Author(s): Floyd M.S.; Mistry R.; Wiliamson E.P.M.; Machin D.G.; Baird A.D.
Source: BJU International; Sep 2017; vol. 120 ; p. 27
Publication Date: Sep 2017
Publication Type(s): Conference Abstract
Abstract:Introduction: Despite a substantial body of literature on the physical and mental health of the prison population there remains a paucity of data pertaining to the specific urological requirements of prisoners. Methods: A 12 month prospective study was performed recording all clinical episodes made by persons detained by Home office Licence presenting to a University Hospital. A proforma recorded detainee demographics, nature of complaint, admission details, outpatient attendances plus surgical and endoscopic interventions. New cancer diagnoses were also recorded. Results: A total of 77 clinical episodes were made by 47 patients. All patients were male. One special high security psychiatric hospital and 7 prisons accounted for the referral base. A total of 18 separate presenting complaints were noted including acute trauma. Outpatient attendances accounted for 38 episodes and emergency admissions accounted for 9. The commonest reason for outpatient attendance was investigation of lower urinary tract symptoms followed by testicular mass evaluation. A total of 12 patients required elective theatre and 9 required emergency theatre. Eleven patients required endoscopic procedures. The commonest reason for emergency theatre was removal of a foreign body, followed by scrotal exploration and emergency shunting for priapism. Rigid cystoscopy was the commonest elective procedure performed. Two urothelial cancers were diagnosed. Seven patients failed to attend appointments. Conclusion: Referrals from the prison service impact significantly on a urology unit’s workload. Difficulties arise with access to emergency theatre and repeat presentations. Additionally, the transient nature of the prisoner population makes follow up and investigation difficult.