title: Shared care for benign prostatic hyperplasia: a feasibility study.
abstract: OBJECTIVE
  To determine the proportion of patients with symptoms of urinary outflow obstruction secondary to benign prostatic hyperplasia (BPH) who could be managed in the community after assessment in a shared-care clinic (managed by nursing staff, supervised by a consultant) to which they had direct access.
  
  
  METHODS
  A total of 127 men were referred to one consultant urologist in a 9-month period for assessment of possible urinary outflow obstruction. All were investigated using urine analysis, serum prostate-specific antigen level, urea and electrolytes, plain abdominal X-ray, renal ultrasonography and urinary flow rate. Additional investigations were undertaken as required. The proportion of men who could have been investigated in a shared-care clinic and then managed in the community was determined.
  
  
  RESULTS
  Of 127 men, 88 (69%) were found to have uncomplicated outflow obstruction secondary to BPH; of these 49 (38%) could have been managed in the community after assessment in the shared-care clinic and a further 27 (21%) could have been managed in the community after additional investigation by a specialist. Twelve men (9%) were found to have uncomplicated outflow obstruction and chose to undergo transurethral resection of the prostate.
  
  
  CONCLUSIONS
  Many men with uncomplicated outflow obstruction could be assessed in a shared-care clinic and then managed in the community. A shared-care protocol for the management of these men has now been introduced in this unit.
authors.affiliation: Department of Urology, St George's Hospital, London, UK.
authors.forename: S B
authors.initials: SB
authors.lastname: Morris
authors.forename: C
authors.initials: C
authors.lastname: Pogson
authors.forename: R J
authors.initials: RJ
authors.lastname: Shearer
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000553:Ambulatory Care; D003153:Community Health Services / Q000458:organization & administration*; D004739:England; D005240:Feasibility Studies; D006801:Humans; D008297:Male; D008487:Medical History Taking; D008875:Middle Aged; D010808:Physical Examination; D011446:Prospective Studies; D017430:Prostate-Specific Antigen / Q000097:blood; D011470:Prostatic Hyperplasia / Q000097:blood / Q000150:complications / Q000628:therapy*; D016055:Urinary Retention / Q000175:diagnosis / Q000209:etiology / Q000628:therapy*; D014563:Urodynamics
chemical_list: D017430:Prostate-Specific Antigen