Authors (including presenting author) :
Wong TKD, Mak CY, Leung WCW, Cheng KC, Chan YL, Hung SY, Cheung PH, Cheung YHK, Li HLF, Leung WMW, Wong MYM, Wong MSM
Affiliation :
Shau Kei Wan Family Medicine Specialist Triage Clinic, HKEC
Introduction :
In the public healthcare system, majority of patients with lower urinary tract symptoms (LUTS) are managed in the primary care setting. Despite the availability of different alpha-blockers for the treatment of Benign Prostatic Hypertrophy in the primary care setting, it is common to encounter patients who are not satisfied with the symptoms control. Before the service enhancement, these patients would be referred to the Urologists for further investigations and management.
Objectives :
In view of the long waiting time of SOPD Urology service, service enhancement at SKW FMSC Triage Clinic was commenced on 29 May 2024 and provide service to patients with LUTS in order to reduce the referral to SOPD and provide the necessary urology service in FMSC Triage Clinic.
Methodology :
Patients with LUTS having suboptimal symptoms control while on medical treatment are referred to SKW FMSC Triage Clinic. After doctor consultation, selected patients will be arranged Uroflowmetry and bladder scan performed by trained staff. These objective measurements, together with the International Prostate Symptom Score (IPSS), help doctors identify patients who need early referral to the Urologists.
Result & Outcome :
From 29 May to 31 Dec 2024, 48 male patients aged 50 or older attended the designated clinic sessions. Trained staff performed Uroflowmetry, post-void residual volume measurement using bladder scan, and IPSS assessment according to the structured workflow. Two out of 48 patients had post-void residual urine of more than 200ml while a total of 17 (35%) patients had a maximum urine flow rate of less than 10ml/sec. Regarding the IPSS, 18 (38%) patients had severe LUTS while 31 (65%) were not satisfied with the symptoms control. Eventually, ten (21%) out of 48 patients were referred to the Urologists for further management.
The waiting time to SOPD Urology service is usually around 1-2 years. But the waiting time to SKW FMSC Triage clinic is less than 6 months. FMSC service enhancement engage nurses in the assessment of patients with LUTS, thereby assisting doctors to decide the onward management. Furthermore, it provides the fast-track management to patients with LUTS in primary health care setting.
