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Identification of patients requiring out‐patient follow‐up after transurethral prostatectomy: is there a role for nurse‐led screening of post‐operative outcomes by telephone?
Author(s) -
Brough R. J.,
Pidd H.,
O'Flynn K. J.,
Payne S. R.
Publication year - 1996
Publication title -
british journal of urology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.773
H-Index - 148
eISSN - 1464-410X
pISSN - 0007-1331
DOI - 10.1046/j.1464-410x.1996.00087.x
Subject(s) - medicine , malignancy , prostatectomy , prospective cohort study , surgery , prostate cancer , cancer
Objective To determine the most efficient method to follow patients after transurethral prostatectomy (TURP) such that only those patients suffering significant post‐operative problems are reviewed. Patients and methods The study comprised two parts: (1) a retrospective review of the case notes of 100 consecutive patients who underwent TURP under one consultant to determine whether any factors could be identified pre‐ or post‐operatively by which those patients most likely to require clinic review could be selected and; (2) a prospective review of the succeeding 100 patients undergoing TURP, using a telephone ‘screening’ call made by the urological research nurse 3 months after the operation. Patients who requested follow‐up and those patients with malignancy or admitted in high‐pressure chronic retention were reviewed in the out‐patient department. Results In the first part, 17 patients (17%) required an out‐patient review for malignancy. Only nine patients (11%) with benign histology required further treatment after TURP; this subgroup could not be identified on the basis of their pre‐ or post‐operative symptoms. In the second part, 23 patients were not reviewed by telephone; 14 had carcinoma of the prostate, eight had no telephone and one could not be contacted after seven attempts. Of the remaining 77 contacted by ‘phone, 61 (79%) declined further clinic review and 16 (21%) requested follow‐up for persistent problems. A mean of two calls was made per patient and the mean duration of each call was 6.3 min. Conclusions Based on pre‐ or post‐operative symptoms at the time of discharge, there is no reliable method of identifying those patients who have a poor result after TURP. Telephone screening of patients at 3 months identified successfully those patients who required an out‐patient review and enabled resources to be targeted towards this difficult group of patients.