1. Janice Reid Continence Services Manager Western Health & Social Care Trust 29/01/2014 LSA Midwifery Conference Mossley Mill

2. PTNS, the Continence Nurse Specialist and the Patient…. the journey to success together 29/01/2014 ROAD TO SUCCESS

3. 6.5 million people in UK today with some kind of bowel problem 29/01/2014

4. Involuntary leakage of  Solid matter  Liquid  Gas (anal incontinence) 29/01/2014

5.  Damage to the rectum or anus  Bowel motility problems  Stool consistency problems  Neurological damage e.g. motor/sensory, MS, Diabetes, post hysterectomy 29/01/2014

6.  20 – 30 referrals per year  Limited treatment options  Incontinence still taboo  Social stigma 29/01/2014

7.  A first for Northern Ireland  Urgent PC neuromodulation system - uses established technique of electrical stimulation  Can be implemented by specialist nurses in a clinic setting 29/01/2014

8.  78.2% improvement in patients with FI treated with PTNS on alternate days for 4 weeks (Shafik et al 2003)  17 patients with FI treated with PTNS for 6 weeks – significant improvement in continence scores (Govaert et al 2008)  100 patients – urge, passive and mixed FI. Statistically significant improvement in mixed & urge (Hotouras et al 2011) 29/01/2014

10.  Funding  Training  Competency framework  Care pathway  Evaluation strategy 29/01/2014

11.  New to NI – training issues?  New treatment - no long term data 29/01/2014

12.  The ethos of Transforming Your Care  A focused and motivated team of specialist nurses with a desire to improve the lives of patients with Faecal Incontinence 29/01/2014

13.  58 yr old nulliparous lady – mixed urge and passive FI  Very weak anal tone / Pelvic floor contraction  After treatment - incidence of FI reduced by 50%  Significant improvement in QoL 29/01/2014

14.  38 yr old para 1  Faecal urgency/incontinence/flatus  Weak anal tone  After treatment – 40% reduction in incontinent episodes / flatus now controlled 29/01/2014

15. My life is transformed – thank you 29/01/2014 I was practically housebound before – I feel I have my life back

16. 29/01/2014 For the first time in years I had the confidence to go out for a family meal

17.  PTNS – safe, well tolerated, minimally invasive procedure  Significant reduction in Faecal Incontinence episodes  Less medication, less pads  Impact on Quality of Life 29/01/2014

18.  Ask questions!!!  Keep in mind that FI is a symptom – often with multiple contributory factors  Keep the patient as the focus  Never be afraid to act on your vision 29/01/2014