National Health Service info
For most people with bladder weakness, the first point of contact they have with NHS Continence Services is through their GP.
For others it is their GP's practice nurse, one of the district nurses or perhaps through a midwife or health visitor.
All these people can help, but they work in conjunction with and mainly under the guidance of the local specialist continence service. Local continence services are staffed by specialist nurses and sometimes also specialist physiotherapists.
Except in a very few places, patients can refer themselves directly without going through their GP.
The InContact organisation can help you find a service in your local area by calling 0870 770 3246 or visiting www.incontact.org.
Continence services cannot themselves see every patient and will often arrange for the patient to see a district or community nurse
What happens next?
New patients first have their condition assessed. This will indicate what type of problem they have and what sort of treatment is advisable.
Mostly the treatments (pelvic floor exercises, bladder retraining, etc) will be delivered by the nurses and physiotherapists. Some patients will be referred elsewhere immediately, some at a later stage if the initial treatment has not worked.
Following an initial assessment the patient might be referred to:
Their GP
For a prescription for medicines or special appliances. (Specialist nurses are increasingly being allowed to write prescriptions themselves in areas like continence, where they are often the experts, so that this may not always be necessary.)
The local hospital's Urodynamics service
For special diagnostic tests.
A urologist, gynaecologist or other consultant
At the hospital for specialist treatment.
A few people are later referred on to regional or national centres of expertise for highly specialised treatment, including more advanced surgery.
Manage your symptoms
If the patient cannot be completely cured, the local continence service will often supply products to help them manage their symptoms.
Usually this means absorbent pads, but sometimes they will decide that it is better for the patient to use a catheter or a catheter valve, while men may be prescribed a sheath.
Catheters, sheaths, legbags, and many other devices will be provided on prescription, although there are some devices that can only be purchased privately. Pads will be given free of charge (but not on prescription). Sometimes, owing to budget restrictions, patients will have to go on a waiting list, or won’t be given as many pads as they need, and sometimes the patient may be told that they are not eligible because supplies are limited to people with severe conditions.
If this happens to the person in your care, you may like to contact the Continence Foundation who will advise whether it is worth protesting. If this fails, then there is a huge variety of disposable pads of different sizes, shapes and absorbencies available now to buy in the high street, at many supermarkets and in some pharmacies.
Please note that the contents of this website are for information purposes only and are not intended as medical advice or as a substitute for your doctor’s advice. For medical care and advice you should consult your doctor on a regular basis.