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Journal Cover Journal of Clinical Urology
  [SJR: 0.183]   [H-I: 5]   [17 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  [851 journals]
  • Editorial
    • Authors: Pearce; I.
      Pages: 292 - 292
      PubDate: 2016-08-03T01:52:12-07:00
      DOI: 10.1177/2051415816663827
      Issue No: Vol. 9, No. 5 (2016)
       
  • NICE prostate cancer quality standards
    • Authors: Madaan, S; Reekhaye, A.
      Pages: 295 - 299
      Abstract: Prostate cancer is the most common cancer in men in the United Kingdom. Over 42,000 men are diagnosed with prostate cancer every year. In June 2015, the National Institute for Health and Care Excellence (NICE) finally published five key statements regarding prostate cancer care. The quality standards are mostly derived from the NICE prostate cancer guidelines. In this article, we discuss the development process by the NICE Advisory Committee and highlight the five key priorities proposed by NICE to drive quality improvements in patient safety, patient experience and clinical effectiveness. We also discuss areas for potential improvement to improve the standard of care for men with prostate cancer.
      PubDate: 2016-08-03T01:52:12-07:00
      DOI: 10.1177/2051415816642694
      Issue No: Vol. 9, No. 5 (2016)
       
  • Radiological investigation of haematuria in 2016
    • Authors: Wong, K. Y; Chaudhry, M, Hamm, R, Belfield, J.
      Pages: 300 - 307
      PubDate: 2016-08-03T01:52:12-07:00
      DOI: 10.1177/2051415816659406
      Issue No: Vol. 9, No. 5 (2016)
       
  • Writing a literature review
    • Authors: Winchester, C. L; Salji, M.
      Pages: 308 - 312
      Abstract: Formal literature reviews are a critical appraisal of a subject and are not only an academic requirement but essential when planning a research project and for placing research findings into context. Understanding the landscape in which you are working will enable you to make a valuable contribution to your field. Writing a literature review requires a range of skills to gather, sort, evaluate and summarise peer-reviewed published data into a relevant and informative unbiased narrative. Digital access to research papers, academic texts, review articles, reference databases and public data sets are all sources of information that are available to enrich your review.
      PubDate: 2016-08-03T01:52:12-07:00
      DOI: 10.1177/2051415816650133
      Issue No: Vol. 9, No. 5 (2016)
       
  • Lymph node parameters and complications following laparoscopic extended
           pelvic lymphadenectomy for prostate cancer in 1000 consecutive patients
    • Authors: Eden, C. G; Soares, R, Bott, S. R, Hindley, R. G, McGregor, R. G.
      Pages: 313 - 320
      Abstract: Objective: The purpose of this study was to investigate the short-term results of extended pelvic lymphadenectomy (ePLND) during laparoscopic radical prostatectomy (LRP). Patients and methods: Of 1330 consecutive patients undergoing LRP during a 90-month period 1000 (75%) had an ePLND for d’Amico intermediate- or high-risk prostate cancer. Results: Operating time, blood loss, conversion and transfusion rates and hospital stay were similar in patients having standard pelvic lymphadenectomy (sPLND) and ePLND. Median lymph node count was significantly greater following ePLND vs sPLND (17 vs 6; p
      PubDate: 2016-08-03T01:52:12-07:00
      DOI: 10.1177/2051415816639775
      Issue No: Vol. 9, No. 5 (2016)
       
