The open access Continence Resource Centre for Greater Glasgow Health Board.

The development of an open access Continence Resource Centre is described. The role of the Centre in helping the sufferers and carers is highlighted. The educational role exceeded expectations. The benefits of the centre in education, research and potential cost saving are discussed. The aims and achievements are in accord with the Department of Health document "An Agenda for Action on Continence". From its opening in August 1989 to the end of February 1992 the centre has served 8070 incontinent individuals and 4736 carers. At a cost of 44,000 pounds per annum this represents good value for money.

Computer applications in a urology department.

An integrated approach to computerising the urology department has been implemented, using a XENIX multi-user system, with 6 terminals. Standard discharge letters, patient databases and urodynamic reporting programs are the main features. In addition, there are programs for patient history-taking and urodynamics on personal computers not linked at present to the main system.

Urological history-taking and management recommendations by microcomputer.

A system has been developed to acquire a complete urological history using an Apple microcomputer. The system can ask up to 300 multiple choice questions which the patient answers using a light pen. The questions are grouped into blocks for urological symptoms and complicating factors. A printout summarises the history and the recommended further investigations. A copy of this is given to the patient and the referring doctor. The clinician discusses the printout and proposed investigations with the patient. The system has been tested against experienced clinicians and the results are presented. The computer system was evaluated for 26 patients and was found to record all of the important information. The system is now in regular use in the out-patient clinic as the first part of the diagnostic work-up in suitable referrals. This system has shortened waiting times for first appointments. To date 261 patients have used the system. The consultant urologist continues his practice of reading all referral letters and allocating priorities. Conditions requiring immediate physical examination (e.g. testicular swelling) are not suitable for this type of approach.

Computerisation and microprocessing within urology.

Computing and microprocessing have become part of everyday life but medical applications have been patchy. Urologists have recognised that computing can facilitate the handling of data and appointment systems. More recently, urodynamic and patient interviewing programs have been developed. The Urological Computing Society formed in 1987 provides a forum for co-ordinating developments.

Personality testing in 226 patients with urinary incontinence.

Two hundred and twenty-six female patients undergoing investigation for urinary incontinence completed the Eysenck Personality Inventory questionnaire. The results of the questionnaire were correlated with the symptomatology and urodynamic findings. Incontinence and neuroticism were found to be related. No special relationship was found between neuroticism and detrusor overactivity, although this has been reported in other smaller series.

DDAVP in young enuretic patients: a double-blind trial.

A double-blind cross-over trial of DDAVP was carried out in 22 patients aged between 9 and 16 years. The patients had previously failed to respond to other treatments for enuresis. While DDAVP resulted in fewer wet nights during the 14-day period of active treatment, the results did not achieve statistical significance. This is in contrast to previous reports. The dose in this study was 20 micrograms intranasally. Further studies may be valuable, possibly relating dosage to body weight.

Microcomputers and microprocessors in urology: present and future.

Urology departments have a heavy outpatient workload requiring efficient secretarial, appointments and records services. Microcomputers are relatively inexpensive and can facilitate efficient routine clinical and research work. Unlike mainframe computers, formal training is not usually required, a simple introduction being sufficient for the enthusiast. An Apple computer is used in this department for word processing incorporating standard letters, paragraphs and phrases. With more sophisticated programs urological screening by computer interrogation could be linked to an appointments system to coordinate investigations, minimising hospital visits. Microprocessors can facilitate a wide variety of measurement recording and data handling. Urodynamic measurements can be computed and graphs superimposed to facilitate interpretation.

The Urilos recording nappy system.

A technical and clinical evaluation of the Urilos recording nappy system is presented. The recording pads were calibrated to determine the variation between and within batches of 25 pads supplied by the manufacturer. Fifty patients were assessed by this system for periods of 2 to 7 h. The results show that the system is useful in the verification of patient histories, although it is difficult to obtain a quantitative measure of urine loss.

Long-term urethral catheter drainage.

Long-term catheter management is best conducted by specially trained community staff, provided there is close liaison with the urologist. Patients, hospital staff, and the primary health care team all benefit. The scheme is cost-effective, more convenient for patients and relatives, and reduces the need for emergency calls to the general practitioner and hospitals. We advocate development of similar schemes in other districts.