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COVID19 service update:

The Continence, Urology and Colorectal Service is restarting routine appointments as from Monday 5 October. 

All initial and urgent appointments will take place over the phone. Patients will only be asked to attend a face to face appointment if this is necessary. 

If you have had your care interrupted as a result of COVID-19 or were awaiting a first appointment please be assured that the service will contact you when the appointment date is known.

If you are concerned regarding a deterioration in your symptoms and would like a telephone consultation, please ring our admin team on 0113 8433715 or email info.cucs@nhs.net.

You may find the following web pages useful:


We provide assessment and treatment of adults with bladder, bowel or stoma and catheter problems. We support patients and their family/carer to self-care and control their symptoms.

We hold specialist clinics across the city and see patients at home if necessary. 

Who's it for?

Any patient, living in Leeds with a Leeds GP, aged 16 years or older. All patients will be asked to complete a self-assessment form before their appointment, this helps to ensure that the first appointment targets the specific problem(s) the patient is experiencing.

A nurse with specialist training in bladder and bowel care will talk to you so you can both decide the best way we can help. Bladder and bowel problems are very common and there is no need to be embarrassed. Simple tests may be necessary to find out what is causing your problem and so we can agree the best possible treatment. We will discuss this with you. We may need to carry out a physical examination. We will discuss this with you at your appointment and only perform an investigation you are happy with.

The service also provides advice and education to Neighbourhood Teams and other health, social or informal carer. 

Examples of our care include: 

  • Accessible care for people with bladder, bowel, pelvic floor and stoma problems

  • Specialist nursing care for patients with complex bladder, bowel, stoma and catheter problems

  • Providing advice on other containment products

  • Prescribing appropriate, cost-effective treatments 

These are only available after completion of suggested treatment program.

Useful Information 

  • The Continence, Urology and Colorectal Service (CUCS) provides high quality care to patients.
    If you think you may be eligible for a home visit please read this leaflet before applying.

    Benefits of attending a clinic appointment

    • The clinic offers specialist treatment and has diagnostic equipment that is not available for home visits.
    • You will be examined/treated on a specially designed couch to ensure you are comfortable during treatment.
    • You are able to arrange your clinic appointments to suit your needs.
    • You will be seen quicker.
    • Patients who really need a home visit will not have to wait as long.

    Providing care for housebound patients is an important part of our service.
    Recent research shows that healthcare professionals are at risk of developing musculo-skeletal disorders, such as back, shoulder, neck, wrist, hand, hip and knee problems.

    These risks are much greater for staff when providing care in a patient’s home.
    To provide patients with safe and effective care and minimise the risk of injury to our staff, we need to ensure they work in a suitable environment.


    Patients eligible for a home visit

    The following criteria for a home visit are based on the Department of Health ‘Eligibility Criteria for Patient Transport Services.’
    Following consultation this criteria has been adopted by the Continence, Urology and Colorectal Service.
    You may be considered for a home visit if the following apply:

    1. It would be detrimental to your condition or recovery if you were to travel to the clinic.
    2. Your medical condition affects your mobility so you are unable to travel without using an ambulance i.e. unable to take a car or taxi.

    Patients not eligible for a home visit
    You will not be eligible for a home visit if you are able to go out either by taxi, private car, motorised scooter, bus or use the Access Bus to visit any of the following:

    • GP
    • shops
    • relatives
    • pick up your pension
    • hairdresser or barber
    • dentist or optician
    • phlebotomist or nurse, or
    • luncheon club.

    In these circumstances, you will be asked to attend your clinic appointment for your continence care.

    Getting to the clinic

    • Use public transport. Metro: 0113 245 7676 www.wymetro.com
    • Use or share a taxi. See Yellow Pages or Thompson Local.
    • Family and friends are often willing to help out.
    • Combine a clinic appointment with another trip such as shopping, personal or health appointments like going to the doctor or hairdresser.
    • If you use the Access Bus to go shopping arrange your continence appointment for the same day. Access Bus 0113 348 1903.
    • Contact a local voluntary agency that may operate a voluntary driver scheme.
      Please refer to ‘The A-Z Health and Social Care Information in Leeds: Mini Guide for Older People and Disabled People’ available in local libraries or Leeds City Council social services.
      0113 398 4702 www.leeds.gov.uk
    • Leeds Alternative Travel will take you door to door for a small charge.
      0113 386 8880
    • If you receive the high rate mobility component of the Disability Living Allowance or War Pensioners Mobility Supplement you must use this to pay for your transport costs to clinic.

