Bladder and Bowel Nurse Team

Bladder and Bowel Nurse Team (Edin, East Lothian & Mid Lothian)

The Bladder and Bowel Nurse Team (BBNT) is a nurse led service, comprising of a small team of nurses who have specialist knowledge in the assessment, diagnosis, treatment and management of adult bladder and bowel dysfunction.

Incontinence is defined as the involuntary loss of urine or faeces that can have a devastating effect upon physical, social and psychological wellbeing of the individual concerned and can have a significant impact on their quality of life. Incontinence is not a disease, but a symptom of an underlying condition which can be treated in many cases.

Referrals to the BBNT are for assessment of bladder and/or bowel dysfunction only.

The assessment will include a self-assessment questionnaire, and a bladder and bowel diary (which can be completed by the patient or a carer/family member). This must be completed prior to the patient being assessed by the BBNT nurse.

Patients cannot be referred directly for incontinence pads. The only exception to this is for some Oncology patients. The BBNT are happy to be contacted by the appropriate nursing teams about these patients these patients (e.g. receiving end of life care).

For any queries or advice regarding whether a patient is suitable for the BBNT, please contact:

0131 537 4572 option 2, option 1 or email

BBNTeam@nhslothian.scot.nhs.uk

Please note that patients with stomas or urostomies, and anything else not related to a bladder and /or bowel dysfunction assessment should not be referred to this service. Please see the link below for the Stoma Service:

stomacareservice@nhslothian.scot.nhs.uk

0131 537 2191

Following assessment and diagnosis, a treatment plan is provided for individual patients on how to improve or resolve their bladder and /or bowel symptoms. If treatment is unsuccessful or inappropriate, then the BBNT will refer onto the Product Specialist Team who are trained in assessing for suitable products to help manage their bladder and/or bowel dysfunction.

Once the referral has been sent in the BBNT will send the patient a self-assessment questionnaire, which can be completed by the patient or a carer/family member. This must be completed prior to the patient being assessed by the BBNT nurse.

J.B & M.G June 2022

Who can refer:

General Practitioners
Care Home Staff
Specialist Women’s Health Physiotherapy
Neurology Nurse Specialists, for example, MS and Parkinson Nurse Specialists
Consultants (Hospital and Community), including Neurology/MS/Parkinsons and MoE
Advanced Nurse Practitioners
Pharmacists
Urology, urogynae and colorectal oncology nurses.

Who to refer:

Females/Males with bladder dysfunction

Urinary incontinence / urgency with or without incontinence / frequency
Nocturia / incomplete bladder emptying
Functional incontinence

Females/Males with bowel dysfunction

Patients who have a bowel dysfunction which has not resolved with conservative treatment

Who not to refer:

Females with bladder dysfunction

Patients who have NOT had a physical examination by their GP to rule out atrophic changes in post-menopausal women. If vaginal atrophy is evident then the patient should have treatment first, and the effectiveness of this treatment reviewed before referral to the Bladder and Bowel Nurse Team.
Patients who have NOT had a physical examination for significant and / or symptomatic prolapse/ pelvic mass.
Patients with red flags, such as bladder pain, haematuria etc should be referred to urology.

Males with bladder dysfunction

Patients with known urinary symptoms indicative of an enlarged prostate, who have NOT had a DRE to examine the prostate. If on treatment for enlarged prostate then time should be give to allow treatment to take effect before referral to BBNT
Patients with red flags, such as bladder pain, haematuria etc should be referred to urology.

Females/Males Bowel Dysfunction

Patients with acute diarrhoea or constipation including faecal impaction, requiring urgent treatment.
Patients with red flags for bowel cancer should be referred to colorectal.
Patients with stomas or urostomies, and requests for stoma/urostomy supplies.