Alan McNeill

Complications of endoscopic extraperitoneal radical prostatectomy (EERPE): prevention and management

Endoscopic extraperitoneal radical prostatectomy (EERPE) is a further advancement of minimal invasive surgery as it overcomes the limitations of laparoscopic (transperitoneal) RPE by the strictly extraperitoneal route of access combining the advantages of minimal invasive surgery with the advantages of an extraperitoneal procedure. Endoscopic extraperitoneal radical prostatectomy has many advantages but is not without complications. The aim of this review article is to describe the most common complications of this procedure. Complications associated with endoscopic extraperitoneal radical prostatectomy are: vascular injury—bleeding—haematoma, bowel injury, lymphocele, injury to the bladder—ureter, port site hernia, anastomotic leakage—stricture, obturator nerve injury—paralysis, gas embolism, catheter blockage, and miscellaneous like perineal pain, pubic osteitis, infection- urosepsis. The present review paper focuses on the identification and management of these complications The incidence of most complications directly correlates with the surgeons’ experience, and the various complications are related to technical errors rather than to the technique itself. The laparoscopist performing endoscopic/ laparoscopic radical prostatectomy should be aware of all these complications. He should be able to recognise promptly, treat efficiently, and ideally prevent these complications.

Elasticity as a biomarker for prostate cancer: a systematic review

To systematically review the range of methods available for assessing elasticity in the prostate and to examine its use as a biomarker for prostate cancer.

Laparoscopic nephroureterectomy for upper tract transitional cell carcinoma: a critical appraisal

Two of the mini‐reviews in this issue evaluate the laparoscopic approach to urology; one critically appraising laparoscopic nephroureterectomy for upper tract TCC, and the other looking back on the first 10 years of laparoscopic pyeloplasty. They are also a testament to the relationship which has developed between the effects of British urologists in becoming experts in this area, and the outstanding help and supervision given by Inderbir Gill and his team at the Cleveland Clinic. The financial backing for this venture came from the British Urological Foundation, which enthusiastically supports the concept of this preceptorship at the Cleveland Clinic.

Prostate size influences the outcome after presenting with acute urinary retention

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Elasticity as a biomarker for prostate cancer

To systematically review the range of methods available for assessing elasticity in the prostate and to examine its use as a biomarker for prostate cancer.

The economic impact of using alfuzosin 10 mg once daily in the management of acute urinary retention in the UK: a 6-month analysis

To calculate the economic consequences of using alfuzosin 10 mg once daily for managing acute urinary retention (AUR) related to benign prostatic hyperplasia (BPH).

Minimally invasive nephron‐sparing surgery for renal cell cancer

factors. Examples include renal calculus disease, chronic pyelonephritis, diabetes mellitus, and Von Hippel–Lindau disease. Elective indications include a small ( ≤ 4 cm) renal tumour in the presence of a normal opposite kidney. Short-term disadvantages of open NSS include the morbidity of the open incision, greater blood loss, urine leak and potential for re-exploration (Table 1) [4,6–9], whilst in the long term there is a small risk of ipsilateral disease recurrence. Decisive factors in the elective setting include surgeon experience, size and position of tumour, comorbidity, and patient preference.

Anaesthetic considerations for endoscopic extraperitoneal and laparoscopic transperitoneal radical prostatectomy.

We focus on the anaesthesiology and requirements for minimally invasive procedures for treating localized prostate cancer. The management of anaesthesia for laparoscopic and endoscopic radical prostatectomy (RP) can be more complex than expected. Numerous groups, especially early in their experience, have had problems (e.g. hypercarbia) with the anaesthesiology of the procedure. Co‐operation between the surgeon and the anaesthesiologist is of paramount importance for a safe and effective laparoscopic or endoscopic RP. Nevertheless, the relative anaesthetic equipment and trained personnel should be available before embarking on such technically proficient procedures.

Endoscopic extraperitoneal radical prostatectomy: critical analysis of outcomes and learning curve.

Study Type – Therapy (case series)
Level of Evidence 4

Acute urinary retention in men: The risks and outcomes with medical therapy

This paper is restricted to the discussion of the relatively modern disorder of sudden painful inability to urinate in older men. It was not a common medical problem until the 19th century when, in developed countries, male life expectancy increased to beyond 60 years; it remains an uncommon problem in those developing countries where male life expectancy remains low, particularly in some sub-Saharan African countries where male life expectancy is only 44.8 years.