    Change in circumstances

    If your situation changes and you are able or unable to attend a clinic appointment, please contact the Continence, Urology and Colorectal Service.
    The nurse will review your eligibility for a home visit at each appointment.
    If you are no longer eligible for a home visit, we will arrange for you to be seen at a clinic appointment.

    How to apply for a home visit

    To apply for a home visit you will need to complete a mobility questionnaire that should be returned to the address on the form.

  • What is the community stoma care service?

    The community stoma care service is a service aimed to provide specialist clinical nursing care and advice to patients living at home with a stoma in Leeds.

    What is the role of the nurse specialist?

    The nurse specialist will:

    • Provide practical, psychological, emotional and social support for patients with a stoma
    • Act as an information source for patients, relatives and carers
    • Offer a telephone advice service for patients, carers and health care professionals
    • Provide integrated community care links with district nurses, GPs and other community health care professionals
    • Maintain links with stoma support groups
    • Offer regular evidence-based education, teachings and study days
    • Provide satellite clinics across Leeds
    • Make joint district nurse home visits where appropriate
    • Ensure the appropriate use of stoma care products
    • Work to improve the service in response to patient and carer needs
    • Work to improve the service in response to health care professional comments
    • Work to improve the service in response to research
  • The Continence, Urology and Colorectal Service (CUCS) is for anyone 16 years or older who experiences a bladder, bowel or stoma problem.

    A nurse with specialist training in bladder and bowel care will talk to you so you can both decide the best way we can help.
    Bladder and bowel problems are very common and there is no need to be embarrassed.

    Continence products may be provided by the Health Service after an assessment and completion of suggested treatment programmes.

    Continence products can be purchased from local shops, supermarkets, chemists, online or over the telephone and then delivered to your home from several companies / charities.

    Company / Charity Details:

    Age Uk:
    Tel: 0800 046 1501
    Mon - Thurs 8am - 6pm, Fri - 8am - 5.30pm, Sat - 9am - 1pm
    www.ageukincontinence.co.uk/incontinence-shop

    Support My Life (Managed by Care & Repair):
    Tel: 0113 240 6009
    Mon - Fri 9am - 4pm
    www.care-repair-leeds.org.uk
    (you can also visit their shop at 323 Roundhay Road, Leeds, LS8 4HT)

    Kylie & Kanga:
    Tel: 0115 978 6111
    Mon - Thurs 8.30am - 5.30pm, Fri - 8.30am - 5pm 

    www.kyliekanga.co.uk

    Tena Direct:

    Tel: 0800 393 431
    Mon - Fri 8.30am - 5pm

    www.tenadirect.co.uk

  • Maintaining a healthy bowel is one of the essentials of healthy living, so it is important to know what can cause unhealthy and poor bowel habits. Poor bowel habits can lead to constipation, and / or faecal incontinence which is often uncomfortable and can be painful. The following information looks at several key factors, which help maintain a healthy bowel.

    Normal bowel function

    The bowel is part of the digestive system and its role is to digest the food that we eat, absorb the goodness and nutrients from the digested food into the blood stream, and then to process and expel the waste products from the food that the body cannot use. As long as stools are passed without excessive frequency, with minimal effort and no straining, and without the use of laxatives, bowel function may be regarded as normal.

    How often should the bowel be emptied?

    There is no right or wrong answer to this. There is a very wide range of ‘normal’ bowel function between different people. Only a minority of the population has a bowel action once per day. Some people go several times a day and others have several days between bowel actions.

