A Prospective Multi-institutional Study Using a Novel Safety Valve for the Prevention of Catheter Balloon Inflation Injury of the Urethra.

Purpose: We prospectively assessed the ability of a novel transurethral catheterization safety valve to prevent urethral catheter balloon injury in a multi-institutional clinical setting.

Materials And Methods: A prospective, multi-institution study was conducted. The safety valve was introduced for urinary catheterization in 6 hospital groups (4 in Ireland; 2 in the UK).

Renal cell carcinoma presenting as painless jaundice and unintentional weight loss.

Painless jaundice and unexplained weight loss is an exceedingly rare presentation for renal cell carcinoma (RCC). Such a presentation is more typical of a hepatocellular pathology. Stauffer syndrome is a paraneoplastic syndrome seen in RCC and is characterized by deranged hepatic enzymes and in association with fever, fatigue and weight loss.

The psychological impact of adverse events on urology trainees.

Introduction: Adverse events (AE) are an inevitable reality in healthcare, with an incidence of 7.5-14.1% worldwide.

A Prospective Multi-Institutional Evaluation of Iatrogenic Urethral Catheterization Injuries.

Objectives: To perform a multi-institutional investigation of incidence and outcomes of urethral trauma sustained during attempted catheterization.

Patients & Methods: A prospective, multi-center study was conducted over a designated 3-4 month period, incorporating seven academic hospitals across the UK and Ireland. Cases of urethral trauma arising from attempted catheterization were recorded.

Laparoscopic left hemi-nephroureterectomy for a patient with suspected urothelial carcinoma in a horseshoe kidney.

A 76-year-old gentleman with a background of benign prostatic hyperplasia, hiatus hernia and anxiety was referred to the rapid access haematuria service following an episode of painless visible haematuria. Flexible cystoscopy did not reveal any concerning bladder lesions. CT Urogram demonstrated a horseshoe kidney with a filling defect in the left upper pole moiety suspicious for an urothelial carcinoma.

Assessment of the workload and financial burden of Bosniak IIF renal cyst surveillance in a tertiary referral hospital.

Background: The Bosniak classification is a CT classification which stratifies renal cysts based on imaging appearances and therefore associated risk of malignancy. Bosniak IIf cysts are renal which have complex features and therefore require surveillance.

Aims: The aim of this study is to assess the economic and workload burden of diagnosing and following up Bosniak IIf cysts on the urology service in a tertiary hospital in the West of Ireland.

Where are the paediatric patients with testicular torsion during the COVID-19 pandemic?

Introduction: The Irish people were put on lockdown in mid-March 2020 due to concern of the spread of coronavirus. With these societal changes came a notable reduction in emergency department attendance. Our aim was to analyse emergency urological procedures performed during the COVID-19 era versus the previous year.

Evaluation of a new disposable flexible ureterorenoscope and comparison to an established disposable flexible ureterorenoscope: a prospective, observational study.

Purpose: To objectively and subjectively assess the performance and surgical outcomes of the new Innovex EU-scope™ single-use digital flexible ureteroscope (fURS).

Methods: A prospective cohort study was carried out (August 2019 to May 2020). The new single-use fURS (Innovex Medical Devices Co.

Strategies to maximise patient comfort during extracorporeal shockwave lithotripsy - A randomised controlled trial.

Background/purpose Of Study: We aim to assess if distraction techniques improve patient comfort tolerability of SWL.

Methods: We carried out a prospective randomised controlled trial of SWL-naïve patients attending for treatment. Patients were randomised into three groups and offered oral analgesia as standard of care.

Biopsy at flexible cystoscopy: is it worthwhile?

Introduction: Flexible cystoscopy is the gold standard for diagnosis and surveillance of bladder carcinoma. Most flexible cystoscopes feature a working channel allowing for bladder biopsy and diathermy if a suspicious lesion is observed. However, the working channel permits only small instruments which limit the volume of material retrieved for histological analysis.

Is Movember synonymous with moustaches or men's health? An examination of internet search activity for prostate and testicular cancer during the campaign.

Background: The Movember campaign encourages men to grow a moustache during the month of November. The campaign's aims include promotion of prostate and testicular cancer awareness.

Aims: To examine the effectiveness of the Movember campaign at generating awareness of prostate and testicular cancers by examining Internet search activity.

Outcomes from the Introduction of a Combined Urology Outpatient Clinic.

