Cost-effectiveness of a novel urethral catheter safety device in preventing catheterization injuries in the UK.

Aims: Intraurethral catheter balloon inflation is a substantial contributor to significant catheter-related urethral injury. A novel safety valve has been designed to prevent these balloon-inflation injuries. The purpose of this evaluation was to assess the cost-effectiveness of urethral catheterisation with the safety valve added to a Foley catheter versus the current standard of care (Foley catheter alone).

Outcome of acute epididymo-orchitis: risk factors for testicular loss.

Purpose: Acute epididymo-orchitis (AEO) is a common urological condition characterised by pain and swelling of the epididymis which can affect men of any age. The aetiology and to some extent the management of the patient differ between paediatric and young and older adult groups.

Methods: A retrospective analysis was performed at the University Hospital Limerick from 2012 to 2016.

Mechanical and morphological characterisation of porcine urethras for the assessment of paediatric urinary catheter safety.

Paediatric urinary catheters are often necessary in critical care settings or to address congenital anomalies affecting the urogenital system. Iatrogenic injuries can occur during the placement of such catheters, highlighting the need for a safety device that can function in paediatric settings. Despite successful efforts to develop devices that improve the safety of adult urinary catheters, no such devices are available for use with paediatric catheters.

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.

The recurrent urinary tract infection health and functional impact questionnaire (RUHFI-Q): design and feasibility assessment of a new evaluation scale.

Introduction: We aim to design a tool to assess the impact of recurrent urinary tract infection (rUTI) on quality of life (QoL) in adult women, given the notable absence of an established instrument for this purpose.

Materials And Methods: Best practice guidelines in health-related survey design were reviewed. A literature review informed creation of an interview guide.

Cryopreservation of porcine urethral tissue: Storage at -20°C preserves the mechanical, failure and geometrical properties.

Cryopreservation is required to preserve the native properties of tissue for prolonged periods of time. In this study, we evaluate the impact that 4 different cryopreservation protocols have on porcine urethral tissue, to identify a protocol that best preserves the native properties of the tissue. The cryopreservation protocols include storage in cryoprotective agents at -20 °C and -80 °C with a slow, gradual, and fast reduction in temperature.

Stress Urinary Incontinence and Pelvic Organ Prolapse: Biologic Graft Materials Revisited.

Symptomatic stress urinary incontinence (SUI) and pelvic organ prolapse (POP) refractory to conservative management with pelvic floor muscle training or vaginal pessaries may warrant surgical intervention with different forms of biologic or synthetic material. However, in recent years, several global regulatory agencies have issued health warnings and recalled several mesh products due to an increase in complications such as mesh erosion, infection, chronic pain, and perioperative bleeding. At present, current surgical treatment strategies for SUI and POP are aimed at developing biological graft materials with similar mechanical properties to established synthetic meshes, but with improved tissue integration and minimal host response.

Significance of spermatic cord invasion in radical inguinal orchidectomy: Will a modified subinguinal orchidectomy suffice?

Introduction And Objectives: Radical inguinal orchidectomy with ligation and division of the spermatic cord at the deep inguinal ring is the treatment of choice for testicular mass suspicious of cancer. In the era of organ preserving and minimally invasive surgery, it may be possible to propose a less radical sub-inguinal orchidectomy that may avoid the morbidity associated with opening the inguinal canal. The effect of this approach on oncological margins is not known.

The Effect of Bladder Filling Rate on the Voiding Behavior of Patients with Overactive Bladder.

Purpose: Many self-help guides advise patients that spreading fluid intake throughout the day can reduce overactive bladder symptoms. However, although animal studies suggest a link between a faster filling rate and increased afferent nerve firing, to our knowledge the relationship between the filling rate and bladder sensation has not been examined in humans. The aim of this study was to investigate the effect of bladder volume and the bladder filling rate on the bladder sensation and voiding patterns of patients with overactive bladder.

Direct mechanical characterization of prostate tissue-a systematic review.

Background: Direct mechanical characterization of tissue is the application of engineering techniques to biological tissue to ascertain stiffness or elasticity, which can change in response to disease states. A number of papers have been published on the application of these techniques to prostate tissue with a range of results reported. There is a marked variability in the results depending on testing techniques and disease state of the prostate tissue.

Bladder neck placement of a synthetic polypropylene sling for the treatment of stress urinary incontinence.

Introduction: Pubo-vaginal sling placed at the bladder neck is the gold standard treatment for stress urinary incontinence (SUI). The synthetic mid-urethral sling (MUS) is now widely used, as morbidity rates with this technique are substantially reduced. This is an initial report on long-term outcomes of a polypropylene sling (PPS) placed in the traditional bladder neck location.

Patient experience after transperineal template prostate biopsy compared to prior transrectal ultrasound guided prostate biopsy.

Introduction: Transperineal template prostate biopsy (TTPB) is reported to have higher cancer detection and lower complication rate compared to transrectal ultrasound guided prostate biopsy (TRUSPB).However, there is no report of the same patient's experience with both types of biopsy.To compare the patient reported experience in the same cohort of patients who underwent both TRUSPB and TTPB, using validated questionnaires.

Life expectancy calculation in urology: Are we equitably treating older patients?

Introduction: The aim of our study was to determine the contemporary practice in the utilization of life expectancy (LE) calculations among urological clinicians.

Material And Methods: Members of the Irish Society of Urology (ISU) and the British Association of Urological Surgeons (BAUS) completed a questionnaire on LE utilization in urological practice.