    Reviewing medication

    Be aware - some medications can have an effect on how your bowels work. If in doubt, organise a review of your medications with your GP or pharmacist. Medication such as pain killers, antidepressants and iron tablets can cause constipation. Medications such as diabetic tablets, antibiotics or antiacids can cause loose stools (poo) which can lead to faecal incontinence. Discuss your laxative use with your healthcare professional and always let them know about medicines you buy from a chemist or on the internet. More than one laxative may be used to relieve your constipation. Too much laxative can make your stools loose. Your clinical nurse specialist will complete an assessment and support you with treatment and / or bowel management to reduce the risks of constipation, poor emptying and / or faecal incontinence to enhance your quality of life.

    What may go wrong?

    A number of things can go wrong with your bowels that may cause constipation or faecal incontinence. The nurse specialist will discuss with you what is wrong in your case.

    What will help to make your bowel healthier?

    • Diet
    • Exercise
    • Morning routine
    • Toilet position
    • Defaecation techniques
    • Medication review

    Dietary fibre

    Fibre is the non-digestible part of plant foods which passes through the stomach and bowel providing bulk. Fibre is important for maintaining a healthy bowel and can improve stool consistency and regularity. Most of us do not eat enough fibre in our diets. You can improve your fibre intake by including more of these foods:

    Bread and cereals

    • Start the day with a high fibre cereal (e.g. weetbiscs, wholewheat cereals, porridge, muesli) or wholemeal or wholegrain bread.
    • Stock up your cupboards with wholegrains such as cereals, oats, brown rice, rye, seeded wholewheat crackers and breads.
    • Add oats, nuts or seeds in your cooking e.g. crumbles, toppings.

    Brace and lift technique

    The brace and lift technique is used to help coordinate defaecation. We teach this technique with the toilet position. Your nurse will show you how to do brace and lift in clinic and may teach you step by step or ask you to practise daily away from the toilet. Over time you may find you have fewer problems in achieving a complete defecation.

    Step 1

    • Keeping your shoulders down, take a deep breath that makes your tummy and waist widen like a bellow effect.
    • Hold that breath and push out your tummy like a beach ball. You have now created extra abdominal pressure.
    • If you now say ‘idge’ you will sense your anus bare down momentarily. This is the first part of the technique helping you to poo.
    • Practise the above away from the toilet. How can we use breathing to help with pooing?

    Step 2 

    • To poo, you need the bottom muscles to be relaxed.
    • Give your anus muscle a squeeze so that you have lifted that muscle and then relax. Relax again - this is the correct position for pooing. 
    • From step 1, try saying ‘idge’ at the same time as relaxing your bottom to enable pooing.

    You can repeat steps 1 and 2 several times to help pooing.

    Bristol Stool Chart

    Type 3 and 4 are classed as normal, easy to pass but also easier to hold on to.

    Type 1: Separate hard lumps, like nuts

    Type 2: Sausage-like but lumpy

    Type 3: Like a sausage but with cracks in the surface

    Type 4: Like a sausage or snake, smooth and soft

    Type 5: Soft blobs with clear-cut edges

    Type 6: Fluffy pieces with ragged edges, a mushy stool

    Type 7: Watery, no solid pieces

    Fruit and vegetables

    Aim to eat 5 portions of fruit or vegetables daily. Fresh, frozen, tinned or dried and juices are all good sources of fibre.

    • Eat the washed, edible skins on fresh fruit, such as apples and pears.
    • Enjoy fresh, tinned or stewed fruit as a pudding after your main course.
    • Add some fresh or dried fruit, nuts or seeds to your breakfast cereal.
    • Have some dried fruit, nuts or seeds as a snack between meals.
    • Try to have two vegetables with your main meal e.g. carrots and broccoli.
    • Add extra vegetables to soups, stews, casseroles and pasta. 
    • Avoid overcooking vegetables.
    • Serve salad vegetables with sandwiches, snacks and packed lunches.

    Dietary fibre

    Pulses E.g. peas, beans, pearl barley and lentils are an excellent source of fibre. These can add bulk to your stool.

    • Have them in stews, soups and casseroles.
    • Use baked beans and mushy peas or garden peas with your meals.

    Fluids

    It is very important to drink plenty of fluids. Have at least eight cups, mugs or glasses daily (11 /2-2 litres, 3-4 pints). Increase the amount of fluid you drink in hot weather and when exercising. A variety of drinks all contribute to your fluid intake.

