Best Practice archive for 2023
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,...
A sigma six approach to improving nephrostomy and antegrade stent services at a district general hospital – an audit project
As hospitals merge into larger trusts there becomes a centralisation of some services. Interventional radiology (IR) has been one of those services. Our district general hospital runs bi-weekly lR lists following service centralisation. Urology and IR most commonly liaise on...
The importance of active investigation and follow-up in bladder injury
Bladder injury (BI) is uncommon, and patients are typically managed by large multidisciplinary teams, dealing concomitantly with other injuries or diagnoses. BI can be categorised by cause (traumatic vs. iatrogenic) or anatomical location (intraperitoneal vs. extraperitoneal), requiring differing approaches to...
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...
Developing a risk calculator to predict cancer in patients with haematuria: The IDENTIFY Study
Patients with haematuria require investigations to rule out urinary tract cancer. We know that the most common cancer found during these investigations is bladder cancer, whereas upper tract cancers such as renal cell carcinoma and upper urinary tract urothelial cancer...
Intelligent triage: improving outpatient efficiency
Background Improving outpatient (OP) efficiency and service structure is of paramount importance as the NHS seeks to manage ever increasing demand in the wake of the COVID-19 pandemic. As we re-establish services and attempt to clear the backlog, new ways...
