Ureteric stents: How well do you know your stent?

1. No. 059A Ureteric stents: How well do you know your stent? Bishoy Soliman, ShekibShahbaz, Andrew Brooks, Howard Lau, Simon Bariol, Audrey Wang, Manish Patel Department of Urology, Westmead Hospital, Sydney, NSW, Australia. Posters Proudly Supported by: Results Introduction The forgotten ureteric stent is a worldwide problem due to inadequate patient education, poor patient compliance and loss to follow up. Apart from stent irritation there could be significant morbidity, mortality and medico-legal implications associated with retained stents. Numerous strategies have been utilised to safeguard against the forgotten stent, however no one strategy has been shown to be effective. 80 patients Arm 1: 40 patients Arm 2: 40 patients • Aim • To evaluate whether the ‘formalised’ inclusion of a patient information sheet as part of the informed consent process can: • Improve a patients understanding of their ureteric stent • Reduce the number of unexpected phone calls and emergency presentations with common post insertion symptoms. • Potentially limit the number of patients with forgotten ureteric stents. 26 males (65%) 14 female (35%) Ave Age: 47 years 83% Spoke / Read English as first language 24 males (60%) 16 female (40%) Ave Age: 52 years 87% Spoke / Read English as first language. • 65% reduction in post stent insertion presentations was demonstrated with the utilisation of an information sheet. • During the telephone interview: • 90% of patients in arm 2 knew the reason for their stent insertion. • 92% of patients in arm 2 could retain the common post insertion symptoms. • 96% of patients in arm 2 knew that they had to have their stent remove within 3 months of insertion or have an appointment with the urology department. • These references were all statistically significant when compared to arm • Methods • A prospective two-arm study was conducted at Westmead Hospital between July and December 2012. • Patients who underwent stent insertion under general anaesthesia were included. • Patients were consented to participate and were randomly allocated to each arm of the study. • Arm 1: Usual informed consent process prior to stent insertion • Arm 2: Patients were given a one-page information sheet during the informed consent process and asked to sign that they had received it and that they would read it in their own time. • Two weeks following their stent insertion each patient was contacted by the primary investigator (who was blinded) and asked questions as part of a telephone survey to ascertain their knowledge of their inserted stent. • The urology registrar was vigilant in recording whether any of the studies participants represented to hospital post stent insertion. Also a dedicated urology nurse kept a detailed record of patients that contacted her post stent insertion and the questions they asked. • Conclusions • Formalisingthe inclusion of a patient information sheet as part of the informed consent process allows patients to play an active role and share the responsibility with their clinician regarding the tracking of their stent. • Educating patients minimises anxiety, reduces unnecessary hospital presentations post insertion and reduces the incidence of the forgotten stent. • References • Monga M, Klein E, Castaneda-Zuniga WR et al. The forgotten indwelling ureteral stent: a urological dilemma. J Urol 1995; 153: 1817–1819. • Saltzman B. Ureteral stents. Indications, variations, and complications. UrolClin North Am. 1988; 15: 481-91. • Joshi HB, Newns N, Stainthorpe A, MacDonagh RP, Keeley FX, Timoney AG. The development and validation of a patient-information booklet on ureteric stents. BJU International 2001; 88:4. Acknowledgements Colleen McDonald (Urology Clinical Nurse Specialist, Westmead Hospital)