Reducing the rate of negative ureteroscopy: predictive factors and the role of preoperative imaging.

Introduction: The aim of this study was to investigate factors that may predict a negative ureteroscopy (URS) performed for ureteric calculi in prestented patients and to assess preoperative imaging in reducing the rate of negative URS.

Methods: Data were collected on emergency stent placement for a ureteric calculus from April 2011 to February 2016 (Group A) and October 2016 to October 2019 (Group B). Data included patient demographics, indication for a stent, stone characteristics, baseline bloods, urine culture, readmission, negative URS rate and the use of pre-URS imaging.

Laparoscopic Repair of Catheter-Induced Intra-Peritoneal Bladder Perforation.

Urinary bladder is the most common urologic organ exposed to iatrogenic injury. The bladder trauma is classified into extra-peritoneal, intra-peritoneal, or combined trauma. Intra-peritoneal bladder injury is conventionally being treated with open surgical repair, mainly to explore the abdominal viscera for possible associated injuries and to insert peritoneal drain.

Single centre versus multi-centre pooled morbidity data in PCNL and the implications for informed consent.

National and international outcome data following PCNL have been available for many years, but multi-centre data may not reflect the outcome from an individual surgeon or hospital. A combination of retrospective and prospective single centre data was collated from 2000-2016 and are compared to large single and multi-centre series. Data were available on 801 unique cases performed between 2000 and 2016, mean age = 55.

The diagnostic yield of computed tomography in the management of acute flank pain and the emergency intervention rate for a proven acute ureteric stone.

Introduction: The diagnostic and management pathways for patients presenting with acute flank pain are complex. Although computed tomography (CT) of the kidneys, ureters and bladder (KUB) is the gold standard investigation for urolithiasis, the multitude of differential diagnoses must also be considered in the context of long-term risk from ionising radiation. This study investigated the integrated role and diagnostic yield of non-contrast CT in cases of acute flank pain.

Combined antegrade and retrograde access to difficult ureters: revisiting the rendezvous technique.

Introduction: Complex ureteric strictures present a significant challenge to the endourologist and uro-radiologist. Multiple separate interventions to try to cross the stricture are often attempted. We describe our experience managing a heterogenous patient group using the 'rendezvous' procedure.

Ureteroscopy in the diagnosis of upper tract transitional cell cancer: a 10-year experience providing outcome data for informed consent.

Purpose: The aim of the study was to assess the effectiveness of ureteroscopy and biopsy in the diagnosis and management of upper tract urothelial carcinoma.

Methods: We retrospectively collated data from pathology, radiology and operating theatre data sets from two large UK hospitals. During the 10-year period examined, 160 patients underwent ureteroscopy prior to nephro-ureterectomy (NU)/distal ureterectomy (DU).

Limiting radiation exposure during percutaneous nephrolithotomy.

Background And Purpose: An increase in the prevalence of urologic stone disease and the refinement of endourologic techniques has seen a concomitant rise in the use of fluoroscopy during surgery. As such, there has been increasing concern in regard to the intraoperative radiation exposure to both clinicians and patients. The objective of the study was to audit contemporary data on radiation exposure during percutaneous nephrolithotomy (PCNL), in comparison with published series, and demonstrate that relatively low levels are achievable with clinical vigilance and attention to technique Methods: A retrospective analysis was performed of all PCNLs undertaken between July 2005 and December 2011.

Blood transfusion, embolisation and nephrectomy after percutaneous nephrolithotomy (PCNL).

Unlabelled: WHAT'S KNOWN ON THE SUBJECT? AND WHAT DOES THE STUDY ADD?: Percutaneous treatment for renal stone disease is associated with a risk of significant morbidity. Our large UK series provides contemporary data on the risk of vascular complications and admission to the Intensive Care Unit (ICU) after PCNL. When compared with recent international databases, these data support the current evidence that better outcomes can be achieved in centres performing large numbers of procedures.

Trends in urological stone disease.

Objective: To summarize the changes in prevalence and treatment of upper urinary tract stone disease in the UK over the last 10 years.

Methods: Data from the Hospital Episode Statistics (HES) website (http://www.hesonline.

The difficult ureter: what is the incidence of pre-stenting?

Introduction: Difficulty may be encountered with retrograde access for rigid and flexible ureterorenoscopy (URS) due to anatomic abnormalities, a narrow ureteric lumen, tortuous ureteric path or previous instrumentation. Ureteric dilatation using a balloon or tapered dilator can occasionally fail and will usually lead to the placement of a ureteric stent. We present our experience and incidence of pre-stenting after failed standard access and dilatation techniques, the aim being to quote a figure for the patient at the time of consent.

A comparative study of quality of life issues relating to open versus laparoscopic nephrectomy: a prospective pragmatic study.

Purpose: We determined whether laparoscopic nephrectomy confers improved health related quality of life in the early postoperative period compared with open nephrectomy.

Materials And Methods: Patients undergoing open or laparoscopic nephrectomy were prospectively recruited. Patients completed the Comorbidity Symptom Scale preoperatively as well as the SF-36(R) quality of life health survey and pain visual analog scale preoperatively, and 2 days and 1 month postoperatively.

A randomized controlled trial of nephrostomy placement versus tubeless percutaneous nephrolithotomy.

Purpose: We established whether totally tubeless percutaneous nephrolithotomy with no nephrostomy or ureteral stent is a safe management technique.

Materials And Methods: Patients were randomized to have a nephrostomy placed (group 1 control) or none (group 2 treatment). A total of 25 patients were randomized to each group.

Clostridium difficile in urology.

Introduction: The objective was to determine the incidence of Clostridium difficile infection in a UK urology ward from 2000 to 2005, and correlate and compare the data with other specialty wards and national figures.

Patients And Methods: Urology patients with a positive stool culture for C. difficile between 2000 and 2005 were identified from a hospital database.

Totally tubeless percutaneous nephrolithotomy.

Purpose: To establish if totally tubeless percutaneous nephrolithotomy (PCNL) is a safe management technique. PCNL is a well-established option for upper tract stones. The procedure traditionally concludes with the placement of a nephrostomy drainage tube but in those patients in whom there has been minimal blood loss and complete stone clearance, it may not be necessary to place a nephrostomy.

Management of renal stone disease in obese patients.

Obesity represents an increasing burden to health care resources. Nephrolithiasis is associated with obesity and type 2 diabetes and the consumption of diets rich in protein, fat and carbohydrates; this article addresses some of the pathophysiological mechanisms associated with stone formation in these patients. Management of stone disease can be more difficult in obese patients; even diagnosis can be problematic because imaging techniques are less sensitive in these patients.

Day-case rigid and flexible ureteroscopy.

Introduction: The aim of this study was to evaluate the feasibility of rigid and flexible ureteroscopy as a day-surgery procedure.

Patients And Methods: All patients requiring elective ureteroscopy from March 2004 were considered for a day-surgery procedure. The standard day-surgery exclusions existed but there were no urological criteria for exclusion.