Urology nurse-led clinic helps in early detection and management of urinary tract stones among patients presented with unilateral or bilateral loin(s) pain

Abstract

Introduction and objectives Introduction: Patients presented withunilateral or bilateral loin(s) pain have to wait for around 52 weeksbefore they have the first urologist consultation at Queen MaryHospital. In order to shorten the waiting time and early detection ofurinary stones, all referrals are screened by urologists and then referredto the urology nurse-led clinic for initial assessment and investigation.Objectives To have early detection and management of patientspresented with unilateral or bilateral loin(s) pain for any urinary tractstones.Materials and methods Methodology: Referrals from the patientspresented with unilateral or bilateral loin(s) pain after screened by theurologists were referred to the urology nurse-led clinic. A standardmanagement protocol on assessment and investigation including bloodchecking, urine for culture and X-ray imaging were performed in thenurse-led clinic for the referred patients. Moreover, a ultrasoundimaging will be arranged. While all investigation results were available,the urology nurse then discussed with urologists on individual patient’smanagement plan/options. Results There were total 115 patients assessed in our urology nurse-led clinic from October 2015 to July 2016 for unilateral or bilateralloin(s) pain. 59 (51.8%) patients were male and 55 (48.2%) patientswere female. 7 cases defaulted follow up or imaging. There were 72(63.2%) patients had no stone found on imaging and 5 of them weredischarged directly from the clinic. 35 (30.7%) patients had stonefound on imaging and refer back to urologists for further management.Meanwhile, 16 (14%) cases with other urological problems such asrenal cysts, microscopic hematuria were detected during screening testand required further investigation. Advanced urological appointmentwere given to 2 patients for being detected obstructive urologicalstones.Conclusion All cases which need active management were referredback to urologists with an earlier appointment. Urology nurse-led clinicnot only shorten the waiting time of first urology consultation but alsohelps in early detection and management of urinary tract stones amongpatients presented with unilateral or bilateral loin(s) pain.