Bladder and bowel dysfunction

Red flags should be excluded (e.g. haematuria, pelvic mass, recurrent UTI) and referrals done via the appropriate pathway as appropriate.

Initial assessment should include:

• Pelvic exam in women with bowel or bladder issues to look for prolapse/mass/vaginal atrophy
• Prostate assessment in men with urinary symptoms
• Urinalysis, U&E

All patients

• Give information on healthy bowel/bladder - patient leaflet available here
• Treat constipation/UTI if needed
• Allow time for conservative measures/advice to work before referral

Postmenopausal women

• If vaginal atrophy is found on examination then vaginal oestrogen should be tried for at least 6 weeks

Men with bladder dysfunction

• Consider and treat benign prostatic hypertrophy

Patients with ongoing bladder or bowel dysfunction after red flags or acute causes have been managed and after simple conservative measures have been tried.

Refer via SCI Gateway...MTC...Continence Clinic...Bladder and Bowel Health

Please do not send paper referrals - these will be returned to the referrer and SCI Gateway referral requested.

• Housebound patients should be referred to Community nurses via Home Teams
• Patients with stomas or urostomies, and requests for stoma/urostomy supplies should be referred to the stoma nurse specialist.
• Patients need to be able to engage with treatment so patients with significant cognitive impairment may not be appropriate for referral. The team are happy to accept referrals for non-housebound patients where there is a carer who can supervise promotional advice as cognitive abilities allow.