Prometheus News


The NHS will offer free pelvic-floor trainers to treat incontinence

Dec 9, 2019 by Hamza Sheraz.

After the vaginal-mesh scandal, can the Elvie trainer help to revolutionise women’s health?

A new device designed to improve women’s pelvic-floor strength is to be made available on the NHS. The trainer, from femtech company Elvie, will be prescribed to those suffering with stress urinary incontinence (SUI). The trainer itself is a small egg-shaped gadget, programmed with biofeedback technology that detects pelvic-floor muscle movements. Once inserted, the device connects to an app via bluetooth, which guides users through a number of exercises designed to tighten the pelvic floor and treat SUI. According to research on the trainer, 80% of Elvie customers who used the device as treatment found it to be successful, and 98% of those did so in under six weeks of use. A 2010 study found that the biofeedback tech within the device can help improve results by 10%, and help reduce the amount of women referred for surgery by 50%. This is good news for the NHS and for women, as many patients with SUI were victims of the vaginal-mesh scandal. Now suspended from surgeries in England, vaginal-mesh implants are a dangerous treatment for SUI, as well as hernias and pelvic-organ prolapses – one woman, 42-year-old Chrissy Brajcic, died from complications of the surgery, while thousands of other women experienced severe and often debilitating agony following implant operations. In all, vaginal-mesh tape has changed many women’s lives for the worse since it was adopted by the NHS in the 1990s.
The Elvie trainer
SUI and other incontinence issues are physical conditions, which do need practical, medical treatments. But it also affects the mental health and confidence of a sufferer, as detailed by writer Luce Brett in a Pool long read earlier this year. “Research shows strong links between leaking and clinical depression and, mentally, I was definitely struggling. A stigmatising two-for-one leaving incontinent people even more marginalised, silenced, ridiculed and ignored,” she wrote. “It's as if our shameful conditions, which lay bare everyone's fragile ideals of humanity, are contagious. In some countries, incontinent women are still ostracised from their communities. In the UK, we write about a serious health issue as if it is nothing more than farting in yoga.” SUI affects one in three women in the UK, creating a cost of £233m to the NHS every year. It is thought that this partnership with Elvie and the offer of the pelvic-floor training device will save £424 per patient, despite the retail price of the trainer standing at £169. None of these costs will be passed on to the patients and, according to reports, the Elvie trainer will be provided for free. So, is the availability of the Elvie trainer on the NHS the golden answer women have been waiting for? Is our health finally being taken seriously? Hannah Rose Thomson, head of strategic partnerships and health at Elvie, thinks so."This is the main single-tolerant biofeedback for long haul use to be accessible to NHS patients, which will empower improved consistence between emergency clinic visits and from there on," she told wellbeing news site  Digital Health Age. "Particularly considering late occasions, we're excited that the NHS is putting resources into devices to help traditionalist administration of stress urinary incontinence and mellow moderate prolapse."
According to research on the trainer, 80% of Elvie customers who used the device as treatment found it to be successful, and 98% of those did so in under six weeks of use
But while patients will benefit from the trainer, so will Elvie. As concerns grow around the number of private companies tied up within the public-health service (earlier this week, it was revealed that Richard Branson’s Virgin owns £2bn worth of NHS contracts), how will the outsourcing of women’s health issues affect ever-increasing NHS costs? Furthermore, who will be responsible for any mistreatment or complications in connection to the device? Elvie’s CEO and co-founder, Tania Boler, thinks the partnership is “game changing” for her company, and that legitimation by the NHS gives their (rather expensive) products “more credibility”. “We focus on younger women in the post-natal phase whereas this offers you access to a much larger population – often the women presenting to the NHS are older,” Boler told City AM. It’s this legitimation that feels somewhat uncomfortable. Incontinence is a very personal, and often embarrassing, condition, and one that some women will be wary of seeking help for. If we can access the same help provided by the NHS without the stress or potentially shameful visit to the doctor, why wouldn’t we splurge nearly £200 on a pelvic-floor trainer? Suddenly, a divide between those who can and those who can’t afford to help themselves is created, and, again, women’s health is at risk of becoming a privilege. There are alternative, similar programmes available for a much cheaper price – one of which is Squeezy, an NHS app costing just £2.99. It can be prescribed by a doctor or downloaded by anyone, and offers a series of programmes designed to remind and aid women to do their pelvic-floor exercises. Squeezy is more of a preventative method, and aimed at all women – a much-needed and helpful system, but one that doesn’t get much recognition, thanks to relatively smaller budgets. Regular exercise, losing weight, giving up smoking and cutting down on caffeine are all things women can do to reduce their risk of incontinence, too. The Elvie trainer may revolutionise incontinence treatment for women across the UK, though some key details are missing. It has not been confirmed how many trainers will be available, nor who will be eligible to receive one. There is little information as to whether the device can help with severe cases of SUI, or if it is a suitable replacement for some of the surgical treatments. There is so far to go with taking incontinence seriously, and treating it accordingly – the Elvie trainer probably won’t solve that alone, but perhaps it’s a start.