B.C.'s stringent new safety regulations for medical devices used in thousands of bladder tests done every year on Island patients will cause delays for non-urgent cases and trips to the mainland for urgent ones.
Dr. Will Orrom, medical director of surgery at the Vancouver Island Heath Authority, said it will take some time to offer the tests, called cystoscopies.
They were previously done in urologists' offices but that can't continue because the offices no longer meet sterilization requirements, he said.
"The ones that are not urgent, yes, they'll back up," Orrom said. "The ones that are more urgent will be done on the mainland."
The tests are used to follow up on bladder cancer or treat and diagnose other urinary tract ailments.
The new regulations will affect Victoria more than most areas of B.C. because of a long-standing tradition for urologists to do most cystoscopies - 7,600 annually - in their offices instead of in clinics or hospitals, said VIHA spokeswoman Suzanne Germain.
All told, 12,000 cysto-scopies are performed annually on the Island, with some patients having several. About 4,400 are done in hospitals due to the need for anesthetic or X-rays, and those will continue.
Unlike the Lower Mainland, the Island does not have any cystoscopy clinics but VIHA is looking for sites.
The rule revisions, to bring B.C. in line with Canadian standards, are meant to further reduce the risk of infection from improperly sterilized cystoscopes.
It's not an optimal situation, Orrom acknowledged. "We'd much rather be able to provide this expediently to our patients."
The decision to discontinue office cystoscopies was "based entirely on patient safety standards," Dr. W. Robbert Vroom, senior deputy registrar of the College of Physicians and Surgeons of B.C., said in a letter to the Times Colonist.
Orrom has not heard of any infections from improper sterilization in office tests.
About a dozen urologists are notifying patients about the change, which took effect two weeks ago.
The urologists were "all practising in a way that was completely acceptable until a short time ago," Orrom said.
"And the risk to patients is minimal. But as we make that minimal number smaller and smaller in all parts of surgery and surgical services, then what we have to do changes."
Nadine McKinnon, who works at a local urologist's office, acknowledged that some patients are upset.
"We're just waiting to find out when to book appointments," she said.
The urologists themselves asked the College of Physicians and Surgeons of B.C. to inspect their office facilities in light of "best practices" norms published in December by the B.C.
Ministry of Health. Since then, several urologists had on-site visits by college inspectors to determine whether they met the new safety standards and they did not, Orrom said.
Doctors noted that it would be too costly and at times require renovations to accommodate equipment, the college said.
VIHA is looking for the most efficient and least costly solution to providing cystoscopy clinics here, such as at one of the hospitals, Orrom said.
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