Variation in urological practice amongst spinal injuries units in the UK and Eire
John Bycroft1, Rizwan Hamid, Helen Bywater
1Department of Neuro-Urology, Spinal Injuries Unit, Stanmore, Middlesex, United Kingdom. j.bycroft@ucl.ac.uk
Aims:
To investigate variations in common urological practice between the Spinal Injuries Units (SIU) of UK and Eire.
Methods:
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.
Results:
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.
Conclusions:
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.
