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Journal Cover Journal of Clinical Urology
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   Hybrid Journal Hybrid journal (It can contain Open Access articles)
     ISSN (Print) 2051-4158 - ISSN (Online) 2051-4166
     Published by Sage Publications Homepage  [753 journals]
  • Editorial
    • Authors: Pearce; I.
      Pages: 373 - 373
      PubDate: 2014-11-26T08:51:34-08:00
      DOI: 10.1177/2051415814558358|hwp:resource-id:spuro;7/6/373
      Issue No: Vol. 7, No. 6 (2014)
  • Cardiopulmonary exercise testing in patients undergoing radical cystectomy
           (open, laparoscopic and robotic)
    • Authors: Hoyland, K; Vasdev, N, Adshead, J. M, Thorpe, A.
      Pages: 374 - 379
      Abstract: The use of cardiopulmonary exercise testing (CPET) is gaining popularity as a preoperative functional assessment tool and is a useful adjunct to risk stratification before radical cystectomy. It is important for urologists to understand the indications, contraindications, methodology and different parameters evaluated during CPET assessment and use this information acquired to tailor pre-, intra- and postoperative care in patients undergoing a radical cystectomy. We present a review on the increasing role of CPET in patients undergoing a radical cystectomy.
      PubDate: 2014-11-26T08:51:34-08:00
      DOI: 10.1177/2051415814537823|hwp:master-id:spuro;2051415814537823
      Issue No: Vol. 7, No. 6 (2014)
  • C-reactive protein to predict the need for surgical intervention in acute
           renal colic
    • Authors: McSorley, S; Drury, M, Majumdar, P, Halsall, A, Nalagatla, S.
      Pages: 380 - 383
      Abstract: Objectives: C-reactive protein (CRP) is a serum marker of systemic inflammation which has been suggested to predict need for emergent surgical intervention in patients with acute renal colic at a value of > 28 mg/l on admission.1 We aimed to determine if this applied to our patients. Patients and methods: We prospectively collected data from all patients admitted with symptomatic urolithiasis, confirmed by CT-KUB, over three months. Fifty-nine patients were included; however, four were excluded because of co-morbidites which could influence CRP, or recent urological surgery, giving N = 55, age 50.0±14.6 years (mean±SD), M:F 40:15. The decision to proceed to intervention was made by each patient’s clinical team and not by the authors; however, there was no blinding to CRP. Results: A total of 24 of 55 patients required intervention on their index admission (22 retrograde ureteric stent, one nephrostomy, one ureteroscopic stone extraction), and 31 were managed conservatively. Those undergoing intervention had higher CRP on admission (mean 16.3 vs 9.4 mg/l, p = 0.06) and higher maximum CRP (mean 94.7 vs 25.7 mg/l, p < 0.001) than those managed conservatively. Nineteen (79%) of those requiring intervention had CRP < 28 mg/l on admission. There were no deaths, no intensive care admissions and all were discharged to outpatient follow-up. Conclusion: Rising CRP during admission is a strong predictor of the need for emergency surgical intervention in patients with acute renal colic; however, CRP at admission is less useful.
      PubDate: 2014-11-26T08:51:34-08:00
      DOI: 10.1177/2051415813495679|hwp:master-id:spuro;2051415813495679
      Issue No: Vol. 7, No. 6 (2014)
  • A retrospective cohort study of patients diagnosed with bladder cancer
           referred with visible haematuria: the impact of source of referral on
           prognostic indicators
    • Authors: Marzouk, S; Lamb, B. W, Harris, A, Mecci, A. J, Gan, J. H, Allchorne, P, Green, J. S.
      Pages: 384 - 388
      Abstract: Objective: Our aim was to establish whether there is a difference in prognostic indicators for bladder urothelial carcinoma (UC) between the patients referred via the 2-week wait (2WW) and those presenting to the emergency department (ED). Patients and methods: We performed a retrospective cohort study of all patients referred with visible haematuria, comparing tumour stage and grade between patients diagnosed with bladder UC via the ED and 2WW at two London hospitals. Results: From 09/2009–09/2011, 51 patients referred from the ED, and 146 from the 2WW clinic were diagnosed with bladder UC. Regarding tumour stage: 57% of the ED group had muscle-invasive UC compared with 23% from 2WW (p=0.001). Regarding tumour grade: 82% of the ED group had G3 tumours, versus 54% from 2WW (p
      PubDate: 2014-11-26T08:51:34-08:00
      DOI: 10.1177/2051415814522036|hwp:master-id:spuro;2051415814522036
      Issue No: Vol. 7, No. 6 (2014)
  • Efficacy of flexible ureteroscopy and laser lithotripsy for lower pole
           renal calculi
    • Authors: Sahai, A; Khan, F, Anjum, F, Dickinson, I, Marsh, H, Sriprasad, S.
