Two specialist nurses are playing a key role in what is thought to be the UK’s first scheme to allow prostatectomy patients to remove their own catheters at home after surgery.
Prostate clinical nurse specialists Maria Innes and Helen Casson provide advice to patients after their prostatectomy on how they can remove their own catheters, offer a follow-up call once the patient has carried out the removal and provide telephone back-up advice for patients if needed.
“Most patients tell us how much easier it was than they anticipated”
The scheme, for patients recovering from robotic assisted radical prostatectomy, was introduced by the urology team at the Royal Surrey NHS Foundation Trust in April this year.
The move means patients do not have to return to hospital for removal of their catheter seven days after their operation.
The catheter is held in place with a fluid-filled balloon. To remove it, the patient inserts a syringe to deflate the balloon and withdraw the fluid. An aesthetic gel is applied to the tip of the penis where the catheter is inserted. Once the fluid has drained from the balloon, the catheter can be gently pulled to remove.
So far, 105 patients have removed their own catheter as part of the programme, with only a very small proportion opting to return to hospital to have the catheter removed.
“Every patient is given a leaflet and spoken to prior to their surgery when we visit them on the ward, and we also help them practice taking the catheter out, removing water from a balloon,” Ms Innes said.
“We suggest they carry out the removal at home in the morning, and then we ring them at lunchtime afterwards to check on how it went.
“Most patients tell us how much easier it was than they anticipated, and we have not had problems with any patients.”
Meanwhile, Ms Casson added: “There is occasionally some apprehension beforehand, but there is always the option to come into the hospital if the patient chooses, and [the] vast majority have been happy to do it at home.
“We collect data from all of the patients after their home removal and evaluate the project on a regular basis.”
Urology consultant at the trust, Dr Wissam Abou Chedid, added: “Royal Surrey is one of the top three trusts in the country in terms of the number of robotic assisted radical prostatectomies performed and the team is constantly thinking of ways to improve our patients’ care and experience.
“We were keen to come up with ideas about reducing waiting time for patients who had catheters in after their surgery and this is a simple but safe and effective solution. It not only saves clinic time, but during a period of rising fuel prices, it’s very helpful for patients.”
The trust is now working with charity Prostate Cancer UK to see if the self-removal programme could be extended to other trusts around the country.