The primary aim of the NHS Borders Bladder, Bowel and Pelvic Floor service is to promote bladder and bowel health and continence by offering advice, treatment and self-management options.
The bladder, bowel and pelvic floor service is a multidisciplinary team and comprises of specialist nurses, physiotherapist and an administrator. Staff have a specialist knowledge in the assessment, diagnosis, treatment and management of adult and children's bladder, bowel and pelvic floor condition.
Incontinence is defined as the involuntary loss of urine, faeces or flatus that can have a devastating effect upon physical, social and psychological wellbeing of the individual concerned and can have a significant impact on their quality of life. Incontinence is not a disease, but a symptom of an underlying condition which can be treated in many cases.
Referrals to the Bladder, bowel and pelvic floor service are for assessment of bladder and/or bowel dysfunction, prolapse and dyspareunia only.
We are unable to accept referrals for the following:-
- Chronic pelvic pain – male and female
- Initial management of constipation / bowel impaction
- Catheter overflow management
- Management of stomas or urostomies
The assessment will include the review of a bladder and bowel diary (which can be completed by the patient or a carer/family member). In order to avoid delay in access to our services these forms should be sent in with the patient referral. If not completed with the referral, these will be sent to the patient and must be completed and returned before an appointment is offered.
Patients cannot be referred directly for continence aids. Please ensure that all patients are aware that they are being referred for assessment and management so that they have the correct expectation for what our service can offer. The only exception to this is for some patients who are at end of life care or have severe cognitive impairment. In these cases a product assessment form along with a completed bladder and bowel diary, can be submitted by the district nurses or a healthcare professional for review by one of our specialist nurses.
Following assessment and diagnosis, a treatment plan is provided for individual patients on how to improve or resolve their bladder and /or bowel symptoms. If treatment is unsuccessful or inappropriate, the team will consider onward referral to appropriate services for further investigation management. In exceptional and at the discretion of the clinical specialist nurse or physiotherapist some patients may be assessed for suitable incontinence products to help manage their bladder and/or bowel dysfunction.
For any queries or advice regarding as to whether a patient is suitable for the Bladder, bowel and pelvic floor team
01896 824555
Admin.BladderBowelService@borders.scot.nhs.uk
Who can refer:
- General Practitioners
- Healthcare Professionals
- Secondary care services
- Ward staff ( for hospital discharges – once date of discharge is known)
- Districts Nurses
- CCNs and School nurses
- Care / Residential Home Staff
Who to refer:
Females/Males/Non Binary patients with bladder dysfunction
- Urinary incontinence / urgency with or without incontinence / frequency
- Nocturia / incomplete bladder emptying
- Patients post RARP
- Functional incontinence
Females/Males /Non Binary patients with bowel dysfunction
- Patients who have a bowel dysfunction which has not resolved with conservative treatment
Who not to refer:
- Chronic pelvic pain – male and female
- Initial management of constipation /bowel impaction
- Catheter overflow management
- Patients with known urinary symptoms indicative of an enlarged prostate, who have NOT had a DRE to examine the prostate.
- Patients with red flags, such as bladder pain, haematuria etc should be assessed by a medical professional in the first instance.
- Patients with acute diarrhoea or constipation including faecal impaction, requiring urgent treatment.
- Patients with red flags for bowel cancer should be referred to colorectal.
- Patients with stomas or urostomies, and requests for stoma/urostomy supplies.
How to refer:
Prior to referral to the service, please ensure the following have been done:
- Rule out / manage constipation
- Advise reduced caffeine levels
- Rule out urinary tract infection (We would expect this to be ruled out by discussion of symptoms or evidence of a urine dip / sample sent to the lab for testing).
- Advise to commence pelvic floor exercises
- Direct to appropriate information on NHS Inform
- Vaginal examination / DRE where appropriate
- Rule out red flags
01896 824555
Admin.BladderBowelService@borders.scot.nhs.uk
Borders Ref Help Toolkit
