Continence care in Romania is progressing step by step along an upward pathway towards attaining basic western standards.
After spending one year at Maastricht University Hospital in the Netherlands training in the field of continence care at the Department of Neurourology led by Professor Philip van Kerrebroeck, I returned to my own country full of new ideas. I joined forces with a fellow urologist trained in continence care, Nicolae Calomfirescu, chief of the Urology Department at Gerota Hospital in Bucharest, who had done a fellowship in Lyon, France, under Professor Leriche. This step was to lead to a most fruitful collaboration. Together we drew up a bold plan to improve continence care in Romania. We carried out a prevalence study for incontinence in active women in Romania and our results indicated that 10% suffered from some form of incontinence, varying from 1 drop a week to a large amount daily. Irrespective of the volume of urine leaked, all the women found their condition devastating.
Until now, our efforts have been concentrated on providing up-to-date medical information to both the medical community and the patients. We contacted organisations of family doctors in Romania and have given regular lectures on female incontinence, neurogenic bladder and overactive bladder (OAB). In addition, we presented our observational studies on urodynamics, neurogenic bladder care, and painful bladder syndrome/interstitial cystitis (PBS/IC) treatments at local urology and gynaecology congresses.
In 2008, we set up a website www.cistita.ro with basic information for Romanian patients on urinary incontinence, neurogenic bladder and painful bladder syndrome/ interstitial cystitis. After just one year, the website is attracting 1600 visitors a month and this encourages us to start media promotion of the site.
We receive a great deal of feedback from patients with OAB, PBS/IC and stress incontinence, but only a small number from the patients with multiple sclerosis (MS) and spinal cord in jury (SCI) who frequently have no access to the internet. We are therefore endeavouring to reach these patients through their patient organisations. Unfortunately, patient organisations are few and far between in Romania and when they do exist are inadequately organised with insignificant influence on government policies.
One exception is the MS patient organisation which – assisted by European know-how - improved its network, its fundraising, established daycare centres, set up a website and a newsletter. We started our collaboration with the Romanian MS Society in 2007, giving lectures at their annual meetings and providing answers to their questions on their website.
Last year we participated in a first meeting of patients and health professionals willing to set up a patient organisation for incontinent people, with help from the Italian organisation “Finco”. The process of officially registering and promoting this foundation is currently underway. Similarly, we are also helping some PBS/IC patients to set up their own network and website.
Plans for 2010 include organisation of a media campaign for the International Continence Week. This could form the start for our second objective which is to provide information and promote conservative treatments for urinary incontinence. Conservative treatments for urinary incontinence are a forgotten Cinderella in the range of treatments used in my country.
2010 should be a rewarding one for us, as ICS has accepted to come to Romania to hold an ICS educational course. It is planned as an add-on course to the Romanian Urogynaecology Society meeting and is scheduled for 7-8 May, 2010. This ICS course will hopefully be the first step in promoting up-to-date standards for continence care, including a conservative approach, and in introducing the role of the continence nurse to Romania.