148 A Retrospective Assessment of the Management of Bladder Outlet Obstruction in a District General Hospital

Aim To evaluate the management & care outcome of all male patients undergoing bladder outlet obstruction(BOO) intervention by benchmarking against national figures as well as established NICE & EAU guidelines. Method A descriptive & retrospective analysis of all patients with BOO, using anonymised unit-level data from patient/operative notes, pre/post-operative clinic letters & investigation portal over 12 months(July 2020 - June 2021). Results Of the 77(out of 125) cases that satisfied the inclusion criteria, retention with an in-dwelling catheter was the most prevalent indication for surgery at 45.45%. Overall, perioperative complications such as unsuccessful trial without catheter(TWOC), transfusion, postoperative infection and return to the theatre was 5.19%, with a median length of stay of one day. Comparatively, the failed TWOC rate was 9.09%(< national average of 13.90%) while the post-operative infection rate was 3.89% which was slightly above the national figures. Nonetheless, the unscheduled re-admission rate was 6.49%, fulfilling the 9.60% GIRFT objective. Furthermore, 82.17% of catheterised patients and those performing self-catheterisation before surgery were catheter-free at follow-up. However, 14.20% of preoperatively uncatheterized patients had one at follow-up. Conclusions The larger sample size of our re-audit showed the service was comparatively similar to the national norm with minimal unplanned 30-day readmissions, perioperative complications & a large proportion of successful TWOC at follow-up as our initial data suggested. However, while most patients were catheter-free at follow-up, we were slightly below the national average. In addition, it highlighted the need to assess the reason(s) why preoperatively catheter-free patients had one at follow-up.