Objective-To measure the unmet need ofpatients with regular urinary incontinence (incontinence twice or more a month) treatable by a nurse.Design-Self completed postal questionnaire and randomised controlled trial of assessment and intervention by a nurse.Setting-One urban and one rural general practice in Somerset.Subjects-7300 adults randomly selected from 10300 aged 35 and over on the combined practice lists. 515 women and 185 men with regular incontinence were offered assessment and treatment, of whom 134 women and 49 men had no intervention for three months (historical controls). They then joined the assessment and treatment programme.Intervention-Four sessions of pelvic floor exercises and bladder retraining supervised by non-specialist nurse who had taken a three week course on assessing and treating uncomplicated incontinence.Main Conclusions-About half the people with regular urinary incontinence took up the offer of treatment (9-2% of women and 3-4% of men in the study population). This condition can be effectively managed by a nurse with limited training.

Objectives To investigate the performance of the EuroQol ment at 12 months in usual activities, mood and pain/discomfort. The EQ self-rated health and com-(EQ) quality-of-life measure and the Nottingham Health Profile (NHP) in assessing the outcome of posite quality-of-life score also showed improvement with TURP which continued for 12 months after transurethral resection of the prostate (TURP) for lower urinary tract symptoms (LUTS) suggestive of surgery. The patients in Group 2 tended to deteriorate over the 6 months of follow-up using all measures, benign prostatic obstruction (BPO), and to determine which men experience the greatest increase in healthbut the changes were not significant. The EQ composite quality-of-life score also discriminated between related quality of life (HRQL) after TURP. Patients and methods A prospective cohort study was patients on the basis of age, number of symptoms and ASA grade, suggesting that these subgroups experiundertaken over 12 months from April 1992 of 314 men who completed the EQ, the NHP and a symptom enced differing amounts of benefit from surgery. Conclusion TURP led to significant improvement in the inventory before undergoing elective TURP for probable BPO (Group 1). Identical postal questionnaires indices of generic HRQL as measured using the NHP and EQ; this improvement continued for 12 months were used to follow up this group at 6 weeks, 6 months and 12 months post-operatively, with after surgery and mirrored the symptomatic improvement. The EQ confirmed clinical experience, in that response rates of 79%, 74% and 69%, respectively. Overall, 92% of patients responded at either 6 or 12 men who were younger, fitter and most symptomatic experienced the greatest benefit from surgery. This months after surgery. A group of 51 men who had not undergone operation, also with LUTS and probable has not been shown previously using a quality-of-life measure. Generic HRQL measures can be incorporated BPO, were similarly followed over 6 months, before eventually undergoing TURP (Group 2). These patients easily into clinical trials and both the measures used in this study have sufficient sensitivity to be used in differed from Group 1 in being younger, less symptomatic and having a higher baseline quality-of-life this population. The EQ has the advantage of generating a composite quality-of-life score which is easy to score, but the inclusion of this group from a broadly similar diagnostic category allowed outcome to be interpret and can be used in cost-utility analysis. The addition of HRQL measures leads to a more robust assessed over time in the absence of surgery. Results There was a significant improvement in all LUTS appraisal of the results of surgical intervention. Ultimately, patient-based outcome from TURP will be 6 weeks after TURP; post-micturition dribbling and storage symptoms continued to improve for up to one assessed using a combination of psychometrically tested disease-specific and generic measures, together year. The NHP revealed pre-operative morbidity in al...

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Medium-term results are presented for the periurethral injection of Teflon in the treatment of stress urinary incontinence. Follow-up data were obtained on 36 women by means of case note review and the completion of a postal questionnaire. Mean follow-up was 5.1 years. Subjective results showed 12 patients to be dry or much improved while the remaining 24 patients did not obtain significant benefit from the procedure. Repeat injections in 12 women resulted in only 3 obtaining useful improvement, while a subgroup of patients who had undergone previous procedures showed a better response. No significant complications were observed. Periurethral Teflon injection is a minor surgical procedure which can produce worthwhile improvement, although an initially good result may not be sustained with longer follow-up. This method may be advocated as treatment for poor risk patients who are unsuitable for surgery, particularly when previous attempts at formal surgical correction have been unsuccessful.