  • A culture of open reporting results in improved quality of bladder tumour
           resections: a closed loop audit
    • Authors: Ching, D; Anastasiadis, E, Patel, P, Sahu, M, Sandhu, S.
      Pages: 321 - 325
      Abstract: Objective: Bladder cancer is the commonest cancer of the urinary tract. Transurethral Resection of Bladder Tumour (TURBT) is the gold standard for diagnosis and treatment of non-muscle invasive bladder cancer. The absence of muscle in a TURBT specimen is associated with a significantly higher risk of residual disease, early recurrence and tumour under staging. Materials and methods: TURBT and bladder biopsy specimens were examined before and after the introduction of an open reporting system as a quality improvement exercise. All specimens from the 4th quarter (between 2010 and 2014) were examined to determine the effect of open reporting on our inadequate resection rates. Results: A total of 244 cases were performed under the care of 5 consultant urologists. Analysis revealed a significant improvement in quality of both T1 and Ta resections (p=0.04*; p=0.02*) after the introduction of open reporting. The total number of TURBT cases increased per year, however the percentage of inadequate resections has significantly decreased (p=0.02*). Conclusion: Individual reporting provided surgeons with direct, personal and timely feedback on their performance. It did not negatively impact on trainee participation, but led to improved training outcomes. We have demonstrated that our simple intervention has improved quality of patient care.
      PubDate: 2016-08-03T01:52:12-07:00
      DOI: 10.1177/2051415816642695
      Issue No: Vol. 9, No. 5 (2016)
       
  • A comparison of clinical parameters at presentation, pathological outcomes
           and biochemical relapse between NHS and private patients undergoing
           radical prostatectomy at a single centre in the United Kingdom
    • Authors: Robinson, S; Laniado, M, Farooq, A, Motiwala, H, Omar, M, Summers, D, Rao, A, Ali, M, Meiers, I, Karim, O.
      Pages: 326 - 334
      Abstract: Objective: We studied our hypothesis that patients with private health insurance (PHI) with prostate cancer present with more favourable pathological outcomes. Patients and methods: Data were analysed from 554 patients undergoing radical prostatectomy from 2002 to 2010. A total of 328 patients under the NHS and 226 men had PHI. Two groups were compared for age, PSA, Gleason score, number of cores involved, maximum tumour length on biopsy core, socioeconomic status, imaging and pathological outcomes. Results: PHI presented at a younger age (63 vs 61, p = 0.008) and lower mean PSA (9.5 vs 8.04, p = 0.0005). Staging MRI showed a significant difference in usage (77% vs 45% p < 0.001). Importantly there was significant difference in the total tumour volume (4 cc vs 8 cc, p = 0.001). There were significantly more wealthy patients being seen privately (p < 0.0001). However, on the final Cox regression model only grade, stage and insurance status were significant predictors of BCR. Conclusions: Patients with PHI were younger, had a lower presenting PSA and were wealthier. There is a significant difference in the social profile seen, but wealth itself is not protective yet health insurance is. Insurance status and not social status represents a factor in predicting final pathological outcomes after RRP.
      PubDate: 2016-08-03T01:52:12-07:00
      DOI: 10.1177/2051415816646704
      Issue No: Vol. 9, No. 5 (2016)
       
  • Image intensifier X-ray beam collimation and its effect on radiation dose
           during ureteroscopy
    • Authors: Horsburgh, B. A; Babajews, W, Altham, S, Cowan, H.
      Pages: 335 - 339
      Abstract: Objective: This study aims to assess the use of primary X-ray beam collimation during ureteroscopy and its effect on patient radiation dose. Methods: A retrospective review of images and radiation doses of patients undergoing ureteroscopy. Results: The use of primary X-ray beam collimation during ureteroscopy is associated with lower radiation doses to the patient. Only 3% of images had evidence of collimation.
      PubDate: 2016-08-03T01:52:12-07:00
      DOI: 10.1177/2051415816649547
      Issue No: Vol. 9, No. 5 (2016)
       
