Recent statements from NICE give the most compelling reason yet why every woman should read The Kegel Legacy (ebook gbp1.99, paperback gbp6.99). The new NICE Guidelines for the treatment of incontinence in women highlight that up to TWO THIRDS OF WOMEN suffer this embarrassing and life-changing condition and may take up to 10 years before seeking help from their GP. The main reasons for this, according to NICE, are that women are too embarrassed to discuss the problem with their GP or believe there is no effective treatment. That this situation should exist in the 21st Century is scandalous but it also masks a history of poor management, wasted resources and indifference. The stark reality is that there is a simple, effective clinically proven treatment that can cure 85% of women in just a couple of weeks but women have been denied access to this treatment by an obsession with surgery and a lack of scientific rigour in the development of treatments over many years. Millions of women are unaware of the causes and effects of stress incontinence and that simple lifestyle management approaches are available. The problem starts at childbirth and new mothers are not being given accurate, relevant post-natal advice. Their high levels of ignorance are preventing them from seeking the information, help and treatment they need to avoid the many problems that arise from childbirth including stress incontinence, prolapse and poor sex. And millions of women are suffering unnecessarily. The Kegel Legacy explores why there is such a high level of ignorance about a condition that affects the majority of women, and sets out educate and inform, and to remove the taboo that still surrounds the subject. The author, Barry Fowler, questions why the medical profession have ignored the Gold Standard treatment in favour of an ineffective course of treatment that is clearly unfit for purpose. He suggests that the overwhelming evidence for his argument is that there are 7 million women in the UK unnecessarily suffering with stress incontinence, millions suffering prolapse and a multi-billion industry supplying designer incontinence pads. Clinical estimates indicate that every week 5000 new mothers will develop stress incontinence which he argues is totally unacceptable. The new NICE Clinical Guidelines (CG171) for the Treatment of Urinary Incontinence in Women, published on 11 September 2013, estimate that as many as two thirds of women aged 15–64 years suffer stress incontinence but as few as 0.2% may be ‘known’ to the health and social service agencies The level of ignorance and embarrassment is so great that NICE believes that women may take up to 10 years before seeking help despite the serious social and health implications for the women who suffer in silence: “In adult women with UI, 60% avoid going away from home, 50% feel odd or different from others, 45% avoid public transport and 50% report avoiding sexual activity through fear of incontinence. Serious psychiatric morbidity has been reported in one-quarter of women attending hospital for investigation of UI.” Source: NICE The NICE Guidelines make it clear that the cost to the NHS is significant: “this would approximate to gbp1.8bn annually in England and Wales, or perhaps gbp600 per incontinent individual.” However, if all the women who are suffering presented for treatment then the potential cost is even more significant. Given that the Guidelines suggest that current NHS involvement is barely scratching the surface of the problem - a figure of gbp4.2bn is probably nearer the mark. That there is a cheap, effective solution is totally ignored! A major part of the problem is that women’s perceptions of the condition and the treatment are influenced by the help, advice, treatment and outcomes that they, their friends and the people they know receive. NICE Guidelines for first line treatment recommend that women are taught pelvic floor exercises in a supervised environment by a specialist physiotherapist (8 – 10 muscle clenches two or three times a day for three months). Experts acknowledge that compliance with these exercises is low. Women know why – they just do not work! The problem is that the exercises recommended by the NHS and the media bear absolutely no comparison to the rigour of the exercises recommended by Arnold Kegel whose large scale clinical trial set the Gold Standard and demonstrated objective cure of 85% of patients in 2 weeks. But such is the dogma surrounding this condition that the vast majority of women presenting with problems will be dismissed with a leaflet urging them to do 8 clenches three times a day – a treatment that has no clinical trials and no evidence of efficacy. Only a very small number may eventually receive the NICE recommended treatment with a physiotherapist supervising them doing 8 clenches three times a day for three months – and in parts of the country women are waiting 2 years for an appointment to receive this valuable assistance! Recently published studies have even gone so far as to recommend that surgery should replace pelvic floor exercises as the first line of treatment basing the comparison of long term surgical outcomes on the performance of the NICE recommended exercise programme. Given the scale of the problem, one can only hope that, before embarking on a hugely expensive change, someone has the common sense to compare surgery with the proven Gold Standard exercises that actually work. The Kegel Legacy (ebook gbp1.99, paperback gbp6.99) sets out the history of this debacle and guides women towards simple, effective self-help solutions. The Kegel Legacy calls for a fundamental review of post-natal rehabilitation and care, the better use of lifestyle management approaches as alternatives to pharmaceutical and surgical intervention, and a change to the practices that are failing millions of women who then suffer a lifetime of discomfort, frustration and embarrassment. If you are a bona fide journalist or writer you can download a free pdf copy of The Kegel Legacy for review purposes by visiting www.thekegellegacy.com Source: sourcewire