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Journal Cover   Journal of Clinical Urology
  [SJR: 0.183]   [H-I: 5]   [7 followers]  Follow
   Hybrid Journal Hybrid journal (It can contain Open Access articles)
   ISSN (Print) 2051-4158 - ISSN (Online) 2051-4166
   Published by Sage Publications Homepage  [821 journals]
  • Editorial
    • Authors: Pearce; I.
      Pages: 295 - 295
      PubDate: 2015-08-25T04:56:49-07:00
      DOI: 10.1177/2051415815597638
      Issue No: Vol. 8, No. 5 (2015)
  • Urodynamics for Prostate Surgery Trial; Randomised Evaluation of
           Assessment Methods (UPSTREAM) for diagnosis and management of bladder
           outlet obstruction in men
    • Pages: 296 - 298
      PubDate: 2015-08-25T04:56:49-07:00
      DOI: 10.1177/2051415815591407
      Issue No: Vol. 8, No. 5 (2015)
  • The importance of second-look transurethral resection for superficial
           bladder cancer
    • Authors: El-Barky, E; Sebaey, A, Eltabey, M, Aboutaleb, A, Hussein, S, Kehinde, E. O.
      Pages: 299 - 305
      Abstract: Objectives: The objective of this article is to evaluate the importance of a second-look transurethral resection of bladder tumour (TURBT) in patients with newly diagnosed superficial bladder cancer and its impact on subsequent treatment plan. Methods: We carried out a prospective study on 100 consecutive patients with newly diagnosed superficial bladder cancer in whom a second-look TURBT was performed two to six weeks after initial resection. We assessed the incidence of residual tumours, sufficiency of initial pathological staging and grading. We also assessed the need for re-staging and grading after the second-look TURBT. Results: Forty-five out of 75 patients (60%) who underwent second-look TURBT had no tumours, 18 (24%) had visible residual tumours and 12 (16%) had microscopic residual tumours. Of the 30 (40%) patients with residual tumours, five had pTa, three had carcinoma in situ (CIS), 12 had pT1, and 10 had pT2 disease. Upstaging and change of treatment plan as a result of the second-look TURBT were necessary in 18/75 (24%) cases, of which 10 cases (13%) underwent radical cystectomy for muscle-invasive tumours. Conclusions: A second cystoscopy with or without TURBT is recommended two to six weeks after initial resection of stage Ta and T1 bladder tumours in patients with high-grade transitional carcinoma of the bladder or in patients with multiple tumours. Second-look cystoscopy in this category of patients may reveal the need for early change of treatment plan in about 25% of patients.
      PubDate: 2015-08-25T04:56:49-07:00
      DOI: 10.1177/2051415814560189
      Issue No: Vol. 8, No. 5 (2015)
  • Investigation of two week wait referred haematuria patients in the UK: A
           national survey
    • Authors: Hughes, K. E; Drake, T, Hamm, R.
      Pages: 306 - 314
      Abstract: Aim: To analyse current UK practice for investigation of patients with visible haematuria (VH) or non-visible haematuria (NVH) who meet referral criteria according to National Institute of Clinical Excellence referral guidelines for suspected cancer. Patients and methods: Questionnaires were sent to 131 trusts. Data collected included demographics, conformity with NICE improving outcomes in urological cancer guidelines, standard first line investigations into VH and NVH and criteria for second line investigations. Results: Seventy-two trusts (55%) responded from 15 deaneries including 48 cancer centres. Almost two-thirds (63.9%) provide a one-stop service. First line investigations into VH varied considerably: 82% of trusts undertake urine tests (cytology 43.0%); three-quarters perform blood tests (prostate-specific antigen 54.2%); all conduct varying radiological imaging of the upper tracts; 95.8% of patients had flexible cystoscopy. Forty per cent of trusts’ first line investigations differ for NVH. Triple phase computed tomography-urogram is not routinely undertaken. Of the trusts, 55.5% perform second line investigations for VH and 55.5% for recurrent VH including computed tomography-urogram or retrograde studies; 20.5% perform non-contrast helical computed tomography scan of the kidneys, ureters and bladder or urine cytology for NVH if the history is indicative. Conclusion: Across trusts, there are wide variations in the regimes for investigation of haematuria. Development of an evidence based guideline to standardise practice across the National Health Service for haematuria referrals is required to abolish the postcode lottery system.
      PubDate: 2015-08-25T04:56:49-07:00
      DOI: 10.1177/2051415815575198
      Issue No: Vol. 8, No. 5 (2015)
  • The changes in prostate cancer and its management in the North West of
           England over a 10-year period
    • Authors: Turo, R; Bromage, S, Smolski, M, Thygesen, H, Cleaveland, P, Esler, R, Hartley, S, Thompson, A, Adeyoju, A, Brown, S, Brough, R, Oakley, N, Sinclair, A, Collins, G.