  • A qualitative analysis of patients reasons for choosing neobladder or
           ileal conduit after cystectomy for bladder cancer
    • Authors: Osborne, L. A; Dixon, C, Edwards, D. J, Begum, R, Younis, A, Lucas, M, Reed, P.
      Pages: 340 - 345
      Abstract: Objective: Choice of reconstruction following bladder removal is often between neobladder or ileal conduit diversion. Identifying patient concerns about this little understood choice should provide better understanding of factors important in making surgical decisions. The current study used a qualitative technique to identify patient concerns and values influencing patient choice of bladder reconstruction following radical cystectomy. Subjects and Methods: Thirty-two patients (neobladder: 11 male, 6 female; ileal conduit: 9 male, 6 female) participated in semi-structured interviews conducted at a Hospital Clinical Research Unit, and their responses were analysed by content analysis. Results: Many procedure and lifestyle factors were secondary to survival considerations. Most patients adapted to reconstruction. Patients chose neobladder because of perceptions of normality and less-restricted activities (including sex life), or chose ileal conduit because of perceived simplicity of this operation, or the fear of urinary incontinence, and extra ‘work’ for the patient involved in having a neobladder. Male and female reasons were consistent with one another, except that body image was a greater issue for females in choosing neobladder. Conclusion: Pre-existing concerns influenced the choice that patients made between undergoing illeal conduit or neobladder reconstruction after removal of their bladder. These findings are a step towards developing a tool to aid joint decision making when planning exenterative and reconstructive surgery for bladder cancer.
      PubDate: 2016-08-03T01:52:12-07:00
      DOI: 10.1177/2051415816650841
      Issue No: Vol. 9, No. 5 (2016)
       
  • Congenital absence of the prostate presenting as primary retrograde
           ejaculation
    • Authors: Gietzmann, W; Magrill, D. S, Symes, A.
      Pages: 346 - 347
      PubDate: 2016-08-03T01:52:12-07:00
      DOI: 10.1177/2051415814548261
      Issue No: Vol. 9, No. 5 (2016)
       
  • A brain lesion as the sole metastasis of prostate cancer
    • Authors: Mithal, P; Gong, Y, Sirkis, H, Aronowitz, J. N.
      Pages: 348 - 350
      PubDate: 2016-08-03T01:52:12-07:00
      DOI: 10.1177/2051415814549204
      Issue No: Vol. 9, No. 5 (2016)
       
  • Ultrasound-guided selective block of the anterior branch of the obturator
           nerve for transurethral resection of bladder tumour
    • Authors: Smith, H; Borowski, W, Bohm, M, Kata, S.
      Pages: 351 - 355
      Abstract: Introduction: Bladder perforation is a serious complication of transurethral resection of bladder tumour (TURBT). One of the risk factors is an "obturator jerk", caused by stimulation of the obturator nerve, causing powerful adduction of the leg. As almost half of all bladder tumours are located on the lateral wall and 55–100% of resections on the lateral wall can result in obturator jerk; this is not an insignificant risk. Patients: We have introduced regional anaesthetic nerve block of the anterior branch of the obturator nerve in patients with known lateral wall tumours undergoing TURBT. Methods: This procedure was performed by two consultant anaesthetists in our unit. Patients are positioned supine with the leg slightly abducted and laterally rotated. Ultrasound (US) is used to identify the anterior branch of the adductor longus, brevis and magnus muscles in the medial thigh, 2–3 cm inferior to the inguinal crease. The obturator nerve is situated in the plane between adductor longus and adductor brevis, medial to pectineus. An insulated needle is passed under US guidance and a nerve stimulator is used to elicit a twitch. Levobupivicaine is used to infiltrate the anterior branch of the obturator nerve to achieve motor block of the adductor brevis, adductor longus and gracillis muscles. TURBT is then performed. Results: This prospective pilot series includes 18 TURBT procedures. These were performed under spinal anaesthetic (n=16) or general anaesthetic without muscle relaxant (n=2). Tumours characteristics were; large flat areas of re-resection (n=5), flat bladder lesions (n=1) or exophytic lesions (n=12). There were no incidences of obturator jerk observed during TURBT (0/18). There were no intra or post-operative complications. Conclusion: This simple technique can be easily applied to patients undergoing TURBT. Larger studies are required, but our series supports the use of this technique to reduce obturator jerk, which is an important risk factors for bladder perforation.
      PubDate: 2016-08-03T01:52:12-07:00
      DOI: 10.1177/2051415816632076
      Issue No: Vol. 9, No. 5 (2016)
       
 
 
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