Quality statement 5: Bladder training

Quality statement

Women with symptoms of urgency or mixed urinary incontinence are offered bladder training for a minimum of 6 weeks as first‑line treatment.

Rationale

Bladder training teaches a woman how to hold more urine in her bladder and so reduce the number of times she needs to pass urine. It also includes lifestyle advice on the amount and types of fluids to drink, and coping strategies to reduce urgency.

For women with mixed urinary incontinence, bladder training is first‑line treatment alongside supervised pelvic floor training.

Quality measures

Structure

Evidence of local arrangements to ensure that women with symptoms of urgency or mixed urinary incontinence are offeredbladder training for a minimum of 6 weeks as first‑line treatment.

Data source: Local data collection.

Process

Proportion of women with symptoms ofurgency or mixed urinary incontinence who have bladder training for a minimum of 6 weeks as first‑line treatment.

Numerator – The number in the denominator who have bladder training for a minimum of 6 weeks as first‑line treatment.

Denominator – The number of women having first‑line treatment for urgency or mixed urinary incontinence.

Data source: Local data collection.

What the quality statement means for service providers, healthcare professionals and commissioners

Service providers (such as GP practices, community continence services and hospitals) ensure that systems are in place for women with symptoms of urgency or mixed urinary incontinence to have bladder training for at least 6 weeks as first‑line treatment.

Healthcare professionals offer bladder training for at least 6 weeks as first‑line treatment to women with symptoms of urgency or mixed urinary incontinence.

Commissioners (such as clinical commissioning groups) ensure that they commission services that offer women with symptoms of urgency or mixed urinary incontinence bladder training for at least 6 weeks as first‑line treatment.

What the quality statement means for patients, service users and carers

Women with urine leakage caused by conditions called urgency or mixed urinary incontinence are offered bladder training (advice on reducing urine leakage) for at least 6 weeks as a first treatment. This can help reduce the number of times a woman needs to pass urine.

Source guidance

Definitions of terms used in this quality statement

Bladder training

Bladder training (also described as bladder retraining, bladder re‑education, bladder drill, bladder discipline) actively involves the woman in trying to increase the interval between the desire to pass urine and actually doing so. [Adapted from urinary incontinence (NICE guideline CG171)].

Equality and diversity considerations

Women with physical disabilities may have difficulty accessing the service so provision needs to be made for a home visit if necessary.

Women with learning disabilities may need to be escorted by a support worker or family member and may need to receive information about the condition in a way that is easy for them to understand.

Some women, including those from certain ethnic groups, religious or cultural backgrounds, may prefer a female healthcare professional to offer them bladder training. Provision for this should be made, if possible.