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Last Updated: Tuesday, 24 October 2006, 23:03 GMT 00:03 UK
Incontinence care plan launched
mother and baby
Pregnancy can cause bladder problems
The millions of women who experience bladder problems will no longer need to "suffer in silence", doctors have said.

The National Institute for Health and Clinical Excellence has published guidance on how medics should treat women with urinary incontinence.

It is estimated more than five million women aged over 20 in England and Wales suffer from the problem.

Campaigners said the guidance was timely, but warned there were too few continence nurses to implement it.

Urinary incontinence is about two to three times more common in women than it is in men, and can occur after pregnancy as well as in later life.

The estimated annual cost to the NHS of managing urinary incontinence is 233m, with millions more spent by individuals living with the condition.

Exercise

NICE has recommended that a range of treatments should be available for women.

Incontinence is one of the last taboo subjects in healthcare
Paul Hilton
gynaecologist

They should first make simple changes to their lifestyle, such as cutting back on fluids, especially caffeine, losing weight or doing regular pelvic floor exercises and bladder training to try to alleviate the problem.

If lifestyle measures or medication -where applicable - do not work, women may be offered surgery.

But NICE says drug treatments are not recommended for most cases of stress urinary incontinence, caused by sneezing or exercise - although they may help women who have bladder problems due to urge incontinence, where a woman feels the need to urinate and cannot stop herself.

It is estimated one in three women aged over 40 suffers stress urinary incontinence, caused by physical exertion such as sneezing, laughing or exercise.

Consultant gynaecologist Paul Hilton, who chaired the guideline development group, said the new standards will improve care across the country.

He said: "Incontinence is one of the last taboo subjects in healthcare, which patients have often been reluctant to discuss, and the medical profession slow to address.

"I see perhaps 1,500 women per year with urinary incontinence, and many are concerned that nothing can be done to help them.

"The guidelines clearly set out what the treatment options are for the main types of urinary incontinence, so that women can have an informed discussion with their health professional about their condition."

Care 'to improve'

Kate Partridge, 52, from London, said she began suffering incontinence after a hysterectomy.

"It simply seemed to me as something that happened to women with age. I didn't do anything about it for eight years.

"It affects all sorts of aspects of your life. You are afraid to live."

"It is very intermittent. I have good days and bad days and it is hard to plan for that."

NICE deputy chief executive Andrea Sutcliffe said: "Urinary incontinence is a distressing condition affecting the lives of millions of women.

"This guideline will help improve the care and treatment of women affected by advising them on which treatments should be offered first, as well as explaining what further treatments may be needed."

Continence Foundation director Judith Wardle said: "We totally approve of the recommendation that women should be doing pelvic floor exercises. But there has to be somebody to teach them.

"And we know that some primary care trusts have been cutting the numbers of continence nurses."


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