Background: A combined urology clinic staffed by four consultants and four non-consultant hospital doctors (NCHDs) was introduced in our institution in October 2015. This clinic is supported by a pre-clinic radiology meeting and a synchronous urology clinical nurse specialist (CNS) clinic with protected uroflow/trial of void slots. Herein, we report on the outcomes of this clinic in comparison with the standard format of urology outpatient review.

Parental awareness of testicular torsion amongst Irish parents.

Purpose: Testicular torsion is the most concerning underlying cause of acute scrotal pain that can lead to loss of the affected testicle. Whether a torted testicle can be salvaged surgically is directly affected by prompt presentation and diagnosis. This study aims to evaluate the awareness of testicular torsion amongst Irish parents and evaluate their response to a potential torsion.

Prospective randomised controlled trial of written supplement to verbal communication of results to patients at the time of flexible cystoscopy.

Purpose: This trial assessed if written information on procedural findings and subsequent treatment improved understanding and reduced anxiety among patients undergoing day case flexible cystoscopy (FC).

Methods: Participants completed pre- and post-procedure questionnaires self-rating anxiety and feeling well informed on 5-point Likert scales. Supplemental written information was provided after FC to half the patients on a standardized template, according to randomized allocation.

Radiation dosing in the investigation and follow-up of urolithiasis: Comparison between historical and contemporary practices.

Purpose: Computed tomography (CT) is the gold standard imaging modality for the diagnosis and follow-up of urolithiasis. Before the use of CT, intravenous urography (IVU) was the imaging modality of choice. CT remains contentious because of the cancer risk related to radiation exposure above a threshold level.

Acute urinary retention and the difficult catheterization: current emergency management.

Acute urinary retention (AUR) is a common presentation to emergency departments. This article updates the reader on the appropriate management, investigations and guidelines for AUR. It looks at the mechanism of normal micturition and describes the theories of AUR.

Renal track creation for percutaneous nephrolithotomy: the history and relevance of single stage dilation.

Introduction: Percutaneous nephrolithotomy (PCNL) was described in the 1980s and revolutionized the treatment of stone disease. The crucial component to this surgery is satisfactory track creation. We examine how the development and production in the 1980s of a single stage dilator (SSD) subsequently modified for pediatric PCNL has become the ideal access tool for mini percutaneous nephrolithotomy (mPCNL) today.

Renal colic: current protocols for emergency presentations.

Flank pain caused by renal colic is a common presentation to emergency departments. This paper reviews the acute clinical assessment of these patients, outlines appropriate diagnostic strategies with labwork and imaging and updates the reader on conservative treatments, suitable choices for analgesia and indications for surgical intervention. Prompt diagnosis and appropriate treatment instituted in the Emergency Department can rapidly and effectively manage this excruciatingly painful condition.

Testicular torsion and the acute scrotum: current emergency management.

The acute scrotum is a challenging condition for the treating emergency physician requiring consideration of a number of possible diagnoses including testicular torsion. Prompt recognition of torsion and exclusion of other causes may lead to organ salvage, avoiding the devastating functional and psychological issues of testicular loss and minimizing unnecessary exploratory surgeries. This review aims to familiarize the reader with the latest management strategies for the acute scrotum, discusses key points in diagnosis and management and evaluates the strengths and drawbacks of history and clinical examination from an emergency perspective.

Paediatric sutureless circumcision--an alternative to the standard technique.

Introduction: Circumcision is one of the most commonly performed surgical procedures in male children. A range of surgical techniques exist for this commonly performed procedure. The aim of this study is to assess the safety, functional outcome and cosmetic appearance of a sutureless circumcision technique.

Septic shock due to Fournier's gangrene of the scrotum.

A 57-year-old morbidly obese (160 kg) man presented with a 12 h history of severe bilateral scrotal pain and swelling. His scrotum was erythematous, with cellulitis advancing superiorly along the anterior abdominal wall. He was in septic shock.

The treatment of vesicovaginal fistula by endoscopic injection of fibrin glue.

Creation of a vesicovaginal fistula (VVF) is a complication seen in a variety of patients from prolonged labour and elective hysterectomies to advanced gynaecological malignancies. Causing distressing symptoms such as a loss of continence and vulval excoriation, conventional teaching has always advocated an open surgical approach as described by Sims in 1852. This however may not be feasible in cases of advanced malignancy or attractive to the post-operative patient.