Researchers trial care home incontinence treatment

12 July 2017

A research team from Glasgow Caledonian University (GCU) is testing the effectiveness of mild electrical stimulation of the leg to reduce incontinence in care homes.

Urinary incontinence is a distressing condition that occurs in around 70% older people who live in nursing or residential care homes, and has major impacts on the person’s dignity and quality of life. Older people who experience incontinence usually rely on the use of absorbent pads to contain the leakage, rather than trying to treat the cause of the problem.

With funding for three years from the National Institute for Health Research’s Health Technology Assessment programme, the research team will work with care home residents across the UK to assess whether electrical stimulation reduces incontinence.

The team, led by Professor Jo Booth, also includes Professors Suzanne Hagen, Doreen McClurg and Dawn Skelton, Drs Helen Mason and Maggie Lawrence as well as partners from five other universities, a Healthcare Trust and BUPA UK.

Nerves that control the bladder are connected to the tibial nerve, which is located on the back of the lower leg. By stimulating this nerve through the skin, nerves that control the bladder are stimulated as well. This is known as transcutaneous posterior tibial nerve stimulation (TPTNS).

TPTNS involves placing two sticky pads (surface electrodes) on a person’s ankle and connecting these to a small, pocket sized electrical stimulator. This sends an electric pulse to the nerve near the ankle which also controls the bladder. Each treatment lasts half an hour and a total of 12 are given over a six-week period. The treatment is similar to a TENS machine, which is sometimes used for treating pain, such as that associated with labour.

TPTNS helps people with bladder leakage because it reduces the feeling of sudden urgency and the need to rush to the toilet and so gives people more warning and more time to find a toilet before they leak. TPTNS also increases the volume of urine the bladder is able to hold, so people do not need to empty their bladder as often.

Professor Booth said: “Small, early studies have all indicated that TPTNS is safe and acceptable and that it can help bladder problems. However, we need better quality evidence that it works before we can recommend that it is used for everyday treatment.

“This research will test the stimulation against a dummy treatment and will involve 500 people living in care homes who have urinary incontinence and who wear absorbent pads. We will also ask their close family members and the care home staff about whether they think TPTNS has had any effect on the older person. We will also explore with the care home staff the best ways to give this TPTNS treatment in a care home and keep it going in the long term.”