The Pelvic Health Program is replacing the Program for the Specialized Management of Urinary Incontinence and the Management of Complications Associated with Suburethral Sling Placement.
Note that the organizational aspect of urinary incontinence management has not yet been deployed. That is the second phase of the program’s implementation.
Description
The Pelvic Health Program improves the support of women experiencing complications or side effects that can occur after a bladder sling, also called a suburethral sling, is placed to treat urinary incontinence.
It allows these women to receive treatment in a designated hospital from a team with expertise in this field.
This team will be able to determine whether the symptoms are associated with the sling and can suggest treatments for the patients that are adapted and relevant to their needs.
Thus, women are very involved throughout the process of evaluating and managing possible complications.
Eventually, the program will also support women who suffer from urinary incontinence.
Organization of services
To support management of complications and side effects that arise after a bladder sling is inserted, some hospitals received a designation because they have the necessary expertise to adequately support women with these issues. These hospitals are designated secondary or reference centres. All other hospitals are considered local centres. These designated centres are distributed across the province’s administrative regions to provide local treatment as much as possible.
Each reference centre is responsible for a group of secondary centres. Each secondary centre is responsible for the local centres in its administrative region. Some regions have no secondary centres. In this case, the secondary centre closest to the local centre is responsible for it.
The designated centre teams consist of a nurse clinician, a physiotherapist and one or more specialist doctors (urologists and/or urogynaecologists). They all offer multidisciplinary treatment with a range of treatment - from physiotherapy to pharmacological treatment to removal surgery - depending on their level of specialization. Note that only the reference centre teams can surgically remove a bladder sling.
Healthcare professionals to consult
If you have symptoms or side effects that you think might be associated with your bladder sling, you must consult your family doctor, specialized nurse practitioner, a physiotherapist with expertise in perineal and pelvic rehabilitation or the specialist doctor (urologist or urogynecologist) who inserted the sling.
Initial consultation
The doctor or health professional that you first consult will assess your condition. This professional might also order additional tests to better understand your situation within the limits of his or her scope of practice.
- The doctor or health professional will ask you questions about your sling insertion;
- There will be an assessment to fully understand your symptoms and their possible link to the sling;
- You will be given relevant and appropriate information for managing your symptoms;
- A medical follow-up may be necessary. If so, the doctor or health professional will inform you;
- If there is a suspected link between your symptoms and your sling, you will be referred, if possible, to the centre that surgically inserted the sling to confirm whether there is a link and they will take over your treatment:
- If your sling was inserted in a local centre and the complications you have are associated with your sling, the local centre team will begin multidisciplinary treatment and will refer you to a secondary centre if necessary.
- If your sling was inserted in a secondary centre and the complications you are having are associated with your sling, your case will be given priority and the appropriate follow-up will be started. If the complications associated with the sling are deemed complex, a transfer to the reference centre is possible.
- If your sling was inserted in a reference centre and the complications you are having are linked to your sling, your case will be given priority and the appropriate follow-up will be started.
Follow-up after the referral
You will be contacted by the designated centre that received the service request.
At that time, although your doctor or health professional has sent the clinical information relevant to your situation to the designated centre, you may still need to complete other questionnaires and forms or undergo additional tests to get a clearer understanding of your situation.
You will then be offered an appointment with a professional (nurse clinician or physiotherapist in perineal or pelvic rehabilitation) or a specialist doctor on the team (urologist or urogynecologist).
Single point of contact for service requests in reference centres
Establishing a single point of contact for service requests to reference centres allows for better distribution of the requests based on the centres’ capacity to take on patients and allows for quicker follow-up.
It is preferable for service requests to be directed to the nearest reference centre to your home. However, if this centre has longer wait times, a transfer to a reference centre that is further away from your home will be recommended. It is up to you to decide whether to accept this offer.
You will be contacted by the single point of contact with all the information you need to make your decision.
Last update: October 11, 2023
