Top

International Urogynecology Journal

Published in:

01-03-2014 | Original Article

Is there a need for postoperative follow-up after routine urogynaecological procedures? Patients will self-present if they have problems

Authors: A. G. Bateman, H. Neilens, C. A. Gericke, J. George, R. M. Freeman

Published in: International Urogynecology Journal | Issue 3/2014

Abstract

Introduction and hypothesis

The value of outpatient appointments for postoperative review has been questioned for many years, and the surgeon practice around this issue is varied. The aim of this study, as part of a larger study assessing postoperative follow-up, was to assess how many patients self-present to their general practitioner (GP) or the emergency department after surgery for urogynaecology procedures.

Methods

A retrospective observational study of postoperative urogynaecology patients between 2007 and 2012 was performed using the British Society of Urogynaecology (BSUG) database to identify patients. These records were correlated with hospital and GP records to assess whether any patient was seen postoperatively for a procedure-related problem.

Results

There were 244 patients with complete data on the BSUG database, of whom 25 (10 %) presented to hospital/secondary care in the year following their surgery; only three of these were admitted for problems related to their surgery. There was a response rate of 70 % from GPs for access to their records. This represented 171 patients, 90 of whom (52.3 %) presented to their GP within a year of surgery mostly for a minor procedure-related event: 11 of these were re-referred to secondary care, and the remainder were treated in the community.

Conclusions

The most important aspect of patient care is safety, and this should not be compromised if, for example, postoperative review were to be moved to primary care. As expected, this study shows that patients will self-present if they have problems postoperatively.

NICE (2006) Urinary incontinence ‘The management of urinary incontinence in women’, p. 1–36

Florey CV et al (1994) A randomized trial of immediate discharge of surgical patients to general practice. J Public Health Med 16(4):455–464PubMed

Worrall SF (1996) Are postoperative review appointments necessary following uncomplicated minor oral surgery? Br J Oral Maxillofac Surg 34(6):495–499PubMedCrossRef

Waghorn A, Thompson J, McKee M (1995) Routine surgical follow up: do surgeons agree? BMJ 311(7016):1344–1345PubMedCentralPubMedCrossRef

Faulkner A et al (1995) Outpatients revisited: subjective views and clinical decisions in the management of general surgical outpatients in south west England. J Epidemiol Community Health 49(6):599–605PubMedCentralPubMedCrossRef

Haylen BT et al (2011) An International Urogynecological Association (IUGA)/International Continence Society (ICS) joint terminology and classification of the complications related directly to the insertion of prostheses (meshes, implants, tapes) & grafts in female pelvic floor surgery. Int Urogynecol J 22(1):3–15PubMedCrossRef

Bailey IS et al (1992) Community surveillance of complications after hernia surgery. BMJ 304(6825):469–471PubMedCentralPubMedCrossRef

Bailey J, Roland M, Roberts C (1999) Is follow up by specialists routinely needed after elective surgery? A controlled trial. J Epidemiol Community Health 53(2):118–124PubMedCentralPubMedCrossRef

Williams HR et al (1998) Out-patient follow-up after routine surgery: a questionnaire study. J R Coll Surg Edinb 43(4):251–253PubMed

10.

O’Brien TS, Perkins JM, Cranston D (1995) Efficiency in the outpatient department: the lessons from urology. Ann R Coll Surg Engl 77(4):287–289PubMedCentralPubMed

11.

Ulmsten U, Johnson P, Rezapour M (1999) A three-year follow up of tension free vaginal tape for surgical treatment of female stress urinary incontinence. Br J Obstet Gynaecol 106(4):345–350PubMedCrossRef

12.

Ward K et al (2002) Prospective multicentre randomised trial of tension-free vaginal tape and colposuspension as primary treatment for stress incontinence. BMJ 325(7355):67PubMedCentralPubMedCrossRef

13.

International Urogynaecological Association (2011) Anterior vaginal repair (Bladder Repair). A guide for women. In: International urogynaecological association, IUGA. (Ed.) p. 1–3

14.

Price N et al (2006) Development and psychometric evaluation of the ICIQ Vaginal Symptoms Questionnaire: the ICIQ-VS. BJOG 113(6):700–712PubMedCrossRef

15.

Avery K et al (2004) ICIQ: a brief and robust measure for evaluating the symptoms and impact of urinary incontinence. Neurourol Urodyn 23(4):322–330PubMedCrossRef

16.

Trochez R, Harber P, Holmes D (2012) Is postal postoperative follow-up in urogynaecology feasible? J Obstet Gynaecol 32(7):663–665PubMedCrossRef

17.

Bateman AG, Neilens H, Freeman RM (2013) Is telephone consultation an acceptable method of following up patients after Urogynaecology surgery? A pilot randomised controlled trial. Int Urogynaecol J 24(1):1–152CrossRef

Title: Is there a need for postoperative follow-up after routine urogynaecological procedures? Patients will self-present if they have problems
Authors: A. G. Bateman
H. Neilens
C. A. Gericke
J. George
R. M. Freeman
Publication date: 01-03-2014
Publisher: Springer London
Published in: International Urogynecology Journal / Issue 3/2014
Print ISSN: 0937-3462
Electronic ISSN: 1433-3023
DOI: https://doi.org/10.1007/s00192-013-2229-1

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Is there a need for postoperative follow-up after routine urogynaecological procedures? Patients will self-present if they have problems

Abstract

Introduction and hypothesis

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Introduction and hypothesis

Methods

Results

Conclusions

Please log in to get access to this content

Other articles of this Issue 3/2014

Overflow urinary incontinence due to bladder stones

A randomised controlled trial of abdominal versus laparoscopic sacrocolpopexy for the treatment of post-hysterectomy vaginal vault prolapse: LAS study. Comment

Urethrovaginal fistulae associated with tension-free vaginal tape procedures: a clinical challenge

Climbing a long hill: pelvic floor surgery and the need for geriatric urogynecology

Long-term efficacy of electrical pudendal nerve stimulation for urgency–frequency syndrome in women

An insight into pelvic floor status in nulliparous women