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 seek emergent medical advice if in a remote region.


  • Urinary Incontinence and enuresis.
    • recent onset of polyuria/polydipsia that might suggest diabetes (mellitus or insipidus)


Useful Managment Information
  • Refer to local care pathway
  • If you have a reason to suspect a child in Queensland is experiencing harm, or is at risk of experiencing harm, you need to contact Child Safety Services: https://www.communities.qld.gov.au/
  • Sudden onset incontinence who have previously been dry can be a marker of serious pathologies (e.g. DM, GU tumours, spinal cord problems) and should be assessed urgently
  • In the majority of cases it is thought inappropriate for children to wait more than 6 months for an outpatient initial appointment
Minimum Referral Criteria

Category 1
(appointment within 30 calendar days)

  • Poor urinary stream in a boy
  • New onset of daytime urinary incontinence in a previously dry child
Category 2
(appointment within 90 calendar days)
  • Primary daytime incontinence

    Refer to general paediatrics if there are no structural abnormalities. 
    Refer to paediatric urology or paediatric surgery if concerned with renal or structural abnormalities.
Category 3
(appointment within 365 calendar days)
  • Nocturnal enuresis without significant daytime incontinence and unresponsive to medical management
  • Children with long term (> 6 months) daytime urinary incontinence who have had previous specialist assessment

    Refer to general paediatrics if there are no structural abnormalities. 
    Refer to paediatric urology or paediatric surgery if concerned with renal or structural abnormalities.

If your patient does not meet the minimum referral criteria

  • Consider other treatment pathways or an alternative diagnosis
  • If you still need to refer your patient:
    • Please explain why (e.g. warning signs or symptoms, clinical modifiers, uncertain about diagnosis, etc.)
    • Please note that your referral may not be accepted or may be redirected to another service
Standard Referral Information

Patient's Demographic Details

  • Full name (including aliases)
  • Date and country of birth
  • Residential and postal address including whether patient resides at an aged care facility
  • Telephone contact number/s – home, mobile and alternative
  • Medicare number (where eligible)
  • Name of the parent or caregiver (if appropriate)
  • Name of delegate and contact details (Department of Corrective Services)
  • Preferred language and interpreter requirements
  • Identifies as Aboriginal and/or Torres Strait Islander
  • Any special needs, access requirements and/or disability relevant to the referral

Referring Practitioner Details

  • Full name
  • Full address
  • Contact details – telephone, fax, email
  • Provider number
  • Date of referral
  • Signature
  • Nominated general practitioner’s details (if known), if the nominated general practitioner is different from the referring practitioner

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
  • All conservative options that have been pursued unsuccessfully prior to referral
  • Body mass index (BMI)
  • Details of any associated medical conditions which may affect the condition or its treatment (e.g. diabetes, BMI), noting these must be stable and controlled prior to referral
  • Any special care requirements where relevant (e.g. tracheostomy in place, oxygen required)
  • 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 functioning – low/medium/high
  • 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

Essential referral information

Without this information the referral will be returned

  • General referral information
  • Is there daytime incontinence of urine?
  • Is there nocturnal enuresis?
  • Report presence or absence of Red flag

    Presence of Red flags
    • poor urinary stream in a boy
  • Physical examination, including abdominal examination, spine and lower limbs
  • Urinalysis (dipstick) 
  • Fingerpick blood glucose if recent onset of symptoms
Additional Referral Information

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 child safety involvement)
  • Height/weight/head circumference and growth charts with prior measurements if available
  • 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.

Out of catchment

Clinical Override

Clinical override of referral criteria may be requested in the following situations:

  • Inability to include essential referral information. If a specific test result is unable to be obtained due to access, financial, religious, cultural or consent reasons.
  • Patient does not meet minimum referral criteria. If the patient does not meet the criteria for referral but the referring practitioner believes that the patient requires specialist review.
  • Presence of clinical modifiers. The presence of clinical modifiers (as listed above in Standard referral information) may impact on the categorisation of a patient.

Include the reason for request for clinical override as part of the referral. Referrals are reviewed by the triaging specialist who determines the most appropriate course of action.

Out of catchment

West Moreton Health is responsible for providing a public health service to people who reside within its catchment area. To appropriately manage demand for service we do not accept referrals from outside this catchment area. If your patient does live outside the West Moreton Health area and it is deemed socially or clinically necessary for their care to be received in the West Moreton Health Service, inclusion of information regarding their particular medical and/or social factors will assist with the triaging of your referral.


To provide feedback about contents on this website or general referral questions please email WM-CPC@health.qld.gov.au or phone 3413 7402.