REMEDY : BNSSG referral pathways

Trial Without Catheter (TWOC)

Checked: 15-08-2018 by Rob.Adams Next Review: 15-08-2019

Community TWOC

TWOC can often be managed in the community. The community continence service suggests using a catheter valve for one week prior to the TWOC to enable the patient to get used to the feeling of a full bladder. The district nurses can then usually supervise the TWOC in the community.

For further advice then the Community Bladder and Bowel Services are a good resource.

TWOC Referral Service - NBT

The Urology TWOC Referral Service is a nurse led service internal to the Urology department at NBT.

If the patient is not under the care of a consultant urologist at NBT please refer them via letter and the attached TWOC Referral Form to UrologyTWOCReferrals@nbt.nhs.uk , where a consultant will triage the referral and determine if they should be seen in the TWOC clinic or in their outpatient clinic. The consultant will then take over their ongoing urology care.  

If the patient already has a Urology consultant assigned to their care, or you have discussed the case with the on-call Urology registrar and they have agreed to take the patient on under their consultant, please refer them via ICE. Please note that any ICE referrals which do not have a Urology consultant named will be rejected.

The current waiting time for an outpatient TWOC clinic is approximately 3 - 4 weeks after the referral has been triaged. Please do not tell the patient they will be seen any sooner as it is unlikely they will be able to accommodate this.

The urology team also have patient information leaflets that can be downloaded from the NBT website. which includes a TWOC PIL.