The Impact of Aging on Bladder and Bowel in Spinal Cord Injury Patients

A publication highlight that provides an understanding of cost-effectiveness analysis in valuing new health technologies, by determining whether a new technology is worth the additional costs to the health and care system under consideration.

During this live webinar, our invited speakers will discuss the importance of understanding the symptoms of pelvic floor dysfunction and the relationship between pelvic pain and bladder and bowel problems. We will discuss treatment options, including low volume transanal irrigation and intermittent catheterization and there will also be the option to ask our speakers questions.

Constipation and fecal incontinence are bothersome symptoms of bowel dysfunction, often more common than talked about. Management of these symptoms is complex and conservative methods do not always improve them. Transanal irrigation (TAI) is an established therapy for constipation and fecal incontinence in some patient groups, while rarely used in others. This webinar will introduce TAI as a possible management option for more patients and discuss how to improve adherence to the therapy.

This continence course has been developed for those healthcare professionals involved in the assessment and treatment of patients with any bladder or bowel health issues. The course will provide the essential evidenced based specialist knowledge needed to offer the very best in continence care. The detailed course will be run over 8 modules including a variety of teaching methods, assessment techniques and highly specialist teaching including the most experienced clinicians working within the field of Gynaecology, Urology, Colorectal and Gastroenterology.

In this webinar you can listen to Bev Collins, Clinical nurse lead, Wellspect, as she gives an explanation of what Autonomic Dysreflexia (AD) is and how someone with a spinal cord injury above level T6 is at risk of this life threatening syndrome. You will learn about what can trigger or cause an episode of AD such as an UTI, pain or even a toe nail which has become stuck in a sock. Bev talks through recognizing the symptoms of AD, the importance of why to act quickly and how to manage and treat this life threatening syndrome.

In this series of short recordings, you can listen to Liam Rice, Clinical Nurse Specialist, MS, Sheffield, UK, as he answers questions about bladder and bowel management in MS, from importance to treating symptoms, how best to manage dysfunction, the advantages of good management to why it is important to avoid UTIs.

This is a summary of the scientific publication, Childhood Constipation, Current Status, Challenges, and Future Perspectives by Rajindrajith et al. Chronic constipation in children is common with a global prevalence of 9.5% and in the review written by Rajindrajith et al, the authors share their view of childhood constipation based on their critical review of the available literature. The healthcare costs of constipation in children are large due to repeated hospital admissions, emergency room visits, and regular clinic visits. A better understanding of management of constipation could reduce healthcare costs.

In this series of short recordings, you can listen to Debbie Green, spinal cord injury specialist lead, Spinal Injuries Association (SIA), UK, as she explains common issues someone can have when managing their bladder and bowel care, what challenges can happen when moving to a non-specialist care setting and the impact this can have.

This is a summary of the scientific publication, A patient-centric tool to facilitate goal attainment scaling in neurogenic bladder and bowel dysfunction, path to individualization by Goldstine et al, People with nervous system disorders often experience neurogenic bladder and/or bowel dysfunction, The associated symptoms can be physically, socially, and psychologically challenging in ways that are highly individualized, This heterogeneity makes it difficult to quantify change in an individual’s symptoms using standardized outcome measures, Personalized assessment tools are designed to capture the heterogeneity of an individual’s experience with various treatments and devices in different disease states,

A series of short films which answer common questions asked by people with Multiple Sclerosis (MS) about bladder dysfunction. These films are aimed at people with MS and uses language and explanations that you may find particularly useful when having discussions with someone who has MS or cares for someone with MS.

This is a summary of the scientific publication, Long-term efficacy and safety of transanal irrigation in Multiple Sclerosis by Passantani et al, Forty-nine patients with Multiple Sclerosis (MS) were introduced to transanal irrigation (TAI) and observed a minimum of 12 and a mean duration of 40 months, Results shows that TAI is an effective treatment option for MS patients with NBD, who have not responded to first line therapy, TAI reduces the use of other health-care services, which may prove to be cost-effective,

In this webinar you will hear registered nurse, uro- and bowel therapist Eva Westling talk about symptoms after surgery or removal of the rectum, or lower part of the bowel and how to treat those. In order to achieve success in treating patients with LARS, it is also important to understand the effects this treatment has as well as the anatomy and complexity of the small pelvis.

