Quality standard

Quality statement 5: Bladder training

Quality statement 5: Bladder training

Quality statement

Women with symptoms of urgency or mixed urinary incontinence are offered bladder training for a minimum of 6 weeks as first-line treatment.

Rationale

Bladder training teaches a woman how to hold more urine in her bladder and so reduce the number of times she needs to pass urine. It also includes lifestyle advice on the amount and types of fluids to drink, and coping strategies to reduce urgency.

For women with mixed urinary incontinence, bladder training is a first-line treatment alongside supervised pelvic floor training.

Quality measures

The following measures can be used to assess the quality of care or service provision specified in the statement. They are examples of how the statement can be measured, and can be adapted and used flexibly.

Structure

Evidence of local arrangements to ensure that women with symptoms of urgency or mixed urinary incontinence are offered bladder training for a minimum of 6 weeks as first-line treatment.

Data source: Data can be collected from information recorded locally by healthcare professionals and provider organisations, for example, from service protocols.

Process

Proportion of women with symptoms of urgency or mixed urinary incontinence who have bladder training for a minimum of 6 weeks as first-line treatment.

Numerator – the number in the denominator who have bladder training for a minimum of 6 weeks as first-line treatment.

Denominator – the number of women having first-line treatment for urgency or mixed urinary incontinence.

Data source: Data can be collected from information recorded locally by healthcare professionals and provider organisations, for example, from patient records.

What the quality statement means for different audiences

Service providers (such as GP practices, community continence services and hospitals) ensure that systems are in place for women with symptoms of urgency or mixed urinary incontinence to have bladder training for at least 6 weeks as first-line treatment.

Healthcare professionals offer bladder training for at least 6 weeks as first-line treatment to women with symptoms of urgency or mixed urinary incontinence.

Commissioners (such as integrated care systems and clinical commissioning groups) ensure that they commission services that offer women with symptoms of urgency or mixed urinary incontinence bladder training for at least 6 weeks as first-line treatment.

Women with urine leakage caused by conditions called urgency or mixed urinary incontinence are offered bladder training (advice on reducing urine leakage) for at least 6 weeks as a first treatment. This can help reduce the number of times a woman needs to pass urine.

Definitions of terms used in this quality statement

Bladder training

Bladder training (also described as bladder retraining, bladder re-education, bladder drill, bladder discipline) actively involves the woman in trying to increase the interval between the desire to pass urine and actually doing so. [NICE's full guideline on urinary incontinence and pelvic organ prolapse in women (September 2013)]

Equality and diversity considerations

Women with physical disabilities may have difficulty accessing the service so provision needs to be made for a home visit if necessary.

Women with learning disabilities may need to be accompanied by a support worker or family member and may need to receive information about the condition in a way that is easy for them to understand.

Some women, including those from certain ethnic groups, religious or cultural backgrounds, may prefer a female healthcare professional to offer them bladder training. Provision for this should be made, if possible.