The feasibility and cost of a large multicentre audit of process and outcome of prostatectomy.

Emberton, Mark; Neal, David E.; Black, Nicholas; Harrison, Michael; Fordham, M.V.P.; McBrien, M. P.; Williams, Richard; McPherson, Klim; Develin, H B

doi:10.1136/qshc.4.4.256

Cited by 8 publications

(4 citation statements)

References 13 publications

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“…First, were the men who participated in the field testing representative? Fortunately, the findings of the National Prostatectomy Audit (NPA) are available, a study of over 4000 men recruited from more than 100 hospitals in the UK [ 34]. The participants in the present study were similar to all men undergoing treatment for BPH in the NPA in age, living alone, social class, ethnicity and postoperative symptom severity.…”

Section: Discussionmentioning

confidence: 93%

Development and validation of an audit instrument: the Prostate Outcomes Questionnaire

Lamping

Rowe

Black

et al. 1998

British Journal of Urology

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Objective To develop a short, patient‐based questionnaire for auditing the outcomes of treatment for benign prostatic hyperplasia (BPH) and to evaluate the acceptability, reliability and validity of the measure. Patients and methods Data from a long research questionnaire used in the Oxford/North West Thames Prostatectomy Study were analysed to identify the subset of items which contained the most scientifically sound indicators of outcome. Items were selected on the basis of standard psychometric analyses to develop a short questionnaire, the Prostate Outcomes Questionnaire (POQ), a 27‐item instrument covering urinary symptoms, complications after surgery, quality of life and patient satisfaction with outcome. The POQ was field tested for acceptability, reliability and validity in a postal survey of 125 men undergoing transurethral resection of the prostate for BPH from seven hospitals in south‐east England. Results The POQ was highly acceptable to patients, as indicated by a 95% response rate, the absence of ‘floor’ and ‘ceiling’ effects and a low proportion of missing data. It showed excellent internal consistency reliability (Cronbach’s α of 0.82–0.93 for the five summary scales and a mean item‐total correlation of 0.56) and test‐retest reliability (test‐retest correlations for items were 0.40–1.00, with a mean test‐retest correlation of 0.85, and for summary scales of 0.91–0.95). Construct validity was confirmed by: high intercorrelations between the five summary scales and the total score (0.88–0.95), with a pattern of intercorrelations among specific subscales that showed item‐convergent and discriminant validity; higher scores for patients who reported an improvement after surgery than in those who were not improved (P<0.001); the expected gradient of scores for patients reporting different levels of symptom distress (P<0.001); high correlations with the longer parent questionnaire (0.75–0.88); and low to moderate correlations with the Nottingham Health Profile and Activities of Daily Living scores (0.15–0.67), with the pattern of correlations providing evidence of scale convergent and discriminant validity. Correlations with age and social class were low, suggesting that responses were not biased by sociodemographic factors. Conclusion The POQ is a practical and scientifically sound patient‐based measure of outcome after treatment for BPH which can be used for routine audit. It takes <5 min to complete, is feasible for routine monitoring of large numbers of patients by postal survey, and is accompanied by a Users’ Manual which provides practical help in conducting a local patient survey, and a computer program for scoring data. Most importantly, the POQ has been shown scientifically to perform well, having met standard psychometric criteria for reliability and validity.

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Section: Discussionmentioning

confidence: 93%

Development and validation of an audit instrument: the Prostate Outcomes Questionnaire

Lamping

Rowe

Black

et al. 1998

British Journal of Urology

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“…[ 1 2 3 4 ] Operative complications of TURP such as bleeding needs transfusion, sepsis and transurethral resection (TUR) syndrome were reported. [ 5 ] The absorption of irrigating fluid during and after TURP surgery causes TUR syndrome. The ideal irrigant fluid for TURP would be translucent, iso osmolar and nonconductor to the electric current.…”

Section: Introductionmentioning

confidence: 99%

Efficacy of bipolar "button" plasma vaporization of the prostate for benign prostatic obstruction, compared to the standard technique