      Pages: 389 - 393
      Abstract: Objective: Our aim was to determine whether flexible ureterorenoscopy and laser lithotripsy is efficacious and safe in treating lower pole renal calculi. Materials and methods: Patient, procedure and stone data of patients who underwent flexible ureterorenoscopy and laser lithotripsy at our referral centre were collected prospectively between November 2005 and November 2011 and entered into a designated database. In all, 242 procedures were performed in 198 patients. Results: The mean age was 51.2 years. The mean calculi size was 10.51 mm (range 4–27 mm). Thirty seven patients had more than one stone in the lower pole. An access sheath was used in 19 patients (9.6%), 171 (86.4%) had a ureteric stent inserted after the procedure, and 165 patients had a single procedure. Re-operation rate was 16.7%. Stone-free rates after one procedure were 89%, 80% and 41%, respectively, for calculi measuring 4–10 mm (n=107), 11–20 mm (n=76) and > 20 mm (n=15). The overall stone-free rate was 83%, 91% and 95% after one, two and three procedures, respectively. Conclusion: Flexible ureterorenoscopy and laser lithotripsy is a safe and effective minimally invasive treatment option for patients with 4–20 mm lower pole calculi. Staged procedures, however, become necessary as the size of the stone increases greater than 20 mm, and this should be mentioned when counselling patients for their primary procedure.
      PubDate: 2014-11-26T08:51:34-08:00
      DOI: 10.1177/2051415814531576|hwp:master-id:spuro;2051415814531576
      Issue No: Vol. 7, No. 6 (2014)
  • Case review in urology multidisciplinary team meetings: What members think
           of its functioning
    • Authors: Sarkar, S; Arora, S, Lamb, B. W, Green, J. S, Sevdalis, N, Darzi, A.
      Pages: 394 - 402
      Abstract: Objective: To improve communication and decision making between specialists, multidisciplinary teams (MDTs) were introduced with the premise they would improve cancer care for patients. Minimal evidence exists on MDT functionality. We investigated MDT members’ views on barriers to optimal functioning and explored their suggestions for improvements. Materials and methods: Twenty urology MDT members from seven hospitals including surgeons, oncologists, pathologists, radiologists and clinical nurse specialists took part in a semi-structured interview study. Interviews focused on information presentation, case discussion, factors affecting the multidisciplinary team meeting (MDM) and potential improvements. Interviews were transcribed and analysed through emergent theme analysis. Results: Factors negatively influencing the MDMs included insufficient time to prepare cases so that enough information is available to make appropriate decisions; absence of the clinician in charge or not knowing the patient; and lack of a systematic approach to case discussion. Recommendations included protected time for case preparation, focusing on performance and comorbidities of the patient, standardising the MDT meeting and improving case selection. Conclusions: MDTs in urology have contributed to advances in cancer care but there is significant scope for further improvement. Implementing recommendations from team members on the front line may help drive quality in this sensitive domain.
      PubDate: 2014-11-26T08:51:34-08:00
      DOI: 10.1177/2051415814532459|hwp:master-id:spuro;2051415814532459
      Issue No: Vol. 7, No. 6 (2014)
  • Patient-reported outcomes in overactive bladder due to idiopathic detrusor
           overactivity: A correlation of two multi-domain questionnaires with a
           focus on quality of life and lifestyle goals
    • Authors: Irwin, P. P; Harris, M.
