P. H. O'reilly

The long-term results of Anderson-Hynes pyeloplasty

Objectives To examine the durability of open pyeloplasty for pelvi‐ureteric junction obstruction.

Priapism in sickle-cell disease; incidence, risk factors and complications: an international multicentre study

Objective  To define the incidence, risk factors and complications of priapism in a large population of patients with sickle‐cell anaemia in five centres in the UK and Nigeria, as priapism is common among these patients, but the precise characteristics of the condition in this population are poorly documented.

Periprostatic nerve block gives better analgesia for prostatic biopsy.

Objective  To prospectively compare two local anaesthetic techniques for prostatic biopsies, which are usually taken with no anaesthesia; because multiple biopsy techniques are becoming more common and there is an increasing need for analgesia/anaesthesia during the procedure.

Early prostate cancer – which treatment do men prefer and why?

Study Type – Preference (prospective cohort)
Level of Evidence 1b

Standardization of the renogram technique for investigating the dilated upper urinary tract and assessing the results of surgery

To recommend a standard technique for the renographic evaluation of the dilated upper urinary tract, and for evaluating the results of surgery.

Extracorporeal shock wave therapy in the management of Peyronie's disease: initial experience

Objective To evaluate prospectively the efficacy of extracorporeal shock wave therapy (ESWT) as a conservative treatment for Peyronies disease.

Management of acute urinary retention secondary to benign prostatic hyperplasia in the UK: a national survey.

To analyse current practice in the management of acute urinary retention (AUR) secondary to benign prostatic hyperplasia (BPH) in the UK, and to assess how much of this is evidence‐based.

The choice of timing for diuresis renography : the F+0 method

Objective To investigate a method of diuresis renography where the radiopharmaceutical and frusemide (diuretic) are given simultaneously, in contrast to conventional renography which involves an intravenous injection with frusemide 20 min after administering the radiopharmaceutical (F+20) or 15 min before (F−15), with particular interest in the effect of this change on assessing split renal function and interpreting upper tract drainage dynamics.

Prostatic manipulation has a minimal effect on complexed prostate‐specific antigen levels

Objective To assess the effect of prostatic manipulation on complexed prostate‐specific antigen (cPSA), as various forms of prostatic manipulation are known to increase the serum free and total PSA level.

The ‘2-Week Wait’ Rule for Referrals for Suspected Urological Cancers – Urgent Need for Refinement of Criteria

INTRODUCTION All NHS-suspected cancers should be seen within 2 weeks of referral and are referred under government guidelines (Health Service Circular 205; HSC 205). This policy will be subject to review in 2009. Review is vital to allow the appropriate detection of malignancy without overburdening the premium clinic slots with the healthy. PATIENTS AND METHODS A total of 170 consecutive patients were referred from January-June 2005. Referral details, patient information, events and time to diagnosis were recorded. RESULTS Of these 170 patients, 143 were suitable for analysis. Forty-three patients (30%) were referred with frank haematuria, of whom 30% had bladder cancer. Nine percent of patients (n = 13) had microscopic haematuria none of whom had cancer. A quarter of the patients (n = 35) were referred with suspected testis cancer but none had cancer. Forty-one patients were referred with serum prostate-specific antigen (PSA) elevation; 18 cancers were detected in this group. Ten men had PSA values greater than 50 ng/ml. Only two cancers were suitable for radical prostatectomy. No cancer was found in patients less than 50 years of age. CONCLUSIONS A high cancer incidence was found (27.9%), the majority of which was bladder cancer or advanced prostate cancer. Out of the 143 patients, no malignancy was diagnosed in any patient less than 50 years of age, no malignancy was diagnosed in any of the microscopic haematuria group and there was no cancer diagnosed in the group of patients referred with scrotal swellings. We suggest that some guidelines are leading to referral of patients with low cancer risk. When the HSC 205 is revised in 2009, we hope studies such as ours are taken into consideration in order to improve resource utilisation.