Bladder Care Centre Opens at UBC Hospital

 

March 30, 2005

Bladder Care Centre Opens at UBC Hospital

Imagine the demoralizing isolation of being trapped inside your home for fear of losing control of your bladder in public.

This scenario of urinary incontinence (UI) is about to change for tens of thousands of B.C. patients who now have access to innovative treatments, with the opening of the Bladder Care Centre at UBC Hospital.

"With the generous support of our donors, this new centre will offer innovative bladder care services, programs and research that will significantly improve the quality of life for the people of B.C. living with this condition," says Ron Dumouchelle, president & CEO, of VGH & UBC Hospital Foundation.

The only one of its kind in the world, the centre will provide an accessible, coordinated and integrated system of care to approximately 10,000 patients annually. In addition, the centre's research program will rapidly translate discoveries into new diagnostics and treatments.

"This multi-focused centre combining patient care, health professional education and fundamental research is a model of integrated health care," says Alison Buchan, associate dean, Research, UBC Faculty of Medicine. "The centre will position the Faculty of Medicine, UBC and Vancouver Coastal Health Research Institute as national leaders in determining the causes and prevention of bladder disorders."

The centre has recently been awarded a $1 million US grant from the prestigious National Institutes of Health to be the only centre in the world to study how cranberry juice works with respect to urinary tract infection.

In addition, the centre is the only place in the world to offer non-invasive examination of the bladder through the use of near-infrared spectroscopy. The centre's director, Dr. Lynn Stothers, developed the technique, which offers critical information about blood circulation to the bladder, filling and voiding, without the use of catheters.

Other centre features that are unique in Canada include clinical staff trained in nursing, urology, gynecology, pharmacy, neurology and physiotherapy. Also, the centre's measuring devices and equipment are linked to a common database that enables seamless data collection to aid rapid and comprehensive care.

"We are incredibly proud of this new centre and its multidisciplinary approach," says Dr. Bernie Bressler, executive director of Vancouver Coastal Health Research Institute (VCHRI). "In addition to integrating health professionals together in a unique diagnostic, treatment, education, and research hub, the centre will translate its research findings and treatment approach out in the community. This year we plan to train eight nurse continence advisors who will work from community health centre locations across Vancouver Coastal Health."

"So many people are suffering in silence with this condition," says Stothers. "We want to offer a new resource that provides a wealth of services including an academic and treatment hub as well as services that extend into the community, making it easier for people to get the help they need."

An estimated 1.5 million Canadians, including nearly 60,000 people in the Vancouver and Richmond area, suffer from UI, according to Canadian Continence Foundation estimates. The numbers are expected to double within 20 years as the population ages. UI most often affects middle-aged women and those with a history of complications at childbirth; long-term care residents; and those with spinal cord injury.

In addition, direct and indirect costs of UI in Canada are about $2.6 billion per year.

The Bladder Care Centre is supported by UBC Faculty of Medicine, Vancouver Coastal Health and Vancouver Coastal Health Research Institute, and the VGH & UBC Hospital Foundation donors (including Pfizer Inc and Teck Cominco) who raised nearly $600,000 for the project.

For more information on bladder incontinence, visit the Canadian Continence Foundation website at www.continence-fdn.ca/indexeng.htm

VGH & UBC Hospital Foundation is a registered charity that raises vital funding for life-saving equipment, world-class research, and improvements to patient care for Vancouver General and UBC Hospitals. The foundation and its donors have contributed more than $185 million to support the critical needs of hospitals.

VCHRI is the research body of Vancouver Coastal Health Authority. In academic partnership with the University of British Columbia and philanthropic partnership with the VGH & UBC Hospital Foundation, the institute advances health research and innovation across B.C., Canada, and beyond.

Easy Access: Broadcasters have free access to UBC's live TV and Radio Studios for interviews. For comprehensive media services, visit www.publicaffairs.ubc.ca/media/

Find a UBC Expert Search our on-line database at www.publicaffairs.ubc.ca/experts

Contact: Lisa Carver Hilary Thomson Communications Specialist, VCHRI UBC Public Affairs Tel: 604-875-4111 x 61777 Tel: 604-822-2644 or 604-319-7533 604-209-3048 lisa.carver@vch.ca hilary.thomson@ubc.ca

A Berry Good Idea

The cranberry. Cheerfully bright and tartly delicious, the cranberry is a mainstay of holiday dinners, not to mention a growing economic force in B.C. agriculture.

Cranberries and cranberry juice have also been used for centuries, beginning with First Nations, for curative purposes including treatment of bladder problems. There is growing medical evidence that cranberries are particularly effective in this treatment, especially with bladder infections. But what amount of cranberry is required? And why does it work?

The Bladder Care Centre at UBC Hospital aims to unravel this mystery. The Centre has been awarded a $1 million (over 5 years) grant from the prestigious National Institutes of Health in the U.S. to become the world's first site to conduct a double blind, placebo controlled study in the adult population. Investigators will be looking at why cranberries work, and in what form - juice or tablet, what amount is optimal, and what the long-term benefits are. The Centre will also conduct a similar study in children (in partnership with BC Children's & Women's Hospital) supported by a second grant from the Lions Gate Healthcare Research Foundation.

