19 May 2016
Our project on preventing post-operative urinary retention (PO-UR) was the brainchild of public contributor Nick, who put the idea forward as part of our open call for research ideas.
As a patient, Nick had experienced post-operative acute urinary retention (not being able to pass urine), requiring catheterisation – inserting a tube to drain the bladder – after three different elective surgical procedures. For three further comparable conditions that required surgery, Nick investigated some of the research literature on PO-UR.
Through discussion with clinicians treating him, based on his investigation, he was able to avoid urinary retention following these procedures. This led him to hypothesise that it should be possible to come up with a set of criteria to identify people who are at risk of urinary retention, and a further set of criteria to reduce the risk of these people developing urinary retention following surgery.
The project has been taken on by CLAHRC West and Nick has stayed closely involved in all stages of the process. The first step in the project was to set up a team to work on the project. We initially had some difficulty in identifying clinicians who were eager to join.
We contacted Tony Blacker, a consultant endo-urologist from University Hospital, Coventry, who was one of the clinicians who had helped Nick to successfully avoid PO-UR. Tony was keen to join the project team. It was more difficult to persuade other clinicians to be involved, because urinary retention is quite often not seen as a major problem by the medical community, but more as a common side effect of surgery that can be solved by catheterisation. However, given the importance of the problem to patients, as highlighted by Nick submitting the research idea, we considered that it was an important area to pursue. We eventually managed to put together an excellent team of clinicians, and to set up a project team jointly led by Dr Penny Whiting, Epidemiology Team Lead at CLAHRC West, and Nick.
The first stage of the project has been to conduct a systematic review of the literature, to identify risk factors and treatments for PO-UR. Nick’s close involvement in the project has continued with him acting as a researcher on the review, setting up an honorary research associate contract at the University of Bristol to allow him to work on the project.
He has contributed to all stages of the review so far, including screening titles and abstracts and assessing full text papers for inclusion. He will also be involved in the next stage of the review: extracting data from the included studies. CLAHRC West has supported Nick by providing him with training around systematic review methodology and with specific training for each task that he has taken on.
Penny Whiting said:
“Having Nick involved in the review team has been a very valuable experience. He has brought a new dimension to the team with his unique knowledge of the topic area, which has resulted in some interesting discussions among the review team. This has also helped us to refine our inclusion criteria, leading to what we hope will be a more relevant review.”
For more information about this project contact Penny Whiting on Penny.Whiting@bristol.ac.uk.