This is a summary of the scientific publication, Transanal Irrigation in Children, Treatment Success, Quality of Life, Adherence, Patient Experience, and Independence by Baaleman et al, The clinical study was a combined retrospective and cross-sectional survey study investigates chronic idiopathic constipation in children and bowel regimen with transanal irrigation (TAI), Results shows that TAI is an effective bowel management system for children with constipation or fecal incontinence associated with relatively high levels of HRQoL, An increase in independence was reported since TAI use, and perceived effectiveness was high, Although the TAI procedure may be perceived as time-consuming and inconvenient, the authors states that TAI should be considered as treatment option for children with constipation unresponsive to conventional medical treatment before more invasive surgical treatment is initiated,

The majority of people with SCI experience significant symptoms related to neurogenic bladder and bowel dysfunction, e.g. over 90% experience bladder issues, 42% experience constipation and as many as 77% experience faecal incontinence.

This is a summary of the scientific publication, The impact of clean intermittent catheterization on students and families in the school environment by Bauer et al.  The study examines what adolescents, young adults and their caregivers experienced when IC was required during the school day, and how well the schools adjusted to their needs, e.g., by enabling privacy, adequate hygiene, and appropriate access to bathroom facilities. Data was obtained by in-depth interviews which were comprehensive, involving multiple aspects relating to IC. The results revealed a lot of challenges that students in need of IC may experience and have to cope with in school. By encouraging an open dialogue and increasing the level of knowledge and education, the experience for students in need of IC, regardless of age or disability, will be improved.

The study is an observational, cross-sectional study of 50 IC users treated at a hospital in Madrid, Spain. IC was used by all participants for chronic urinary retention, with the majority of participants having a congenital birth disorder such as spina bifida or myelomeningocele. The study also included patients with non-neurogenic bladder dysfunction (related to a weak bladder muscle or a blockage in the flow of urine), as well as spinal cord injured individuals and a few individuals with neurological diseases such as Parkinson’s disease or multiple sclerosis. The mean age of the study participants was 49 years with the majority being females.

This is a summary of a published article providing a great tool for HCPs to further understand urinary incontinence and bowel control issues. It shows prevalence numbers, explain the different types of issues, as well as continence assessments and how to incorporate these into practice.

Interactive tool for recurrent Urinary Tract Infections in patients who perform Intermittent Catheterization. This material was developed together with HCPs from Sweden, Denmark, Italy and Spain and follow EAUN IC guidelines from 2024. It’s directed towards HCPs who meet patients with recurrent UTIs (rUTI), and also performing intermittent catheterization (IC). The aim is to facilitate for the HCP to find the best treatment pathway and to use the material as a checklist.

When a child is about to start with IC, it is important that children and parents gain knowledge about the anatomy and physiology of the urinary tract, as well as why the child needs to start with IC. Not being able to completely empty the bladder in a normal way is more common than you’d think. Every year, many children are born who, for various reasons, cannot urinate like others do. To some people, these problems are temporary, while others will endure them for the rest of their lives. Today, most people who experience this type of problem are helped by a therapy called Intermittent Catheterization (IC). This presentation will help HCPs who will teach IC to children.

The intention of this material is to increase core competences on the basic principles around pelvic floor dysfunction, the risk factors, symptoms and consequences, as well as management options. Also to describe how intermittent catheterization and transanal irrigation can increase QoL for individuals with various types of pelvic floor dysfunctions.

Rectocele or posterior vaginal prolapse is a common condition in women, where the rectum pushes forward into the posterior wall of the vagina, causing a lump inside the vagina. Stool is trapped there, thus making it hard to empty the bowel and also the bladder. The symptoms of a rectocele impacts quality of life and may be treated with non-surgical options such as medical management, lifestyle alteration, pelvic floor re-training or transanal irrigation.