    • Water
    • Squashes
    • Fruit juices
    • Flavoured water
    • Milk
    • Tea
    • Herbal teas
    • Coffee

    Drinking less than 8 cups could be a cause of constipation. However, over hydrating will not resolve constipation.

    Do not ignore the call to have your bowels opened.

    Putting off the call to go can be a cause of constipation or lead to urgency. Try to work with the body’s natural rhythm (emptying the bowel first thing in the morning).

    Toileting position

    The best way to sit on the toilet is:

    • Legs apart
    • Knees higher than hips by either using a foot stool or slowly bring your feet in to tip toe position (avoid doing at speed so as not to contract your pelvic floor)
    • Sit upright with your body leaning slightly forward (rest elbows on your thighs).

    This position is the best way to assist with complete emptying of the bowel. Privacy and comfort will assist in the complete emptying of your bowels. Try to work with the body’s gastro-colic reflex (body’s natural rhythm) - it is at its most powerful first thing in the morning and secondarily post other meals in the day.

    Morning routine

    1. Start the day with a hot drink, like water, lemon, tea or coffee. This helps kick start the body’s rhythm.

    2. Eat breakfast! This helps to move stools in the bowel, which will in turn help fill the rectum, and increase the urge to have your bowels opened.

    3. After breakfast, wash and dress or do 10 minutes exercise such as walking or stretches.

    4. Then sit on the toilet to encourage bowels to empty at a regular time each day (for no longer than ten minutes).

    The morning routine can be used with all meals including lunch and dinner.

    Remember

    When increasing fibre in the diet, introduce the changes gradually, as a sudden increase can cause discomfort and bloating. Aim to increase the number of fibre rich foods you eat gradually over 3-5 days. It is important to drink plenty of fluid when increasing your fibre intake. Fibres and fluids work together to ensure a regular, comfortable bowel movement. Try to eat regularly, 3-4 meals a day will improve bowel regularity.

    Activity

    Whatever your activity level, increasing the amount you do will improve your bowel function. Aim for 30 minutes of activity a day e.g.  walking, aerobics or chair aerobics, gardening, housework, cycling, swimming or team sports.

    If you are unable to achieve this for health or mobility reasons speak to your GP for advice.

    Eat well guide 

     

  • leg_and_g_strap_croppedHaving a urinary catheter is a helpful treatment for many service users but sometimes problems can occur. Proper care of your catheter will reduce the risk of getting problems.

    Reducing the risk of urine infections

    Having a catheter increases your risk of getting a urine infection as it is easier for bacteria to enter your bladder.

    Catheter infections can be serious and difficult to treat.

    Sometimes the infections can be life threatening.

    Hand washing and keeping clean helps reduce the risk of getting urine infections.

    Hand washing

    • You should always wash your hands thoroughly with soap and water before and after dealing with your catheter and drainage bags.
    • Carers should always wash their hands thoroughly with soap and water before and after dealing with your catheter and drainage bags and should also wear a new pair of disposable gloves each time.

    Keeping clean

    • Wash the area where the catheter enters your body every day with mild soap and water.
    • Wash the area after you have opened your bowels and if the area gets dirty.
    • Avoid using talc or creams.
    • Have a daily shower or bath if possible.
    • Do not remove your leg bag when you have a shower or bath.
    • Dry your leg bag by patting it with a clean towel.

    Contact your nurse to discuss if it is possible to:

    • try without your catheter;
    • use a catheter valve (a discreet product to use instead of a leg
      bag); or
    • do intermittent catheterisation (use a removable catheter to periodically drain urine from your bladder – this may have less risk of urine infections).

    Contact your nurse if you would like advice leaflets on:

    • sex and catheters;
    • disposal of continence products; or
    • advice for patients using catheter valves.

    Contact your nurse if you would like to discuss any other concerns about your catheter. Your nurse’s telephone number should be at the front of your file or patient notes.

