Helen Jefferis1, Francis Muriithi2, Beverly White2, Natalia Price2, Simon Jackson2. 1. Department of Gynaecology, The Women's Centre, John Radcliffe Hospital, Oxford University Hospitals NHS Trust, Headley Way, Oxford, OX3 9DU, UK. helenjefferis@doctors.org.uk. 2. Department of Gynaecology, The Women's Centre, John Radcliffe Hospital, Oxford University Hospitals NHS Trust, Headley Way, Oxford, OX3 9DU, UK.
Abstract
INTRODUCTION AND HYPOTHESIS: Post-operative review allows assessment of individual patient outcome, evaluation of any ongoing symptoms and an audit of departmental surgical outcome and therefore represents best clinical practice. Current TVT surgery follow-up practice varies widely, with most centres routinely seeing patients face to face in an outpatient setting. However, unnecessary outpatient attendance can be inefficient and inconvenient for patients and staff. One proposed alternative is telemedical follow-up, as introduced by our unit in 2010. We report on 5 years of experience with telephone follow-up. METHODS: The British Society of Urogynaecology (BSUG) database was searched for all cases of primary retropubic TVT slings performed by the unit in the period 1 January 2010 to 31 December 2014. Cases identified from the BSUG database then had their case notes reviewed. Patients having additional surgery were excluded from analysis. This yielded a cohort of 356 patients. No ethical approval was required for this investigation as it was a simple observational study (clinical audit). RESULTS: Two hundred and sixty-two patients were initially followed up via telephone; the remaining 94 were seen in a conventional outpatient clinic setting. Of the 262 followed up by telephone, 28 patients (10 %) subsequently required review in an outpatient clinic for a variety of reasons. CONCLUSIONS: Telephone follow-up is an appropriate mode of follow-up for uncomplicated primary incontinence surgery. By using telemedicine, 234 patients who would previously have been seen in clinic were followed up remotely, saving valuable clinic time for patients with greater clinical need.
INTRODUCTION AND HYPOTHESIS: Post-operative review allows assessment of individual patient outcome, evaluation of any ongoing symptoms and an audit of departmental surgical outcome and therefore represents best clinical practice. Current TVT surgery follow-up practice varies widely, with most centres routinely seeing patients face to face in an outpatient setting. However, unnecessary outpatient attendance can be inefficient and inconvenient for patients and staff. One proposed alternative is telemedical follow-up, as introduced by our unit in 2010. We report on 5 years of experience with telephone follow-up. METHODS: The British Society of Urogynaecology (BSUG) database was searched for all cases of primary retropubic TVT slings performed by the unit in the period 1 January 2010 to 31 December 2014. Cases identified from the BSUG database then had their case notes reviewed. Patients having additional surgery were excluded from analysis. This yielded a cohort of 356 patients. No ethical approval was required for this investigation as it was a simple observational study (clinical audit). RESULTS: Two hundred and sixty-two patients were initially followed up via telephone; the remaining 94 were seen in a conventional outpatient clinic setting. Of the 262 followed up by telephone, 28 patients (10 %) subsequently required review in an outpatient clinic for a variety of reasons. CONCLUSIONS: Telephone follow-up is an appropriate mode of follow-up for uncomplicated primary incontinence surgery. By using telemedicine, 234 patients who would previously have been seen in clinic were followed up remotely, saving valuable clinic time for patients with greater clinical need.
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