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Clinical Negligence Solicitor on new guidance for female Urinary Incontinence

Clinical Negligence Solicitor Christian Beadell reports that on 10th September 2013, the National Institute for Clinical Accidents updated its Guidelines for the management of urinary incontinence in women.

"On 10th September 2013, the National Institute for Clinical Accidents updated its Guidelines for the management of urinary incontinence in women.

Those Guidelines can be found here. The Guidance brings together some of the most recent updates in relation to the management of incontinence into a single document. Specifically, there is now provision made for the management of overactive bladder through the prescription of the relatively new drug Mirabegron. The Guidance also identifies areas of treatment which should not be pursued. For example, transcutaneous sacral nerve stimulation therapy is not recommended for overactive bladder treatment. This is the application of electrical pads to the skin as opposed to the more effective treatment whereby electrodes are inserted below the skin (percutaneous) and which is recommended.

As with previous Guidance, it is noted that whilst Botox is considered to be an approved treatment for overactive bladder, there continues to be little or no licensing of Botox medication for the use in managing urinary incontinence. This will undoubtedly be of some concern to patients who are actively pursuing Botox given that there is a lack of data regarding long term efficacy and/or side effects of the treatment.

Particular attention has been paid within the Guidance to the use of mesh devices such as transvaginal tapes (TVTs). It is noted that this should be offered in cases involving urinary stress incontinence and that if a surgeon cannot provide that treatment then he should arrange for an appropriate referral. By comparison, it is also noted that TOTs (transobturator tapes) should not be offered without a warning being provided to the patient that outcomes are uncertain due to the lack of long term data studies.

Overall, the Guidance serves as an effective resource for clawing together a number of recent separate Guidances which have been prepared since the last general Guidance in 2006.

Patients will find the online care pathway a helpful device in giving them an understanding of how their treatment and management should progress and also enable them to raise informed questions with their treating consultant"

Christian Beadell is an Associate Solicitor in the Clinical & Medical Negligence Department has a particular interest in urogynaecological cases and has been involved with the George Rowland litigation for a number of years.

If you are affected in any way by the contents of this item and would like to discuss it with Christian or another solicitor then please contact us on 0151 257 6000.

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