Results: The survey was delivered to 1251 clinicians and the response rate was 17% (n = 208/1251).

Hospital burden of long-term genitourinary and gastrointestinal toxicity after radical radiotherapy for prostate cancer.

Introduction: Treatment options for prostate cancer (PCa) include radical radiotherapy (RT) and radical prostatectomy, both of which have comparable oncological outcomes. The aim of this study was to investigate the hospital burden of long-term genitourinary and gastrointestinal toxicity among patients with PCa who were treated with radiotherapy at our institution.

Methods: The radiotherapy department database was used retrospectively to identify all patients who underwent radiotherapy for PCa from January 2006 to January 2008.

Increasing detection of significant prostate cancer in younger men - ten year trends in prostate cancer risk profile in the Mid-West of Ireland.

Introduction: Although PSA (prostate specific antigen) based screening for prostate cancer (PCa) is controversial, an increasing number of men are undergoing Transrectal Ultrasound Guided prostate biopsy (TRUSPB) through primary care-based PSA testing and referral to hospitals. The aim of our study was to investigate presenting risk profiles of PCa over the last decade in a cohort of men in Ireland and to examine any change in the same over this time period.

Material And Methods: The hospital patient administration system was analysed for patients who underwent TRUSPB from January 2005 to December 2015.

The role of reconstructive surgery in patients with end-stage interstitial cystitis/bladder pain syndrome: is cystectomy necessary?

Introduction: Interstitial cystitis is a debilitating condition that has a profound effect on quality of life. Although many approaches to treatment have been explored, no consistently effective treatment has been identified. Reconstructive surgery is offered to patients with refractory IC/BPS; however, expert opinion is divided as to whether simultaneous cystectomy is necessary to achieve symptomatic cure.

Comparative effectiveness of adrenal sparing radical nephrectomy and non-adrenal sparing radical nephrectomy in clear cell renal cell carcinoma: Observational study of survival outcomes.

Introduction: We compare the survival outcomes of patients with clear cell renal cell carcinoma (RCC) treated with adrenal sparing radical nephrectomy (ASRN) and non-adrenal sparing radical nephrectomy (NASRN).

Methods: We conducted an observational study based on a composite patient population from two university teaching hospitals who underwent RN for RCC between January 2000 and December 2012. Only patients with pathologically confirmed RCC were included.

Experience with sliding-clip splenorrhaphy for splenic injury during radical nephrectomy.

Introduction: We report our experience with sliding-clip splenorrhaphy (SCS), a novel splenic conservation technique, for iatrogenic splenic injury (ISI) during a left radical nephrectomy (RN). We also reviewed the literature on ISI.

Methods: We retrospectively reviewed data from patients who had RN between January 2005 and December 2013 at our institution.

Are Adult Ureteroscopes Safe in the Management of Urolithiasis in a Pediatric Population?

Introduction: Debate remains regarding the optimal caliber of ureteroscopes in the management of pediatric urolithiasis, ranging from pediatric scopes to standard scopes. The aim of this study was to assess the safety and efficacy of stone management in a pediatric population using standard adult ureteroscopes.

Methods: A retrospective review of all ureteroscopic procedures in patients under the age of 16 years was carried out.

On-table urethral catheterisation during laparoscopic appendicectomy: Is it necessary?

Introduction: Laparoscopic appendicectomy (LA) is the most commonly performed surgical emergency procedure. The aim of this study was to highlight a series of iatrogenic bladder injuries during LA and suggest a simple method of prevention.

Methods: A retrospective review was carried out of all LA performed in a university teaching hospital over a two year period 2012-2013.

YouTube as an educational tool regarding male urethral catheterization.

Objective: Urethral catheterization (UC) is a common procedure carried out on a daily basis. The aims of this study were to assess the quality of YouTube as an educational tool regarding male UC and to assess the experience of newly qualified doctors regarding UC.

Materials And Methods: YouTube was searched for videos containing relevant information about male UC.

Filling the void: a case of sepsis following the injection of a penile bulking agent.

Many cosmetic procedures are now performed by non-medical personnel. Owing to the wide coverage of aesthetic procedures by the media, patients may be less informed of the serious complications that can be seen when impure materials are injected by less-skilled practitioners. The authors present a case of sepsis following the injection of a non-medical grade penile bulking agent.

Evaluation of xenogenic extracellular matrices as adjuvant scaffolds for the treatment of stress urinary incontinence.

Introduction And Hypothesis: Tissue-engineered biomaterials have shown recent promise as adjuvant scaffolds for treating stress urinary incontinence (SUI). The objective of the present study was to compare their mechanical and regenerative properties with synthetic biomaterials in this urogynaecological setting.

Methods: The biomechanical properties of polypropylene (Serasis®; n = 12), four-ply urinary bladder matrix (UBM; n = 12) and four-ply small intestinal submucosa (SIS; n = 12) were determined with uni-axial tensile testing protocols and compared with stress-strain curves.

Ureteric obstruction due to fungus-ball in a chronically immunosuppressed patient.

Candida albicans is a fungus that can cause opportunistic urinary tract infections in immunocompromised patients. Disseminated fungaemia secondary to Candida albicans is associated with considerable mortality and therefore merits aggressive treatment. Diagnostic investigations for urosepsis and disseminated fungaemaia secondary to Candida albicans include positive urine and blood cultures.