NICE guidelines review

Published: 16 September 2011

Alison Bardlsey reports on a review of NICE incontinence guidelines

The women’s and children’s collaborative is leading a review of the NICE women’s incontinence guidelines from 2006. Tony Smith is lead clinician.

They are looking at four areas:

• the effectiveness of neuromodualtion for the treatment of Overactive bladder symptoms(OAB and iincludes tibial. This will consider the evidence and check if tibial could be part of the primary care pathway rather than waiting for referral to secondary care
• the effectiveness of botulinium toxin A for OAB. The license is an issue and where it should come in the treatment pathway
• the comparative effectiveness of the pharmacological interventions for the treatment OAB. There is grade (a) evidence from the original document, and there have been some new medications and some have been removed
  What is the comparative effectiveness of transvaginal tape, transobturator or single incision sling procedures for stress urinary incontinence? This will consider the question of which surgery should be first line, how many fail and if they fail what should be the next line of surgery
• the review group will focus on the groups of women at greatest risk of not receiving treatment, which should give a clearer referring prompt for women over 65 with UI, who are often not referred to secondary care for treatment.

The drafts will be available on the NICE guidelines website for consultation.