“We know the NHS will have to save £15-20bn over the next five years.

Health secretary Andrew Lansley has said that this “implied something like 3-3.5%, probably about 3%, efficiency savings each year in the NHS… we may need to do more, because we have increases in demand”.

On the ground, we have all been told we need to make significant savings within our individual departments of approximately 10% of our budgets. This means that those of us working in continence services are under considerable pressure to save, on average, more than £100,000 per year. This is almost impossible when we are already struggling on limited budgets, while the cost of disposable incontinence products and the ageing population who need continence care are both increasing.

The cost of continence products produced in the Eurozone has been dramatically affected by the exchange rate. Between 2007 and 2009, costs rose over 30%.

While the exchange rate has moved slightly this year, industry has still seen a cost increase of around 28% since 2007. Products produced outside the Eurozone are affected by fluctuating local currencies. In addition, raw material prices are increasing and, as those used in continence products are priced internationally in US dollars, there will be a double hit as the euro is weak against the dollar.

The figures do not add up. We want to provide the same level of service, balance the books and save 10% at a time when products are costing nearly 30% more.
Continence services can only realistically seek to cut costs via efficiency savings, rather than on product price. However, many of us are frustrated that our ideas to improve efficiency are often lost within the bureaucracy of the NHS and because continence is not anyone’s “target”, which means it sparks little interest.

Particularly frustrating is the snail’s pace at which services are being transferred from acute to primary care, where they could be better served.

Yet it is disposable product provision that leaves many continence nurses in the line of fire. Calls to the PromoCon helpline, a charity that offers product advice, are increasing. Patients and families are complaining about the limited type and number of products for which they are eligible. The phrase “Don’t shoot the messenger!” often comes to mind as nurses are told by management to restrict the type and number of products they prescribe to save money. This means that many services are not able to provide products to meet patients’ needs.”

World Continence Week (June 21-27), is a creation of the International Continence Society, and is designed to build awareness of incontinence issues and treatments. It’s estimated that more than 33 million individuals are affected by incontinence in the United States and about 6 million people in the United Kingdom.
Incontinence is not something people should be ashamed of or silent about and World Continence Week is all about giving individuals the tools they need to understand and manage their incontinence issues.
“Unfortunately, many incontinence sufferers are unaware of the treatment options and products available to them,” said Diane Newman of the University of Pennsylvania’s Center for Continence and Pelvic Health.

Allanda fully support this aim and hope that it help increase significantly both awareness of the prevalence of the condition and also helps people experiencing the condition better understand the many treatments and incontinence management products available to them.

A 2009 study by the University of California, San Francisco showed that women who lost as little as eight percent of their body weight experienced an average 47% reduction in episodes of both stress incontinence and urge incontinence, with some seeing the number of incontinence episodes drop by an astounding 70%.
The study’s findings, which were reported in the New England Journal of Medicine, concluded that reduction in urinary incontinence can be considered among the primary benefits of even moderate weight loss in significantly overweight women.

The study included a group of 338 overweight and obese women between 45 and 60 years of age, all of whom were experiencing at least 10 episodes of urinary incontinence per week. The participants were divided into two groups, one of which was put on an intensive six-month weight loss program that included diet, exercise, and lifestyle modification.

The other group of participants did not take part in any structured weight loss program, but were given educational classes on the importance of weight loss to incontinence management.

At the end of the six months, the participants in the weight loss group had dropped an average of eight percent of their body weight, while the control group showed an average weight loss of just over one percent.

Episodes of urinary incontinence dropped in both groups during the study period, but the difference between the groups was striking. The weight loss group reported 47% fewer episodes on average, while the control group reported 28% fewer episodes. The weight loss group showed a clinically relevant drop in the number of episodes of all types of incontinence, the researchers said, but episodes of stress incontinence showed the most dramatic reduction.

Stress incontinence, which is the involuntary loss of urine caused by seemingly inconsequential actions such as sneezing, coughing, or laughing, or by movement such as exercise or lifting, is one of the most common female health problems in the US.