      Pages: 315 - 320
      Abstract: Objectives: Our aim was to evaluate changes in prostate cancer diagnosis and management and to examine changes in the stage and grade of newly diagnosed prostate cancer in the North West of England over a 10-year period. Materials and methods: Data was collected concerning the diagnosis (including stage and grade) and management of newly diagnosed prostate cancer in the North West of England. There were three time points: 2003, 2007 and 2011 including a total of 648 patients. For assessment of median time changes Spearman’s Rank correlation test was used, for the assessment of changes in Gleason grade and clinical stage Mann–Whitney U test was used, and assessment of positive margin rates was done with Fisher’s test. Results: Median time from management decision to surgery has reduced from 46 (2003), 34 (2007) to 27 days (2011) (p=0.074). The proportion of patients managed with active surveillance has remained relatively constant over time (18%, 16% and 21% respectively). More minimally invasive, nerve-sparing prostatectomies are now performed, and positive margin rates have significantly reduced from 53% (2003) to 23% (2011) (p
      PubDate: 2015-08-25T04:56:49-07:00
      DOI: 10.1177/2051415815575218
      Issue No: Vol. 8, No. 5 (2015)
  • Haematological considerations in urology: A systematic review
    • Authors: Abusanad, O; Floyd, M, Johnson, E, McHugh, J, McCabe, J.
      Pages: 321 - 328
      Abstract: Deep venous thrombosis (DVT) remains a serious and common complication of surgical procedures and is therefore an issue of importance for all urologists. In the UK, pulmonary embolism (PE) following DVT in hospitalised patients causes 32,000 deaths each year. DVT and PE represent the outcome of venous thromboembolism (VTE). The total cost for management of VTE in 2005 was approximately 640 million. Early risk assessment and optimising modifiable risks are paramount in order to reduce the incidence of VTE. In this article we review common risk factors for VTE and emphasise specific risk factors for urological procedures. The perioperative management of urological patients who are chronically anticoagulated is discussed. We review the literature regarding anticoagulation and its relevance to all urological procedures and mention the problems associated with new anticoagulant agents. All urologists should be familiar with the new range of anticoagulant agents due to the increasing number of patients taking them.
      PubDate: 2015-08-25T04:56:49-07:00
      DOI: 10.1177/2051415815577314
      Issue No: Vol. 8, No. 5 (2015)
  • I-STOP/PMP: A tool for monitoring prescription drug abuse in patients with
           chronic pain syndromes
    • Authors: Bahlani, S; Mehta, S, King, A, Moldwin, R.
      Pages: 329 - 333
      Abstract: Background: Patients with chronic pain syndromes often require analgesics and muscle relaxants for symptom management. Unfortunately, many of these agents have abuse potential, and specific concerns have been raised with regard to drug-seeking behaviours that involve multiple clinicians dispensing similar, if not identical, agents. The Internet System for Tracking Over-Prescribing (I-STOP) is a newly implemented law targeted at monitoring the abuse and diversion of controlled substances in New York State. The purpose of this study is to describe the use and the potential for abuse of agents commonly used in the treatment of a variety of urological pelvic pain patients. Materials and methods: Clinical data from 397 patients with interstitial cystitis/bladder pain syndrome (IC/BPS), chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS), and pelvic floor dysfunction (PFD) were identified through medical record review over a consecutive 6-month period. These names were entered into the Prescription Monitoring Program (PMP) database to which all prescribers have access. I-STOP monitors prescription use over a prior 6-month interval from the date of access. Categoric data were compared with Fisher’s exact test and the chi-square test. Kaplan–Meier product limit curves were stratified by group and compared using the log-rank test. Results: In total, 397 patients with IC/BPS, CP/CPPS, and PFD were included; 14 patients (3.5%) had been prescribed duplicate medications by more than one practitioner. Of those patients who received duplicate prescriptions, 4 of 14 (29%) were for benzodiazepines, and 10 of 14 (71%) of duplicate medications prescribed were opioids. Conclusions: The implementation of the I-STOP/PMP registry provides an innovative way for practitioners to monitor prescribed controlled substances while allowing patients to receive necessary medications for symptom control.
      PubDate: 2015-08-25T04:56:49-07:00
      DOI: 10.1177/2051415815575219
      Issue No: Vol. 8, No. 5 (2015)
  • Preventing 'same-day' cancellations in elective urological surgery: Are
           different strategies needed for inpatient, day case and procedural
    • Authors: O'Dwyer, A; Pridgeon, S, Green, J.
