Bycroft John, Hamid Rizwan, Bywater Helen, Patki Prasad, Craggs Michael, Shah Julian
Department of Neuro-Urology, Spinal Injuries Unit, Stanmore, Middlesex, United Kingdom.
Neurourol Urodyn. 2004;23(3):252-6; discussion 257. doi: 10.1002/nau.20005.
To investigate variations in common urological practice between the Spinal Injuries Units (SIU) of UK and Eire.
In December 2002, each of the 12 SIU in the UK and Eire were sent a questionnaire addressing basic practice relating to urological outpatient follow-up, management of urinary tract infection, upper tract surveillance, and urodynamic studies.
Regarding frequency of urological review, two units only saw patients when specifically required. One unit reviewed patients every 6 months and six centres reviewed patients annually. The remaining three units had a patient-specific follow-up protocol. Regarding urinary tract infection, only five units had a unified departmental management protocol. Four units advocated antibiotic prophylaxis for recurrent UTI. Only one unit would routinely treat asymptomatic UTI in individuals using catheters. The range of recommended duration of treatment for symptomatic UTI was 3-14 days (mean 6.3). All units performed routine upper tract screening, ranging from annually to every 3 years. Six units did not perform routine urodynamic studies; in other units the range of frequency of urodynamics was from annually to every 3 years.
The variation in urological practice amongst SIU in the UK and Eire is considerable. This finding supports the need for an increase in the level of collaboration and research.
调查英国和爱尔兰脊髓损伤治疗单位(SIU)常见泌尿外科诊疗方法的差异。
2002年12月,向英国和爱尔兰的12个脊髓损伤治疗单位各发送了一份问卷,内容涉及泌尿外科门诊随访、尿路感染管理、上尿路监测和尿动力学研究等基本诊疗方法。
关于泌尿外科复诊频率,只有两个单位在有特殊需求时才诊治患者。一个单位每6个月复诊患者一次,六个中心每年复诊患者一次。其余三个单位有针对患者的随访方案。关于尿路感染,只有五个单位有统一的科室管理方案。四个单位主张对复发性尿路感染进行抗生素预防。只有一个单位会常规治疗使用导尿管患者的无症状尿路感染。有症状尿路感染的推荐治疗时长为3 - 14天(平均6.3天)。所有单位都进行常规上尿路筛查,筛查间隔从每年一次到每三年一次不等。六个单位不进行常规尿动力学研究;在其他单位,尿动力学检查的频率范围是从每年一次到每三年一次。
英国和爱尔兰脊髓损伤治疗单位之间泌尿外科诊疗方法的差异相当大。这一发现支持了加强合作与研究水平的必要性。