More than 13 million women experience stress incontinence, and it is estimated that one in three women will experience it at some time. The condition is caused be weakness in the pelvic floor muscles, including the sphincter muscle that closes off the bladder. Weakness in these muscles can be caused by a number of factors, including pregnancy, childbirth, menopause, certain medical procedures (notably, hysterectomies), and some medications.

Major depression, hypertension, enlarged prostates, and older age are all associated with an increased risk of moderate to severe urinary incontinence (UI) in men, a large study suggests.

The findings, which provide one of the first snapshots of urinary incontinence in men, may help improve doctors’ ability to identify men who are suffering from the condition, says study head Alayne Markland, of the University of Alabama at Birmingham.

Overall, 4.5% of American men were found to experience moderate to severe urinary incontinence, which corresponds to having leakage at least once a month, the study showed.

The rate increases with age, from 0.7% in men ages 20 to 34 to 16% in men age 75 and older, the study showed.

The findings were presented at the annual meeting of the American Urological Association.

Studies suggested that urinary incontinence is less common among men than women, but there was felt to be a lack of data on Urinary Incontinence and risk factors in men, Dr. Markland felt.

So she and colleagues analyzed data from 5,297 men aged 20 and older who participated in the National Health and Nutrition Examination Survey, a nationally representative survey of the U.S. population.

Men were interviewed in their homes, and Urinary Incontinence was assessed using the 12-point Incontinence Severity Index in which participants are asked if they leak and if so, how much and how often. Moderate to severe Urinary Incontinence was defined as a score of 3 or higher.

Among all the men, major depression and hypertension were associated with a 2.6-fold and a 30% increased risk of moderate to severe UI, respectively.

Each 10-year increase in age was associated with an 80% increased risk.

Among the 3,010 men aged 40 and older, enlarged prostate — called benign prostatic hyperplasia (BPH) — was associated with a 20% greater chance of having moderate to severe UI.

The rate of moderate to severe Urinary Incontinence did not differ by race or ethnicity.

A total of 49% of the men had what is known as urge urinary incontinence, in which you feel like you have to go but can’t get to the bathroom in time, Dr. Markland said. Thirteen percent had stress urinary incontinence, which occurs when an activity, such as coughing or sneezing, causes a small amount of urine to leak. The rest had a combination.
BPH a Known Cause of Urinary Incontinence

BPH is a well-known cause of UI, says Ira Sharlip, MD, clinical professor of urology at the University of California, San Francisco.

“Nightly bathroom runs may be the first sign of an enlarged prostate, other symptoms may include trouble starting a stream of urine, leaking, or dribbling” says Dr. Sharlip, who was not involved with the study.

That’s because an can press against the urethra (the tube that carries urine out the body) and block the flow of urine. This causes the bladder wall to become irritable. The bladder begins to contract even when it contains small amounts of urine, causing more frequent urination.

More research is needed to find out why depression and hypertension are associated with higher rates of UI, Dr. Markland said.

Medications called diuretics that are often used to treat may play a role, she says. They flush excess fluid from the body and can cause frequent urination.

Some of the drugs used to treat depression may also cause UI, Sharlip says.

“Urinary incontinence is something people don’t want to talk about,” says Lauren P. Wallner, PhD, MPH, a research fellow in the department of urology at the University of Michigan in Ann Arbor.

“If you’re having symptoms, bring it to the attention of your Doctor or Health professional as it can often be treated with medication, behavioral therapy and, in severe cases, surgery,” she said.

As usual the conference was designed to offer a wide variety of updates on professional practices as well as general motivational presentations by top-level speakers.

The Conference will appeal to:

* All those involved in promoting continence in the community and hospital settings
* Colo-rectal surgeons
* Geriatricians
* Gynaecologists
* PCT managers
* Paediatricians
* Physiotherapists
* Specialist nurses including Continence Advisors
* Urologists
* Urogynaecologists

The 17th UK Continence Society Annual Conference will Feature:

* Keynote Presentations
* Oral Presentations (following Abstract Review)
* Poster Presentations (following Abstract Review) and Poster Walk
* Skills Workshops and Clinical Physiology Workshop
* ACA supported session
* Urodynamics Workshop
* Networking Opportunities

For more information visit the UKCS Scientific Meeting official website and stay tuned on our blog as more news emerge we will sure be the first ones to have it.

