Continence - Promotion and Management by the

These guidelines were developed as part of the NHS Executive Consensus Strategy for Major Clinical Guidelines. The methods used for the production of the guidelines were (i) a systematic review of the literature on incontinence and continence promotion and (ii) a multidisciplinary consensus conference of invited experts and clinicians in continence care and consumers of continence services.Since advances in health care may soon outdate current methods, the guidelines do not aim to direct the practitioner to specific named treatments. Rather, the aim is to aid clinicians in making decisions about purchasing and providing appropriate continence services in Primary Care.

Denise Button BSc(Hons), MSC, RN, RNT, Postgraduate student, School of Nursing Studies, University of Manchester. Formerly Project Officer, Castlefields Health Centre, Runcorn, Cheshire.

Brenda Roe PhD, RN, FRSH, Honorary Senior Research Fellow, Institute of Human Ageing, University of Liverpool. Formerly Senior Research Fellow, Health Services Research Unit, University of Oxford.

Christine Webb BA (Hons), MSc, PhD, RN, RSCN, RNT, Professor of Health Studies, Institute of Health Studies, University of Plymouth. Formerly Professor of Nursing, School of Nursing Studies, University of Manchester.

Tony Frith MB, ChB, MRCGP, General Practitioner, Castlefields Health Centre, Runcorn, Cheshire.

David Colin-Thome MB, BS, FRCGP, D(Obst) RCOG, DCH, (Hon)MFPHM, General Practitioner, Castlefields Health Centre, Runcorn, Cheshire.

Lance Gardner MSc, RN, RHV, NPDip, Professional Development Officer, Queens Nursing Institute and Salford Community Health Care NHS Trust. Formerly Business/General Manger and Nurse Practitioner, Castlefields Health Centre, Runcorn, Cheshire.

Foreword

vii

The Authors

ix

Acknowledgements

x

Contributors

xii

Chapter 1 Introduction and Background

1

(4)

Chapter 2 Summary of Guideline Statements

5

(4)

Chapter 3 Guidelines

9

(26)

Chapter 4 Systematic Review of the Literature

35

(70)

Introduction and background

35

(1)

Methodology

35

(4)

Definition of incontinence

39

(1)

Prevalence of urinary incontinence

40

(15)

Incidence of urinary incontinence

55

(1)

The burden of urinary incontinence

56

(5)

Causes and types of urinary incontinence

61

(10)

Assessment of urinary incontinence and enuresis

71

(4)

Promotion/restoration of continence

75

(15)

Management of incontinence

90

(7)

Faecal incontinence

97

(2)

Educational issues

99

(4)

Audit issues

103

(1)

Conclusion

104

(1)

Chapter 5 Recommendations for Further Research and Development

105

(2)

Appendix I Examples of Good Practice and/or Useful Resources

107

(4)

Appendix II Useful Addresses

111

(2)

Appendix III Methodology

113

(4)

Glossary of Terms

117

(8)

References

125

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Continence - Promotion and Management by the Primary Health Care Team Consensus Guidelines

Summary

Author Biography

Table of Contents

Supplemental Materials