HNY Policy and Pathway Repository - York

Please see also: Uro-gynaecology (including urinary incontinence)

York Hospital runs two linked services for management of female urinary incontinence. Cases are reviewed for management at combined MDTs.

Urology:

• Urge Incontinence pathway; with flexible cystoscopy and intra-vesical Botox for failed medical therapy. This is done under LA. Pre- and post-operative support is offered by a Urology Specialist Nurse.
• Stress Incontinence; surgical options and post-op support.
• Offers a One-stop clinic for assessment of other Urinary Symptoms eg. Painful micturition.
   

Uro-gynaecology:

• Offers the above services, but surgical interventions are performed under GA.
• Incontinence in combination with significant prolapse should be referred to this service.
• Offers uro-dynamics and diagnostic testing for other urinary symptoms.

None provided

For Stress Incontinence:

• A 3-month course of pelvic floor exercise under the supervision of either a physiotherapist or continence advisor.
• Review at the end of the course. If there is no improvement then refer with bladder diary
   

For Overactive Bladder and Urge Incontinence

• See the overactive bladder pathway
• Referral to the Urinary Incontinence Service, Urology Department, York Teaching Hospital 

Information to include in referral letter

• Clear indication for referral: stress, urgency or mixed incontinence or other. 
• Details of therapies to date
• 3 day bladder diary
• Past medical / surgical history
• Drug history
• Detail of therapy tried as per local Vale of York guideline
• Smoking cessation
• BMI

Information for Patients

NHS leaflets on Urinary Incontinence

• a. Overview
• b. Symptoms
• c. Causes
• d. Diagnosis
• e. Non-surgical treatment
• f. Surgery and procedures
• g. Incontinence products
• h. 10 ways to stop leaks

There are some more links at the end of the Uro-gynaecology (including urinary incontinence)
 

References

York Urology Continence Service