NICE publishes guidance on urinary incontinence in neurological disease
09 August 2012
The guideline recommends that detailed assessments should be offered to people who have neurological conditions including MS
The National Institute of Health and Clinical Excellence (NICE) has published Clinical Guideline 148 on urinary incontinence in neurological disease: management of lower urinary tract dysfunction in neurological disease. The MS Trust contributed as a member of the Urology User Group Coalition.
NICE clinical guidelines set standards for high quality healthcare for people with specific conditions or diseases and the treatments they should receive. There is a version of the guideline for patients and carers which can be downloaded from the NICE web site (see link below). This document aims to explain the care and treatment options that should be available in the NHS.
The guideline recommends that detailed assessments should be offered to people who have neurological conditions, including stroke, MS and head and spinal cord injuries, who are experiencing incontinence or other urinary problems. The aim of the guideline is to minimise the distressing effect that bladder symptoms can have on people with neurological conditions, and their families, and to promote active participation in their care.
Healthcare professionals are advised to assess other health issues including bowel and sexual problems, the use of medications and therapies, as well as other factors such as mobility, hand function, cognitive function, social support and lifestyle which may affect how incontinence or other urinary problems can be managed. The guideline recommends that patients are reassessed at least every three years, with more frequent reassessments for some patients depending on their individual circumstances.
A UK consensus on the management of bladder symptoms in multiple sclerosis was published in 2009. It makes recommendations on the assessment and most appropriate management techniques for the different presentations of bladder problems in MS. Management techniques may be as simple as reviewing fluid intake and bladder retraining. In other cases medication may be prescribed or catheterisation required. Bladder problems can be managed by a nurse or a specialist continence advisor.
Bladder symptoms are often reported by people with MS. They can have a significant impact on quality of life and on emotional well being. There are a number of ways to manage bladder symptoms and it is vital that people with MS get the advice and help they need. The MS Trust welcomes the publication of this guideline which, together with the UK consensus on the management of bladder symptoms in MS, should allow better assessment and treatment of bladder symptoms for people with MS.Amy Bowen, Director of Service Development, MS Trust