Urinary incontinence and pelvic organ prolapse in primary care

2019 ◽  
Vol 30 (7) ◽  
pp. 332-337
Author(s):  
Angie Rantell
Keyword(s):  
Primary Care ◽  
Urinary Incontinence ◽  
Pelvic Organ Prolapse ◽  
Conservative Management ◽  
Secondary Care ◽  
Care Setting ◽  
Primary Care Setting ◽  
Pelvic Organ ◽  
Specialist Services ◽  
Made In

The National Institute for Health and Care Excellence has released an updated guideline on urinary incontinence and pelvic organ prolapse. Angie Rantell explores the changes and recommendations for patients, highlighting which are relevant to management in primary care In 2019, the National Institute for Health and Care Excellence published a new guideline on urinary incontinence and pelvic organ prolapse. This articles provides an overview of the changes to the recommendations relevant to the primary care setting, mainly related to assessment and conservative management, along with a review of when to refer into specialist services. A brief overview of the changes it has made in secondary care will also be discussed.

Pelvic organ prolapse

2016 ◽  
Vol 9 (12) ◽  
pp. 723-731
Author(s):  
Thomas G Gray ◽  
Sarah McVey ◽  
Jill Green ◽  
Anupama Saxena ◽  
Daksha Patel
Keyword(s):  
Quality Of Life ◽  
Primary Care ◽  
Pelvic Organ Prolapse ◽  
Care Setting ◽  
Primary Care Setting ◽  
Pelvic Organ ◽  
Initial Management ◽  
Pelvic Organs ◽  
Vaginal Canal

Pelvic organ prolapse is the descent of one or more of the pelvic organs, (including the bladder, uterus and rectum) from their normal anatomical position into the vaginal canal in women. This is a result of failure of the fascial, muscular and ligamentous supports of the pelvic organs and is a common problem encountered in primary care. Pelvic organ prolapse can have a profound and significant impact on quality of life, and it is important for GPs to understand how to diagnose and manage women with this condition. The majority of women presenting with pelvic organ prolapse are suitable for initial management in a primary care setting.

scholarly journals Determinants of referral of women with urinary incontinence to specialist services: a national cohort study using primary care data from the UK

2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Ipek Gurol-Urganci ◽  
Rebecca S. Geary ◽  
Jil B. Mamza ◽  
Masao Iwagami ◽  
Dina El-Hamamsy ◽  
...  
Keyword(s):  
Primary Care ◽  
Urinary Incontinence ◽  
Cohort Study ◽  
Secondary Care ◽  
Referral Rates ◽  
Primary Care Data ◽  
Specialist Services ◽  
One Year ◽  
The Impact ◽  
Minority Ethnic

Abstract Background Female urinary incontinence is underdiagnosed and undertreated in primary care. There is little evidence on factors that determine whether women with urinary incontinence are referred to specialist services. This study aimed to investigate characteristics associated with referrals from primary to specialist secondary care for urinary incontinence. Methods We carried out a cohort study, using primary care data from over 600 general practices contributing to the Clinical Practice Research Datalink (CPRD) in the United Kingdom. We used multi-level logistic regression to estimate adjusted odds ratios (aOR) that reflect the impact of patient and GP practice-level characteristics on referrals to specialist services in secondary care within 30 days of a urinary incontinence diagnosis. All women aged ≥18 years newly diagnosed with urinary incontinence between 1 April 2004 and 31 March 2013 were included. One-year referral was estimated with death as competing event. Results Of the 104,466 included women (median age: 58 years), 28,476 (27.3%) were referred within 30 days. Referral rates decreased with age (aOR 0.34, 95% CI 0.31–0.37, comparing women aged ≥80 with those aged 40–49 years) and was lower among women who were severely obese (aOR 0.84, 95% CI 0.78–0.90), smokers (aOR 0.94, 95% CI 0.90–0.98), women from a minority-ethnic backgrounds (aOR 0.76, 95% CI 0.65–0.89 comparing Asian with white women), women with pelvic organ prolapse (aOR 0.77, 95% CI 0.68–0.87), and women in Scotland (aOR 0.60, 95% CI 0.46–0.78, comparing women in Scotland and England). One-year referral rate was 34.0% and the pattern of associations with patient characteristics was almost the same as for 30-day referrals. Conclusions About one in four women with urinary incontinence were referred to specialist secondary care services within one month after a UI diagnosis and one in three within one year. Referral rates decreased with age which confirms concerns that older women with UI are less likely to receive care according to existing clinical guidelines. Referral rates were also lower in women from minority-ethnic backgrounds. These finding may reflect clinicians’ beliefs about the appropriateness of referral, differences in women’s preferences for treatment, or other factors leading to inequities in referral for urinary incontinence.

scholarly journals Free uroflowmetry for voiding dysfunction measurement in women with pelvic organ prolapse and urinary incontinence in primary care

2015 ◽  
Vol 22 (8) ◽  
pp. 801-802 ◽  
Author(s):  
Niek F Casteleijn ◽  
Chantal MCR Panman ◽  
Marian Wiegersma ◽  
Boudewijn J Kollen ◽  
Embert J Messelink ◽  
...  
Keyword(s):  
Primary Care ◽  
Urinary Incontinence ◽  
Pelvic Organ Prolapse ◽  
Voiding Dysfunction ◽  
Pelvic Organ

scholarly journals Conservative management for female urinary incontinence and pelvic organ prolapse review 2013: Summary of the 5th International Consultation on Incontinence

2014 ◽  
Vol 35 (1) ◽  
pp. 15-20 ◽  
Author(s):  
Chantale Dumoulin ◽  
Kathleen F. Hunter ◽  
Katherine Moore ◽  
Catherine S. Bradley ◽  
Kathryn L. Burgio ◽  
...  
Keyword(s):  
Urinary Incontinence ◽  
Pelvic Organ Prolapse ◽  
Conservative Management ◽  
Pelvic Organ ◽  
Female Urinary Incontinence ◽  
International Consultation

Development of oral surgery competency: undergraduate foundation training

2013 ◽  
Vol 4 (2) ◽  
pp. 44-47 ◽  
Author(s):  
Colette Balmer
Keyword(s):  
Primary Care ◽  
Cost Effectiveness ◽  
National Health Service ◽  
Health Service ◽  
Secondary Care ◽  
Care Setting ◽  
Primary Care Setting ◽  
Oral Surgery ◽  
Local Level ◽  
Dental Services

The National Health Service globally is currently undergoing significant scrutiny in terms of cost effectiveness, and services in the secondary care sector are being rationalised and, where possible, relocated into a primary care setting. The new commissioning bodies are keen to further develop and continue this trend. Dental services will be commissioned nationally by the NHS Commissioning Board although the implementation will be maintained at a more local level.

Sign in / Sign up

Export Citation Format

Share Document