    Possible problems 

    what to do if Your catheter is not draining

    • Check the tubing is not kinked or squashed.
    • If possible try changing your position or walking about.
    • Check your drainage bag which may be full and need emptying.
    • Check your drainage bag is below the level of your bladder.
    • If it is still not draining contact your nurse.

    Your catheter is leaking (bypassing) where it enters your body

    • Check the tubing is not kinked, pulled or squashed.
    • If possible try changing your position or walking about.
    • If leaking is an ongoing problem contact your nurse.

    Your catheter gets pulled out or falls out

    • Contact your nurse.

    You may have a urine infection and need to contact your nurse or doctor if you feel unusually unwell and have any of the following:

    • a fever;
    • pain near your bladder or lower back pain;
    • blood in your urine;
    • unusual confusion;
    • unusual tiredness; or
    • feeling like you want to vomit or you are vomiting.

    Changing your leg bag correctlyChanging leg bag

    • This will help reduce the risk of urine infections.
    • Only change your leg bag every seven days or if it gets dirty or damaged.
    • When you change your leg bag, do not touch the tip of the tube (which gets pushed into your catheter).
    • Never reuse a leg bag after it has been removed.

    Emptying your leg bag

    • Do not let your leg bag get too full and heavy as it will pull and damage your body.
    • Empty your bag when it is two thirds full.
    • Empty your bag into a clean toilet, jug or urinal.

    Connecting your night bag correctly

    • This will help reduce the risk of urine infections.
    • Use a new night bag every night.
    • Connect your night bag to your leg bag.
    • Do not touch the tip of the night bag tube (which get pushed into your leg bag).

    Securing and supporting your catheter and drainage bags

    • This helps reduce the risk of pulling and harm to your body and bladder.
    • Secure the catheter to your leg or tummy with a securing device (speak to your nurse if you do not have a securing device).

    New g strap     Clinifix

    • Support your leg bag by either elastic straps or a stretchy sleeve.

    Leg bag fastening     Leg bag1

    • Catheter bag standSupport your night bag by a floor stand/bed hanger.
    • Never leave your drainage bag touching the floor as it may pick up bacteria.
    • Ensure your drainage bags are always positioned below the level of your bladder to help the urine drain.

    Fluids

    • Drink at least 1½ - 2 litres (2½ - 3½ pints) a day (unless advised otherwise by a healthcare professional).
    • This may help reduce the risk of infections.

    Bowels

    • Eat a healthy diet to avoid constipation as this may cause blocking or leaking of your catheter.
    • Speak to your nurse or doctor if you suffer from regular constipation.

    Storage of catheters and catheter products

    • Store your products in a clean, cool and dry place out of direct sunlight in their original packaging.
    • Dispose of products if they are passed their expiry date or if the packaging has been damaged.

    Disposal of used catheters and catheter products

    • Place used products into two plastic bags before putting them into your household waste bin.
    • If you have an infection ask your nurse for advice as you may need to use a special bin.
    • This may help to reduce the risk of spreading infection.

     

    References
    Guidelines for urinary catheterisation: adults and children (urethral, supra pubic and intermittent). NHS Leeds Community Healthcare February 2009
    Catheter care, RCN guidance for nurses. The Royal College of Nursing March 2008

Referrals

Most referrals come to the Continence, Urology and Colorectal Service by a GP, Neighbourhood Team or hospital, although patients may refer themselves to the service using a self-referral form. GPs or other healthcare professionals refer patients by sending a completed referral form to the service.

Self-referral form 

Referral form (for professionals only)

Self-help videos

Abdominal Massage - self-massage 

Abdominal Massage - for carers

Tel: 0113 8433715

Email: info.cucs@nhs.net

8:30am - 4.00pm, Monday - Friday

Halton Clinic
2A Primrose Lane
Halton
Leeds 
LS15 7HR

Domiciliary visits are provided and clinics are held across the city.

We are currently reviewing our website to make all content accessible. If you are looking for a download, such as a leaflet or booklet that you can no longer find, please contact the service on the details above.

Service Downloads and Useful Links 

Eat well guide

CUCS Referral FormThis file may not be suitable for users of assistive technology.

Catheter Passport

What to do if you need to speak to someone urgently...