      Pages: 334 - 341
      Abstract: Background: Late surgical cancellations adversely impact patients and efficient use of hospital resources. Non-clinical reasons have a cancellation rate of 0.77%, but when including clinical reasons this rate rises to 13%–15%.1–4 Objectives: The objectives of this article are to identify reasons for cancellations of elective urological procedures at a single centre across different procedure types and to make recommendations for prevention. Methods: Rates and reasons for late cancellation of urological surgery were retrospectively audited for the period April 2009 to April 2012. For each cancellation, reasons were classified: Patient-related, Facility-related, Work-up, Change in medical condition, Process-related, Miscellaneous. Results: During the study period, 9039 elective operations were reviewed to find 2804 cancellations: 580, 450, 1774 (rates = 15.6%, 21.7% and 29.3%) for inpatient, day case and procedure-room cases, respectively. Thirty per cent of inpatient cancellations were due to process-related factors, and 35% due to change in medical condition, of which 78% were urinary tract infection (UTI). Patient-related factors accounted for the majority (52%) of day case and procedural cancellations. Conclusions: Causes for cancellations vary according to procedure type, suggesting tailored strategies are needed for prevention. Change in medical condition caused similar rates of cancellation across procedure type (35%, 28% and 25%). Inpatient procedures were prone to process-related cancellations especially over-run theatre sessions. Patient surveys and reminders closer to time of operation, improvements in preoperative UTI detection and treatment and further process mapping is recommended to identify exact reasons behind and decrease cancellations.
      PubDate: 2015-08-25T04:56:49-07:00
      DOI: 10.1177/2051415815587213
      Issue No: Vol. 8, No. 5 (2015)
  • Higher specialist urology trainees' opinions on preparation for the
           consultant role
    • Authors: Cleaveland, P; Parnham, A, Tang, V, Ali, Z, Brown, S.
      Pages: 342 - 346
      Abstract: Introduction: Trainees are objectively assessed during their surgical training rotations in order to be awarded the certificate of completion of training, thereby allowing independent consultant practice. Our study looks at senior trainees’ opinions on UK urology training in preparation to becoming a consultant. Patients and methods: A questionnaire was sent to UK senior urology trainees ST 6 or above and new consultants. Parameters including demographics, qualifications, sub-specialist interests and questions related to the candidates’ perceived readiness to carry out a range of activities as a consultant were recorded. Results: Twenty-eight candidates completed the questionnaire. All trainees thought the FRCS exam covered topics useful for consultant practice. The majority of respondents felt comfortable dealing with emergencies, general urological procedures and managing research/audit (85%, 96% and 90%, respectively). However, a number of respondents felt unprepared for educational and leadership/management roles (30% and 40%). A further 55% felt unprepared to achieve a good work/life balance. Overall, 93% felt training prepared them for the consultant role. Conclusion: The survey has highlighted that most trainees feel confident in dealing with clinical and academic aspects of urology. However, there seem to be concerns with achieving a good work/life balance and in particular limited confidence in delivering educational, management and leadership roles. With an increasing emphasis within the NHS for consultants to adopt managerial roles and increasing pressures on their personal time, this survey highlights the need for specific training to address these issues.
      PubDate: 2015-08-25T04:56:49-07:00
      DOI: 10.1177/2051415815587444
      Issue No: Vol. 8, No. 5 (2015)
  • Paediatric stones: An overview
    • Authors: Erotocritou, P; Smeulders, N, Green, J. S.
      Pages: 347 - 356
      PubDate: 2015-08-25T04:56:49-07:00
      DOI: 10.1177/2051415815577332
      Issue No: Vol. 8, No. 5 (2015)
  • A very unusual case of spontaneous adrenal artery rupture
    • Authors: Sedgwick, R; Lam, W, Sandhu, S.
      Pages: 357 - 358
      PubDate: 2015-08-25T04:56:49-07:00
      DOI: 10.1177/2051415813518530
      Issue No: Vol. 8, No. 5 (2015)
  • An 18-year-old girl with renal carcinoma and a cluster of skin
    • Authors: Ginige, A; Ranatunga, N, Wasalaarchchi, K, Abeygunasekera, A. M.
      Pages: 359 - 361
      PubDate: 2015-08-25T04:56:49-07:00
      DOI: 10.1177/2051415814522798
      Issue No: Vol. 8, No. 5 (2015)
  • Renal plasmacytoma secondary to multiple myeloma
    • Authors: Moon, A; Bashir, J, Cumming, J.
      Pages: 362 - 363
      PubDate: 2015-08-25T04:56:49-07:00
      DOI: 10.1177/2051415814523954
      Issue No: Vol. 8, No. 5 (2015)
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