New outpatient pathway is changing lives for men with lower urinary tract symptoms

A one-stop clinic at Bolton NHS Foundation Trust is improving patient care for men with Lower Urinary Tract Symptoms (LUTS). Males with LUTS often experience challenges as part of their treatment, including multiple hospital visits prior to being listed for surgical intervention, which this new model aimed to reduce. It also utilises a technology called the UroLift System to move procedures away from theatres and develop an improved, entirely outpatient, pathway.

Neil Harvey, Consultant Urologist at Bolton NHS Foundation Trust

Males with lower urinary tract symptoms (LUTS) experience various challenges as part of their treatment, including multiple hospital visits prior to being listed for surgical intervention. This project was led by a Consultant Urologist at Bolton NHS Foundation Trust, Mr Neil Harvey, who recognised those challenges.

The lower urinary tract includes the bladder and the tube that urine passes through as it leaves the body (urethra). LUTS are common as people get older and can include an urgent or frequent need to pass urine, problems passing urine, and problems after passing urine, such as feeling the need to go again.

Supported by Health Innovation Manchester, the aim of this one-stop clinic was to improve the efficiency of the patient pathway, with the shortest possible referral of treatment and minimising the number of times a patient would need to visit a clinic. By achieving a reduction in hospital visits, this would free-up outpatient appointments for other patients. Delivering procedures for patients with enlarged prostates in the outpatient setting also enables them to be treated more quickly and without needing to stay in hospital overnight, resulting in an increased theatre capacity and more hospital beds for other patients that need them.

This was delivered via the implementation of two weekly clinical sessions – a one-stop clinic and a weekly outpatient procedure list where treatment using the UroLift technology would be given. The list operates in a procedure room that is typically used for other LA procedures, such as flexible cystoscopy and trans-perineal prostate biopsy.

The UroLift System is a Benign Prostate Hyperplasia technology, supported by the MedTech Funding Mandate (MTFM) for 2022/23, which is delivered in collaboration with the Health Innovation Network and Accelerated Access Collaborative (AAC).

The technology uses a minimally invasive approach to treating Benign prostatic hyperplasia (BPH) that lifts and holds the enlarged prostate tissue, so it no longer blocks the urethra. The treatment is performed by a urologist and is typically performed using local anaesthesia in the outpatient clinic or day surgery unit. Patients typically return home the same day without a catheter.