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Demanding cases or nightmares in endourology? May/June 2017

In the sixth article in this series the authors describe endourology nightmares involving ileal conduits and calculi. Case 1 A 69-year-old man who had a cystectomy and ileal conduit for muscle invasive bladder cancer, presented with an acute kidney injury...

Factors associated with post ureteroscopy urosepsis

The authors investigate which factors were most likely to increase the risk of postoperative urosepsis within 28 days of ureteroscopy (URS) and laser stone fragmentation by analysing the 34 of 562 patients who developed this complication. Stone size, same session...

Effect of collimation on radiation dose during ureteroscopy

Over 60,000 ureteroscopies are performed annually in the UK. During these procedures radiation is used and there are concerns regarding the cumulative dose during a surgeon’s career. Common ways to minimise the dose to the theatre team are wearing lead...

Kidney stone basketing forces unmasked

Ureteral avulsion is the most dreaded situation for any urologist to be faced with. Although uncommon, with rates of ureteroscopy on the increase, the potential for this serious complication should also be recognised. To avoid such serious complications, smart devices...

A negative ureteroscopy for stone disease: is it acceptable and is it avoidable?

Urinary tract stone disease and the consequent demand for endoscopic intervention in the upper urinary tract is an increasing phenomenon [1]. Although ureteroscopy is generally considered to be associated with low morbidity [2], risks do exist. Recognised complications include urothelial...

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...

ESWL and URS for treatment of paediatric urolithiasis

Tejwani et al. have undertaken a comparative effectiveness study to characterise differences in procedure frequency, postoperative re-admissions and emergency room (ER) visits, and repeat treatment rates for children (≤18 years) with urolithiasis who underwent initial intervention with extracorporeal shock wave...

Worldwide flexible ureteroscopy practice uncovered

While guidelines recommend flexible ureteroscopy (fURS) for treating renal stones <1.5cm, considerable differences exist among urologists in the technique, use, and indications of fURS. In 2014, the Endourology Society set out to explore the differences in the fURS technique and...

Sustainable healthcare: what steps can urologists take?

Human health is intrinsically linked to environmental health, making the ever-pressing climate crisis fundamentally a public health emergency. The healthcare sector is responsible for 8% of the UK’s greenhouse gas (GHG) emissions worldwide [1]. As the largest publicly funded healthcare...

Rethinking stone-free rates and surgical outcomes in endourology

Retrograde intrarenal surgery (RIRS) and percutaneous nephrolithotomy (PCNL) are two key minimally invasive treatments for kidney stones in both adults and children. The success of these procedures is primarily measured by two factors: (1) the absence of complications and (2)...

Clinical visit for PCNL experience: Agra, India

In September 2015, I travelled to India for a two-week clinical visit with Professor Madhu Sudan Agrawal at the Global Rainbow Hospital, Agra. Having completed my training I wanted to further develop my skills with PCNL, particularly with regards to...

A new treatment algorithm for ureteral fibroepithelial polyps in children

Fibroepithelial polyps are rare in the urinary tract (found in 0.5% of all paediatric pyeloplasties and 5% of all cases of paediatric ureteral obstruction). The advent of ureteroscopy in paediatrics has increased the identification and treatment of these. This paper...