We are pleased to announce the publication of the NICE guideline on Urinary incontinence (update) and pelvic organ prolapse: management developed by the National Guideline Alliance (NGA).
The guideline is an update of the 2013 NICE guideline on urinary incontinence in women and includes a new section on pelvic organ prolapse. The guideline’s main aim is to help women choose which management option for urinary incontinence (UI) and pelvic organ prolapse (POP) is right for them, with a clear focus on the woman’s choice.
Urinary incontinence is a common symptom that can affect women of all ages, with a wide spectrum of severity and nature. Although rarely life threatening, incontinence may seriously affect the physical, psychological and social wellbeing of women and have an impact on their families and carers.
Pelvic organ prolapse is defined as symptomatic descent of 1 or more of: the anterior vaginal wall, the posterior vaginal wall, the cervix or uterus, or the apex of the vagina (vault or cuff). Symptoms include a vaginal bulge or sensation of something coming down, urinary, bowel and sexual symptoms, as well as pelvic and back pain. These symptoms affect women’s quality of life.
The prevalence of pelvic organ prolapse is high; in primary care in the UK, 8.4% of women reported vaginal bulge or lump, and on examination prolapse is present in up to 50% of women. One in 10 women will need at least 1 surgical procedure, and the rate of re‑operation is as high as 19%.
This guideline covers the assessment and management of urinary incontinence and pelvic organ prolapse in women aged 18 years and older. It reviews the safety, clinical and cost effectiveness of surgical procedures for stress urinary incontinence and pelvic organ prolapse, including the use of mesh devices.
The areas of the guideline updated as part of this guideline update are:
- multidisciplinary teams
- urodynamic testing in urinary incontinence
- absorbent products for urinary incontinence
- medicines for overactive bladder
- botulinum toxin A for overactive bladder
- surgical procedures for stress urinary incontinence.
The guideline also reviews the evidence and adds new recommendations in the following areas:
- assessment and management of pelvic organ prolapse
- management of coexisting urinary incontinence and pelvic organ prolapse
- assessment and management of complications associated with mesh surgery for urinary incontinence or pelvic organ prolapse.
"Urinary incontinence (update) and pelvic organ prolapse: management" is available from Tuesday 2 April 2019 to view and use at the following link: