IDENTIFICATION OF PATIENTS REQUIRING OUTPATIENT FOLLOW-UP AFTER TRANSURETHRAL PROSTATECTOMY - IS THERE A ROLE FOR NURSE-LED SCREENING OF POSTOPERATIVE OUTCOMES BY TELEPHONE

Objective To determine the most efficient method to follow patients af ter transurethral prostatectomy (TURF) such that only those patients s uffering significant post-operative problems are reviewed. Patients an d methods The study comprised two parts: (1) a retrospective review of the case notes of 100 consecutive patients who underwent TURF under o ne consultant to determine whether any factors could be identified pre - or post-operatively by which those patients most likely to require c linic review could be selected and; (2) a prospective review of the su cceeding 100 patients undergoing TURF, using a telephone 'screening' c all 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 ou t-patient department. Results In the first part, 17 patients (17%) req uired an out-patient review for malignancy. Only nine patients (11%) w ith benign histology required further treatment after TURP; this subgr oup could not be identified on the basis of their pre- or post-operati ve symptoms. In the second part, 23 patients were not reviewed by tele phone; 14 had carcinoma of the prostate, eight had no telephone and on e could not be contacted after seven attempts. Of the remaining 77 con tacted 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. Concl usions Based on pre- or post-operative symptoms at the time of dischar ge, there is no reliable method of identifying those patients who have a poor result after TURF. Telephone screening of patients at 3 months identified successfully those patients who required an out-patient re view and enabled resources to be targeted towards this difficult group of patients.