Aboutaleb

2015

Urol Ann

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Objective:The objective of the following study is to evaluate the efficiency of transurethral plasma vaporization of the prostate in saline bipolar plasma vaporization of the prostate (BPVP) using the button electrode and comparing it to the standard transurethral resection of the prostate (TURP).Patients and Methods:During the period of the year between 2007 and 2013, 152 patients with benign prostatic hyperplasia were rolled in our study. Fifty-two patients were underwent BPVP and 100 TURP. All patients were evaluated preoperatively, 24 h and at 3 months postoperatively. International Prostate Symptom Score (I-PSS), quality-of-life (QOL) score, Qmax and Qave and post void residual (PVR) urine. Operative time, hospital stay, catheterization time, and complications were reported. Mean serum Hb, hematocrit and serum sodium changes were reported preoperatively and within 24 h postoperatively in both groups. Statistical analysis is performed using SPSS program version 20 for windows.Results:Mean age at surgery was 60.8 ± 8 (range 63- 92) and 66 ± 8.6 (range 50-83) for BPVP and TURP groups, respectively. Mean prostatic volume was 46 ± 11 (range 30-92) and 43 ± 8 (range 30-80) in both groups, respectively. Patients from both series had similar preoperative characteristics. The mean operative duration 53 ± 21 1 ± 2.1 (range 1-7) versus 3 ± 3.3 (range 3-8) days (P value 0.0001) were significantly (range 20-80) versus 62 ± 16 min (range 30-126) (P value 0.004), catheterization period 2 ± 0.28 ( range 2-4) versus 3 ± 3.2 (range 2-7) days (P value 0.03).Conclusions:BPVP has superior efficacy in short-term results and less complication rates compared with classic TURP.

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“…Complete data were received in ~80% of men undergoing BOO surgery over the study period at a cost of £44.00 per patient over the study period; around 5300 men were recruited. In the present study we have demonstrated the feasibility of an alternative snapshot methodology, which enabled greater coverage than the NPA with equivalent outcome returns of 80% at a fraction of the cost [19]. In the future although likely that regular audit will be performed using routinely collected data, we have shown there will still be a need to measure preoperative evaluation standards and patient satisfaction outcomes, which will not be evidenced in such data.…”

Section: Discussionmentioning

confidence: 83%

UK national bladder outlet obstruction surgery snapshot audit

et al. 2021

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To determine the preoperative assessment and perioperative outcomes of men undergoing bladder outlet obstruction (BOO) surgery in the UK. Patients and MethodsA retrospective cohort study was conducted of all men undergoing BOO surgery in 105 UK hospitals over a 1-month period. The study included 1456 men, of whom 42% were catheter dependent prior to undergoing surgery. ResultsThere was no evidence that a frequency-volume chart or urinary symptom questionnaire had been completed in 73% or 50% of men, respectively in the non-catheter-dependent group. Bipolar transurethral resection of the prostate (TURP) was the most common BOO surgical procedure performed (38%). Monopolar TURP was the next most prevalent modality (23%); however, minimally invasive BOO surgical procedures combined accounted for 17% of all procedures performed. Of the cohort 5% of men had complications within 30 days of surgery, only 1% had Clavien-Dindo Grade ≥III complications. Less than 1% of the cohort received a blood transfusion after BOO surgery and 2% were re-admitted to hospital after their BOO surgery. In total only 4% of the whole cohort were catheter dependent after BOO surgery. Pre-and postoperative paired International Prostate Symptom Score scores reviewed suggest that minimally invasive surgical procedures achieved comparable levels of improvement in both symptoms and bother at 3 months postoperatively in men who were not catheter dependent preoperatively. ConclusionsThere has been a substantial shift in the available choice of procedure for BOO surgery around the UK in recent years. However, men can be reassured that overall BOO surgery treatments are safe and effective. Evidence of adherence to guidelines in the preoperative assessment of men with lower urinary tract symptoms undergoing surgery was poorly documented and must be improved.

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The feasibility and cost of a large multicentre audit of process and outcome of prostatectomy.

Cited by 8 publications

References 13 publications

Development and validation of an audit instrument: the Prostate Outcomes Questionnaire

Development and validation of an audit instrument: the Prostate Outcomes Questionnaire

Efficacy of bipolar "button" plasma vaporization of the prostate for benign prostatic obstruction, compared to the standard technique

UK national bladder outlet obstruction surgery snapshot audit

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