      Pages: 403 - 408
      Abstract: Aims: The aims of this article are to correlate two multi-domain patient questionnaires for overactive bladder (OAB) and to assess their performance against quality-of-life measures. Methods: Patients with OAB symptoms due to idiopathic detrusor overactivity completed an Overactive Bladder Symptom Score (OABSS), an ICIQ-OAB questionnaire and a Likert quality of life (QoL) score before and six weeks following intravesical botulinum toxin treatment. They also listed lifestyle goals to which they aspired following treatment. Correlations between domains, total scores, QoL and goal achievement were calculated. Results: Fifty-seven patients returned 113 sets of questionnaires for analysis. A very close correlation was found between individual symptoms scores (Spearman r ranging from 0.93 for nocturia to 0.74 for urgency incontinence) and between the total scores of the two questionnaires (r = 0.83). The sum of the OABSS+QoL scores also correlated strongly with total ICIQ-OAB scores (r = 0.85). The correlation between total problem scores on the ICIQ-OAB and the Likert QoL was lower (r = 0.689) but remained significant. The effect sizes (ES) were large (ranging from r = 0.6 to r = 1.0) and the standard response means (SRM) varied between 0.6 and 1.1, indicating a good correlation between the two questionnaires. Conclusions: Both questionnaires provide similar information in terms of symptom presence or absence and their impact on QoL. The addition of the QoL score to the standard OABSS did not add to its benefit.
      PubDate: 2014-11-26T08:51:34-08:00
      DOI: 10.1177/2051415814536159|hwp:master-id:spuro;2051415814536159
      Issue No: Vol. 7, No. 6 (2014)
  • The scope of private practice amongst consultant urologists in the UK and
           Ireland - a BAUS Workforce survey
    • Authors: Payne, S; Joyce, A.
      Pages: 409 - 417
      Abstract: Introduction: A 2012 workforce survey of consultant members of the British Association of Urological Surgeons (BAUS) found that up to 75% of members participated in private practice. This survey specifically addresses the scope of private practice and members’ attitudes towards the private health industry (PHI). Methods: An online survey of all consultant members of BAUS was undertaken in May 2013. Questions were asked about how many had a private practice, how much time they devoted to it, about their relationship with insurers and their expectation of BAUS’s role within private health care. Results: A total of 47.2% responded to the survey, of whom 76.3% have a private practice. Among the respondents, 73.6% work as individual practitioners and 61% spend
      PubDate: 2014-11-26T08:51:34-08:00
      DOI: 10.1177/2051415814552721|hwp:master-id:spuro;2051415814552721
      Issue No: Vol. 7, No. 6 (2014)
  • Bladder outlet and rectal obstruction secondary to a large pelvic hydatic
    • Authors: Almazeedi, S; Ali, Y, Diba, F. A, Rajgopal, V, Kehinde, E. O.
      Pages: 418 - 420
      PubDate: 2014-11-26T08:51:34-08:00
      DOI: 10.1177/2051415813514972|hwp:master-id:spuro;2051415813514972
      Issue No: Vol. 7, No. 6 (2014)
  • A case of benign vesica melanosis - four-year follow-up
    • Authors: Manson-Bahr, D. A; Swamy, R, Adshead, J. M.
      Pages: 421 - 424
      Abstract: Benign vesica melanosis (BVM) is a rare condition with only 15 reported cases in the literature (Table 1). There is limited understanding of its aetiology. Here we present a four-year follow-up of a case of BVM in a 53-year-old Caucasian male presenting with lower urinary tract symptoms.
      PubDate: 2014-11-26T08:51:34-08:00
      DOI: 10.1177/2051415813507053|hwp:master-id:spuro;2051415813507053
      Issue No: Vol. 7, No. 6 (2014)
  • Improvement in urethral diverticular abscess with urinary retention by
           transvaginal drainage: a case report
    • Authors: Watanabe, R; Sugahara, T, Hamada, H.
      Pages: 425 - 426
      PubDate: 2014-11-26T08:51:34-08:00
      DOI: 10.1177/2051415814526184|hwp:master-id:spuro;2051415814526184
      Issue No: Vol. 7, No. 6 (2014)
  • Response to: Prostate cancer in Scotland: does geography matter' An
           analysis of incidence, disease characteristics and survival between urban
           and rural areas by Karina A Laing et al.
    • Authors: Leung, H; Reid, S, Forbat, L.
      Pages: 427 - 427
      PubDate: 2014-11-26T08:51:34-08:00
      DOI: 10.1177/2051415814549348|hwp:master-id:spuro;2051415814549348
      Issue No: Vol. 7, No. 6 (2014)
  • Abstracts
    • Pages: 428 - 431
      PubDate: 2014-11-26T08:51:34-08:00
      DOI: 10.1177/2051415814558177|hwp:resource-id:spuro;7/6/428
      Issue No: Vol. 7, No. 6 (2014)
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