This research may have a significant impact on population health since urinary tract infections are so common. It is estimated that 27-48 per cent of healthy women with normal urinary tracts have recurrent infections. It is a costly problem because it is one of the most common reasons for doctor visits and repeated use of antibiotics.

Facts: Urinary Tract Infection (UTI) is one of the most common problems presenting in North American physicians' offices, clinics and emergency departments, with an estimated 8 million visits per year in the United States alone. The cost per person with urinary tract infection is $4278 US per year (1999 Ingenix data). Further studies suggest that almost half of women with a UTI have a recurrence within a year, due to a new infection rather than relapse. There appear to be few, if any, long-term adverse effects from recurrent UTIs in terms of either renal infection or mortality, despite frequent recurrence. However, there are major implications for the health-care system in terms of both cost (physician visits, diagnostic tests and treatment) and repeated antibiotic use. E coli is the causative agent in approximately 70-95 per cent of cases of uncomplicated UTIs in adults. Staph infections accounts for a further 5-20 per cent.

Catheters cancelled with new technique

Dr. Lynn Stothers has developed a new technique, first in the world, to measure bladder function without the use of catheters inserted into the urinary tract.

Called near-infrared spectroscopy, the technique allows clinicians a non-invasive method of viewing blood circulation to the bladder, and measuring rates of filling and voiding.

Measuring blood flow to the bladder is key because of the bladder's susceptibility to ischemia, or deficiency of blood. This condition is usually due to functional constriction or actual obstruction of a blood vessel in the organ. Some symptoms of prostate disease may be linked to ischemia of the bladder.

Near-infrared spectroscopy will be demonstrated during the media tour.

 

It can happen to anyone

"I can tell you the location of every public washroom in Vancouver," says Janet Gormick, a retired professor of nursing. Five years ago, Janet suffered from what is called "urge" incontinence or the sudden need to void one's bladder. Janet is diabetic and was taking new medication to treat high blood pressure. The medication was a triggering factor in the urge incontinence.

At that time, in 2000, there really weren't many treatment options. Gormick waited a year to be diagnosed and a further year to between referral and being treated. "It was the pits, I felt I couldn't go out anywhere and I was constantly worried about having anything to drink throughout the day," says Gormick, "but now I have my life back."

Janet Gormick was treated through a variety of exercises, timetable management, education about triggers such as caffeine and soda, and records of intake and how it relates to elimination. She says, "Incontinence is debilitating and humiliating. This new centre which will treat serious bladder disorders, conduct research, and train nurse and physiotherapist continence advisors who will work out in the community, offers treatment and hope in a timely and appropriate manner."

BACKGROUND

The Bladder Care Centre at UBC Hospital The Bladder Care Centre is a state-of-the-art facility that links multidisciplinary health professionals with the community at large in a unique diagnostic, treatment, education and research environment. The Centre conducts leading edge research, integrates new knowledge into education programs, and translates the results of research to guide patient care. These strategies ultimately support the mission of the Centre, which is to provide excellence in bladder care for all British Columbians.

BCC Infrastructure The Bladder Care Centre has: a large reception area a clinical examination suite consisting of 3 exam rooms, a laboratory and teaching area three urodynamics (bladder function) rooms networked with a database, with integrated equipment in the bathrooms to more accurately measure bladder function state-of-the art procedure room equipped with telescopes and equipment for minor surgery two dedicated research rooms physiotherapy and pelvic floor rehabilitation room, including equipment for biofeedback a library with internet access for up to 12 students simultaneously integral sterilization facility video urodynamics room located in the Department of Radiology seven fully-accessible washrooms/change rooms with lockers and seating

BCC Staff

Current staff includes physiotherapists, nurse continence advisors, and researchers. Medical staff includes sub-specialists in bladder function from both urology and gynecology.

Current Capacity

Some of the procedures and activities that take place at the Bladder Care Centre include: Urodynamics tests - up to 80 per week. Care for BC neurogenic bladder patients (those with a loss of bladder function due to nervous system damage such as spinal cord injury, multiple sclerosis, Parkinson's disease, diabetes, and stroke). Pelvic floor retraining, treatment for bladder problems without surgery or drugs - approximately 16 per week Cystoscopy and other minor procedures - up to 50 per week Research in complementary and alternative therapies

Statistics on Bladder Problems

Recent statistics including work done from researchers at the BCC can be found on the US government website www.uda.niddk.nih.gov

 

Urinary incontinence information

According to the Canadian Continence Foundation www.continence-fdn.ca/, UI affects 60% of women with a history of problems during childbirth 50% of all long-term care residents 25% of all middle-aged women 15% of all men 60 years and older

The World health Organization reports that UI affects 1 in 3 women worldwide

A recent study conducted at Emory University found that UI was experienced but previously unreported by: almost 45% of all women over 20 years of age over 20% of men over 20 years of age UI is a primary reason for transfer from independent living to long-term care facilities. It can cost up to $10,000 per resident to manage the problem. For those in the community - typically a senior on a fixed income - incontinence supplies can cost more than $2,000 annually, according to data from the Canadian Continence Foundation.

Indirect costs include sleep loss, low self-esteem, and withdrawal from social interaction. It is estimated that seven per cent of women with UI quit their jobs due to an inability to control incontinence episodes in the workplace.

Individuals with spinal cord injuries are at risk for multiple related complications such as infections, which are a leading cause of death among people with spinal cord injuries.

www.uda.niddk.nih.gov

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