Adult Integrated Continence Service

This service is provided by a team of specialist nurses and physiotherapists who treat people with bladder, bowel, and prolapse problems.

Problems we treat

  • stress urinary incontinence - leaking urine when you laugh, cough, sneeze or with exertion e.g. walking or running
  • urgency - the feeling of urgently wanting to go to the toilet that is difficult to put off
  • urge urinary incontinence - urgently wanting to go to the toilet and then leaking urine before you get there
  • frequency - needing to go to the toilet more than 6-8 times over a 24 hour period 
  • overactive bladder (OAB) syndrome - urgency and frequency, with or without incontinence (urine leakage)
  • recurrent urine infections 
  • prolapse - this is the dropping down of one of your pelvic organs causing a feeling of heaviness or a bulge from the vagina or back passage
  • chronic faecal urgency - long standing problem of needing to open your bowels without much warning
  • constipation - hard stools, infrequent opening of your bowels, the feeling of straining, and sometimes feeling like you can’t completely empty your bowels
  • faecal incontinence - this is an inability to control wind or stool resulting in leakage. This can also be associated with urgency
  • problems with equipment (such as catheters or sheaths) - often people present with more than one of these problems as they are closely related. Sometimes the above problems can also impact on your sex life – we can discuss this when we assess you.

What do we do?
It has been shown that treating the above conditions conservatively first (i.e. not with surgery) can be very effective. We will perform a thorough assessment to establish the causes of your problems; this will probably include an internal examination.

We will assess your pelvic floor to see if you need to strengthen it or change the way you exercise it (if you have not been shown how to do this properly you may well be doing it wrong).

Urinalysis
This is where we test your urine to make sure there are no problems that might be causing your bladder problems such as infection or diabetes.

Bladder scan
This is an ultrasound scan of your bladder to make sure that it is emptying properly.

Bladder diary
This can be useful to fill out to find out how much you are drinking and how often you pass urine. If you have an appointment fill this out before you get there and bring it with you. It is suggested you complete 3 days to get the most accurate information, ideally a mix of home and work days.

Tip: Buy a plastic measuring jug and urinate into this to get an accurate measure of how much your bladder can hold. Record this on the diary. Also measure your favourite cup or mug then you won’t have to keep measuring your drinks.

There are various types of treatments available including pelvic floor exercises, bladder retraining, biofeedback and muscle stimulation. We can then give you advice on your problem and tailor a treatment program to meet your needs.

We can assess your bladder and bowel function and commence a training program. We also advise you on things you can do to stop your problems getting any worse.

Treatment options:
Advice and guidance regarding healthy bladder and bowel habits including diet and fluids, going to the toilet, clothing and products.

Bladder retraining
Bladder training is about getting rid of bad habits, learning good habits and putting you back in control, rather than your bladder controlling you and your life. Research has shown that many women find bladder training reduces frequency, urgency and urge leakage.

Pelvic floor exercises
It has been shown that performing pelvic floor exercises properly and frequently enough can significantly reduce many of the above symptoms, and in some cases get rid of symptoms completely. Once you know what you are doing, they are not difficult.

Bear in mind that ALL women should be aware of these muscles and should be exercising them regularly, but in particular if you are showing signs of some weakness.

If you are not sure what to do, get a referral to see us through your GP so we can assess and guide you.

Medication
There are a number of different medications that may help your bladder and/or bowel problems. We can discuss these and then ask your GP (family doctor) to prescribe them.

Group sessions
It has been shown that women with pelvic floor problems often get a lot of benefit from attending a group session. It provides you with more information than you can get in a one to one session, perhaps gives you a different perspective on your problem, and it is positive to be around other women with the same difficulties.

We run a number of different groups:
Overactive bladder group: if you feel like you wee too often and you may or may not leak before you get to the toilet.

Pelvic Floor Group: an overview of the pelvic floor, things that can go wrong and hints and tips on improving the situation.

Bowel group: covering normal bowel function and reasons for problems with your bowels, including constipation or leaking from your back passage (this may be wind or stool) and ways to improve it.

Turkish-language bladder and bowel group: this is a monthly group for Turkish-speaking women with bladder or bowel problems run with a therapist and an advocate.

Core and Floor group: an exercise group aiming to improve activation of your pelvic floor and ‘core stability’ muscles. Patients are invited to attend for up to 8 sessions as an adjunct to treatment. Referral is through your nurse/therapist. Speak to your clinician if you would like to attend one of these groups.

Getting a referral
Referrals can be made by you or your GP via The Electronic Referral Service (e-RS). 

Contact details
tel: 020 7683 4144
email: huh-tr.aics@nhs.net

To change an appointment time, please call the central appointment office on: 020 7683 4144. If possible please book in with the same healthcare professional that you have been seeing.