Brand has been cleared by the BBC Trust over the gags, after a formal complaint to the Trust was originally rejected earlier this year and now an appeal to the Trust’s Editorial Standards Committee has also been turned down. The committee concluded the joke about incontinence were “editorially justified”, did not amount to prejudice and did not breach programme guidelines.

Dr Hywel Francis, Labour MP who chairs the All Party Parliamentary Group on Carers, said:

“Carers need to be treated with more dignity and respect.”

Tory MP Peter Bottomley added:

“I’m glad The Mirror is campaigning.”

In the National Strategy for Carers the government pledged that, by 2018 ‘carers will be supported so that they are not forced into financial hardship by their caring role.’

Carers cannot wait another 9 years, that is why Carers UK is asking for your help, head over to the Carers Poverty Charter page and complete the form to show your support to the campaign.
Carers UK’s poverty charter is backed by Alzheimer’s Society, Citizens Advice, Contact a Family, Counsel and Care, Crossroads Caring for Carers, Every Disabled Child Matters, for dementia, Mencap, Macmillan Cancer, Motor Neurone Disease Society, National Autistic Society, Oxfam, Parkinson’s Disease Society, Princess Royal Trust for Carers, Rethink, USDAW and Vitalise.

Developed by Novasys Medical, Inc., the Renessa treatment offers women afflicted with stress urinary incontinence an opportunity to resume activities that make their lives fulfilling.

The Renessa treatment can be performed in the convenience of a physician’s office, or in an outpatient setting, using local anaesthesia. There are no incisions, bandages or dressings required. Recovery is rapid and comfortable, with minimal post-procedure limitations.

More than 350 urologists, uro-gynaecologists and gynaecologists have been trained and have performed the Renessa procedure on nearly 3,000 patients.

About Novasys Medical

Novasys Medical, Inc. is a privately held, venture-backed company which develops innovative therapies in women’s health. The company’s initial focus is the development and commercialization of the Renessa System, a proprietary, non-surgical approach to the treatment of female stress urinary incontinence (SUI).

Today we would like to talk about an invasive procedure to treat prostate cancer that can increase the chances of post-sugary incontinence. A less invasive robotic surgery used in the treatment of prostate cancer is being related to male incontinence and erectile dysfunctions.

Men who had this surgery have greater chances of becoming incontinent than men who had conventional open surgery, says a study published in the Journal of the American Medical Association.

However, the newer technique cuts patients’ hospital stays, requires far fewer blood transfusions, and carries less than half the risk of leaving behind scar tissue necessitating a second surgery.

That is one of the reasons why you should always ask for second medical opinion in cases like this.

With that in mind, The Daily Mirror and Carers UK are launching a campaign to improve the lives of Britain’s carers. On Sunday 11th October, the Daily Mirror joined forces with Carers UK to call for an immediate review of carers’ benefits. Carers UK chief executive Imelda Redmond said:

“The whole issue of allowances is an absolute disgrace. It is not properly recognised how people have to give up their jobs and look after sick and disabled relatives.”

The current Carers Allowance or main benefit for carers, is the lowest of its kind and many carers are not even aware they are entitled to such benefit. Payments are way below the national minimum wage. Carers are currently paid just £53.10 a week which in a minimum of 35 hours’ caring works out at £1.52 per hour when the government minimum wage is £5.80 per hour.

But the benefit is denied to carers if they care for fewer than 35 hours a week, if they receive a state pension, if they earn more than £95.0 a week after tax or if they are full-time students.

The campaign first launched by Carers UK has already won the backing of over 200 organisations including the Daily Mirror.

The campaign’s demands the Government to:

1. Protect carers from falling into poverty or financial hardship.
2. Reflect carers’ different circumstances.
3. Help carers to combine caring with paid work and study.
4. Be easy to understand and straightforward to claim.

What are your views on the current legislation on benefits for carers? Do you think the government is right to assume family should look after their relatives for less than people not working and claiming Job Seekers Allowance, which currently stands at £64.30 for over 25 year olds? Write your comments in the box below.