Your NHS journey

Who's who?

Meet the team whose help will be on offer:

1. The GP

   Your GP is likely to be your first port of call and may take responsibility for your treatment – or may refer you to a specialist.

2. Continence service

   If you prefer not to go to your GP, or if you’d like some more advice, you can visit your local NHS continence clinic. You don’t need to be referred by your doctor if you want to go to a continence clinic – you can simply phone and make an appointment. At the clinic, a continence advisor will assess you and give you the advice you need, including how to do pelvic floor exercises. Continence clinics are usually based in hospitals or health centres – to find your nearest clinic, phone your local hospital or contact the Bladder and Bowel Foundation on 0845 345 0165, or visit its website.

3. Hospital specialist

   If your bladder problems don’t resolve easily with treatment, your GP may refer you to the hospital to see a doctor who specialises in conditions such as bladder problems (a Urologist). A Urologist will ask you to describe your symptoms and may order some tests to assess how well your bladder is working.

4. The pharmacist

   If you need to take medication for your bladder problem, your pharmacist can be a very useful source of information for you when it comes to wanting to know how best to take your medicine. See more on the role of the pharmacist.

5. NHS Direct

   NHS Direct is a 24-hour helpline which gives you access to confidential healthcare advice and information, provided by a nurse. You can contact NHS Direct on 0845 4647. If you prefer, you can visit NHS Direct online (www.nhsdirect.nhs.uk)

Seeing your GP

Explaining the problem to your GP is the first step to finding an answer and starting treatment. Try to overcome any feelings you may have of embarrassment or not wishing to 'bother' your doctor - remember, it's the doctor's job to help you.

Here's what's likely to happen:

• On your first visit, your doctor may ask you to keep a bladder diary to show how much urine you pass compared with how much you drink. Your GP may also wish to examine you to assess your pelvic floor muscles or, if you're a man, your prostate gland.
• Your may need to do a urine test to check for infection or underlying disease such as diabetes. You may also have a blood test.

If the urine test shows an infection, your doctor may give you an antibiotic, although if you're a man, you may be referred for further tests.

• If your doctor decides you have overactive bladder or stress incontinence, he or she will discuss the various treatment options open to you. It's likely you'll be advised to do pelvic floor exercises and/or bladder training. Your GP may refer you to a physiotherapist specialising in stress urinary incontinence.

At the hospital

Your GP will refer you to the hospital if he or she thinks you need further tests, or if your bladder problems don't resolve easily. At the hospital, you may have an ultrasound scan and possibly tests that assess how well your bladder is working (known as urodynamic testing) . If you're a woman, you may also have a vaginal examination.