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Summary of Results

Health Topic:   Urogenital
Guidance:   Urinary incontinence
Description:   The summary of the published clinical guideline on Urinary incontinence. It links to the published guidance and key documents.

NICE implementation uptake reports

Implementation uptake report Assessment Published Date Coverage
NICE Implementation Uptake Report: Drugs used in the management of urinary incontinence Practice appears to be in line with guidance 2009 National

External literature

External literature Assessment Coverage

Basu M et al (2009) Clinicians' views on the NICE guideline on the management of female urinary incontinence Journal of Obstetrics and Gynaecology 29(6):529-32

Description: A questionnaire was sent to all UK-based members of British Society of Urogynaecology (BSUG). There was a 64% response rate. 56.8% of respondents agreed that NICE Guideline 40 reflected their current practice. The survey found significant concerns regarding some of the recommendations and the results indicate that over half of the respondents would not change their practice to follow these recommendations.

Not graded National

Ismail S (2009) An audit of NICE guidelines on antenatal pelvic floor exercises International Urogynaecology Journal 20(12) 1417-1422

Description: The study was carried out at a district general hospital, a self-constructed questionnaire was given to patients after their first delivery. 223 questionnaires were returned over a 6-month period. Over 95% of respondents were aware of the importance of pelvic floor exercises however, only 7.6% of respondents indicated that they should perform exercises 3 times a day. Patient awareness and actual practise did not meet NICE guidelines calling for strategies to improve awareness and adherence.

Practice appears not to be in line with guidance Local

Fatima S et al (2009) Transobturator tape for urinary incontinence S93-S396 International Journal of Gynaecology and Obstetrics

Description: 51 cases of TOT identified randomly over a 3 years period. Results found that there were no major complication like bladder injury, vaginal perforation, or vaginal erosion. There were 5 cases with minor complications including urinary retention, infection and postoperative pain. Success rate was more than 80% 10% patients developed new symptoms in the form of urgency and voiding problems.

Doubts about or mixed impact in practice Local

Royal College of Physicians (2010) National Audit of Continence Care, Combined Organisational and Clinical Report

Description: The National Audit of Continence Care provides detailed evaluation of continence care. All NHS trusts in England, Wales and Northern Ireland were potentially eligible to take part. Overall, adherence to national guidance (NICE) for urinary and faecal incontinence is very variable. The proportion of hospitals routinely offering an assessment of continence is still low, at 54%, but has increased from 40% in 2005.

Practice appears not to be in line with guidance National

Wagg A et al (2011) Do older women with urinary incontinence receive evidence informed care? Neurourology and Urodynamics 30 (6) (pp 1122-1123), 2011

Description: All NHS trusts in England, Wales and Northern Ireland were eligible to participate. Data on 7846 women were returned by 80% (128/161) acute and 52% (75/144) PCT's in England and 71% (10/14) combined trusts including Northern Ireland. Results found variations in the level of adherence to evidence informed recommendations in the care of women with UI in hospital and primary care e.g. a documented treatment plan for UI was provided to 65% of older women in hospitals and 71% in primary care.

Doubts about or mixed impact in practice National

Wagg A et al (2011) To what extent are national guidelines for the management of urinary incontinence in women adhered? Data from a national audit British Journal of Obstetrics and Gynaecology Dec 2011;118(13):1592-1600

Description: This study assessed adherence to NICE guidelines on the management of urinary incontinence (UI) in women. Data were returned by 128 acute and 75 primary care trusts for 7846 women. Results found that a higher number of younger women had a documented diagnosis, underwent multichannel cystometry before conservative therapy and had a documented discussion of causes and treatment of UI in both hospitals and primary care trusts, compared with older women.

Doubts about or mixed impact in practice National

Royal College of Physicians (2013) National audit of continence care (NACC) Pilot audit evaluation report June 2012

Description: This report evaluates changes made to the format of the NACC since the last audit in 2010 and their applicability to future audits. Results are presented from a two month pilot audit carried out from 1 November to 31 December 2011 in order to test the changes. Eighty?]three organisations submitted data in the pilot (60 acute hospitals, 23 primary care trusts) on 814 cases. Results included that 50% of cases in primary and 59% in acute care were documented as having a digital rectal examination.

Doubts about or mixed impact in practice National

SPM Ltd (2012) GP Practice survey indicates that NICE Guidelines are being ignored and budgets wasted

Description: A survey on treatment for Urinary Stress Incontinence (USI) completed by nearly 300 GP practices nationwide was conducted in February 2012. Results found that three-quarters of practices had no policy for dealing with women presenting with USI symptoms; 41.5% correctly identified the NICE recommended treatment, and overall 62% of women were sent home with an exercise instruction sheet.

Doubts about or mixed impact in practice National

This page was last updated: 19 July 2013

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Copyright 2014 National Institute for Health and Care Excellence. All rights reserved.