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A guide to local anaesthetic transperineal prostate biopsy

In the UK, nearly 100,000 men undergo a prostate biopsy annually, a figure projected to double in the next decade [1]. In recent years, we have observed a paradigm shift in urological practice in numerous UK hospitals. The conventional transrectal,...

MRI targeted transperineal prostate biopsy: a local anaesthetic approach

Transperineal template biopsy remains the gold standard investigation in diagnosis of prostate cancer. Data from the PROMIS study demonstrated the low sensitivity of transrectal ultrasound (TRUS) biopsy as a diagnostic tool, and highlighted the need for a better diagnostic pathway....

Ambulatory local anaesthetic implantation of percutaneous sacral nerve stimulators

Background The current treatment paradigm for detrusor overactivity (DO) and dysfunctional voiding (DV) includes conservative measures, pharmacotherapy, intravesical onabotulinum toxin A (Botox®), sacral nerve modulation (SNM / SNS) and urinary diversion as a last resort [1]. Incidence of DO is...

Theatre utilisation in urology theatres at a UK tertiary referral centre

Introduction The efficient use of operating theatres is important to ensure optimum cost-benefit for the hospital and to clear waiting lists. The key elements in the efficient use of operating theatres are: effective management and good communication, trained staff, appropriate...

Comparison of PCNL under spinal versus general anaesthesia

There are several advantages of performing percutaneous nephrolithotomy (PCNL) under spinal anaesthesia including lower cost, reduced adverse effects and less tracheal tube displacement. Another advantage is that the patient remains awake throughout making positioning easier and reducing the risk of...

Read all about it Sep/Oct 2015

It can be awkward when a patient asks you about a report in their favourite tabloid detailing an amazing research breakthrough or a ‘cutting-edge’ new treatment / test and you don’t know what they are talking about! So this section...

Liquid paraffin versus lidocaine

Topical anaesthetics have been used in urology since 1884, when Pease described using “cocaine in a sensitive urethra with charming results”. Since 1949, 2% lidocaine has been increasingly used intraurethrally for cystoscopy and other procedures. This article is a pilot...

Prilocaine irrigation for pain relief after TURP

Transurethral resection of the prostate (TURP) is one of the commonest procedures undertaken by urologists. There are well known complications following the procedure which commonly include haematuria but also TUR syndrome, failure to pass urine and infections, amongst others. The...

The role of an enhanced recovery protocol in patients undergoing robotic radical cystectomy

Enhanced recovery after surgery (ERAS) protocols are patient pathways designed to reduce surgical stress and accelerate postoperative recovery. Uptake of such protocols in colorectal surgery in particular has been high, however ERAS protocols developed or utilised in urological surgery have...

Age does not impact risk for urethroplasty complications after TIP repair of hypospadias

This paper is evidence of an increasing trend (especially in the USA) to lower the age at which hypospadias repair is undertaken. The current generalised best accepted age to repair hypospadias is between 6-18 months, which was reduced in the...

Establishing a new TPPBx service during the COVID-19 pandemic

COVID-19 had a major impact on our hospital services from early in the pandemic, with almost three times as many patients being ventilated compared to the normal ITU capacity at the beginning of April. During the build-up to this point,...

A greener urology

Healthcare in England is responsible for 4-5% of the country’s carbon footprint which is defined as the amount of greenhouse gasses, primarily carbon dioxide, released into the atmosphere by a particular activity. The six greenhouse gasses which vary in their...