NICE puts physio at the forefront of incontinence and prolapse care

Women with stress urinary incontinence should receive supervised pelvic floor muscle training for at least three months as first-line treatment, says the National Institute for Health and Care Excellence (NICE).

NICE advises training of the pelvic floor muscle

In guidance published on 2 April, NICE also says this type of training should be considered as a first option for women with pelvic organ prolapse. It recommends a duration of at least 16 weeks for this patient group.

Katie Mann, chair of POGP, the society for pelvic, obstetric and gynaecological physiotherapy, said her organisation was glad NICE had put physiotherapy at the core of firstline treatment for these conditions.

‘By setting a duration for firstline treatment, NICE gives a framework to help patients to understand their responsibility,’ she said.

‘The document enables commissioners, when they are developing services, to understand that conservative therapies are not a quick fix. But it also shows there are no negative side effects to pelvic floor muscles training, as opposed to surgery.

‘And that this training is as effective as surgery for 50 per cent of women with stress urinary incontinence.’

Alongside its guidance, NICE has published patient decision aids for women who are considering surgery. They are designed to help women decide what surgery, or other treatment, would be right for them.

The aids include information about the condition, the types of surgery NICE recommends, possible complications and alternatives to surgery.

‘The aids are a very useful adjunct to direct the conversation between the clinical and the patient and are written in a clear and understandable format,’ said Ms Mann, who is also a specialist physiotherapist in the NHS.


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