- What treatments have been tried and efficacy
Desirable information-will assist at consultation
- Family history of nocturnal enuresis or daytime urinary symptoms
- Diet history
- Bowel habit history or history of constipation
- Treatments used for constipation if present
- Developmental history
- Other past medical history
- Immunisation history
- Medication history
- Significant psychosocial risk factors (especially parents mental health, family violence, housing and financial stress, Department of Children, Safety, Seniors and Disability Services involvement)
- Other physical examination findings inclusive of CNS, birth marks or dysmorphology
- Any relevant laboratory results or medical imaging reports, urinalysis results
- Consider renal tract USS with pre and post void volumes if there is daytime incontinence. Not required for isolated nocturnal enuresis.
4. Request
-
Patient's Demographic Details
- Full name (including aliases)
- Date of birth
- Residential and postal address
- Telephone contact number/s – home, mobile and alternative
- Medicare number (where eligible)
- Name of the parent or caregiver (if appropriate)
- Preferred language and interpreter requirements
- Identifies as Aboriginal and/or Torres Strait Islander
Referring Practitioner Details
- Full name
- Full address
- Contact details – telephone, fax, email
- Provider number
- Date of referral
- Signature
Relevant clinical information about the condition
- Presenting symptoms (evolution and duration)
- Physical findings
- Details of previous treatment (including systemic and topical medications prescribed) including the course and outcome of the treatment
- Body mass index (BMI)
- Details of any associated medical conditions which may affect the condition or its treatment (e.g. diabetes), noting these must be stable and controlled prior to referral
- Current medications and dosages
- Drug allergies
- Alcohol, tobacco and other drugs use
Reason for request
- To establish a diagnosis
- For treatment or intervention
- For advice and management
- For specialist to take over management
- Reassurance for GP/second opinion
- For a specified test/investigation the GP can't order, or the patient can't afford or access
- Reassurance for the patient/family
- For other reason (e.g. rapidly accelerating disease progression)
- Clinical judgement indicates a referral for specialist review is necessary
Clinical modifiers
- Impact on employment
- Impact on education
- Impact on home
- Impact on activities of daily living
- Impact on ability to care for others
- Impact on personal frailty or safety
- Identifies as Aboriginal and/or Torres Strait Islander
Other relevant information
- Willingness to have surgery (where surgery is a likely intervention)
- Choice to be treated as a public or private patient
- Compensable status (e.g. DVA, Work Cover, Motor Vehicle Insurance, etc.)
-
If any of the following are present or suspected, please refer the patient to the emergency department (via ambulance if necessary) or follow local emergency care protocols or seek emergent medical advice if in a remote region.
Please note that where appropriate and where available, the referral may be streamed to an associated public allied health and/or nursing service. Access to some specific services may include initial assessment and management by associated public allied health and/or nursing, which may either facilitate or negate the need to see the public medical specialist.
A change in patient circumstance (such as condition deteriorating, or becoming pregnant) may affect the urgency categorisation and should be communicated as soon as possible.
Please indicate in the referral if the patient is unable to access mandatory tests or investigations as they incur a cost or are unavailable locally.
Last updated: 4 December 2024
© State of Queensland (Queensland Health) 2023
Except as permitted under the Copyright Act 1968, no part of this work may be reproduced, communicated or adapted without permission from Queensland Health. To request permission email ip_officer@health.qld.gov.au1.