This is a summary of scientific publications about incomplete emptying and conditions causing it. Patients report incomplete emptying as one of the most bothersome symptoms of constipation and evacuation difficulties causing incomplete emptying also commonly cause fecal incontinence. A common cause of evacuation difficulties is pelvic floor dysfunction that refers to different symptoms and anatomic changes related to abnormal function of the pelvic floor. Globally, it is an increasing problem due to the ageing population, affecting millions of, mainly, women every year.

In this summary of the scientific article by Ethans et al. from 2022 you can read about how to manage bowel dysfunction in individuals with cauda equina syndrome. Ethans et al has made a clinical study on the use of transanal irrigation in patients with cauda equina syndrome showing an improvement of bowel function.

This is a summary of the article written by Sara Morgan, ”Management of autonomic dysreflexia in the community.”  published in British Journal of Community Nursing 2020. Autonomic dysreflexia (AD) is an episodic uncontrolled elevation of systolic blood pressure sometimes accompanied by bradycardia. If not managed it can lead to cerebral and spinal hemorrhage, seizures and pulmonary edema.

Cauda equina syndrome (CES) is a condition that affects the bundle of nerves located at the lower end of the spinal cord, called the cauda equina. These nerves is part of the control over bladder, bowel, and sexual function as well as the lower limbs and when they are damaged, it can lead to various symptoms such as incontinence or difficulties emptying bladder and bowel.

This is a summary of the scientific publication, Women with Chronic Constipation have more Bothersome Urogenital Symptoms by Ortega et al published in Techniques in Coloproctology 2022. In this retrospective study the aim was to evaluate the impact of constipation on urogenital symptoms in women. Bowel problems in women are hypothesized to be associated with the presence and severity of urogenital symptoms and linked to pelvic floor dysfunction.

In this article you will learn about how the bowel is controlled with nervous systems such as the intrinsic nervous systems. The normal defecation process is described and what is not working in a neurogenic bowel.

Safety is always important and that includes insight on what may happen when you perform transanal irrigation (TAI). Bowel perforation is a severe but rare risk with TAI that is important to be aware of. Autonomic dysreflexia (AD) is a condition that may affect as many as 90% of spinal cord injured patients with injuries at or above the 6th thoracic vertebrae. Users could also experience bleeding, challenges with the rectal balloon and leakage. A specialist is in the following films sharing his tricks to a successful outcome of TAI.

This series of webinars will follow the patient journey towards adherence to the therapy of Trans Anal Irrigation, offering insight and support for clinicians looking to initiate this therapy with their patients. In this webinar, the third in the series, Jessica Aparo, Pelvic Floor Specialist Nurse at Oxford University Hospitals NHS Trust, talks about complementary and alternative interventions to consider when supporting a patient using TAI, and tips and tricks for ensuring patient adherence in the first few weeks after starting therapy.

This series of webinars will follow the patient journey towards adherence to the therapy of Trans Anal Irrigation, offering insight and support for clinicians looking to initiate this therapy with their patients. In this webinar, the fourth in the series, Jessi answers some of the questions that are most frequently asked by patients when first starting to use Transanal Irrigation.

The Wellspect Transanal Irrigation Webinar programme is designed to guide clinicians that are teaching and supporting adherence of their patients to the therapy of Transanal Irrigation. Delivered by Jessica Aparo, a Pelvic Floor Specialist who is experienced in the teaching and support of the therapy, this webinar, the second in the series, will introduce the therapy Transanal Irrigation.

The Wellspect Transanal Irrigation Webinar programme is designed to guide clinicians that are teaching and supporting adherence of their patients to the therapy of Transanal Irrigation. Delivered by Jessica Aparo, a Pelvic Floor Specialist who is experienced in the teaching and support of the therapy, this webinar, which is the first in a series, will address the topic of patient assessment and factors that the healthcare professional should consider when determining the suitability of the patient for the therapy of Transanal Irrigation.