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1. 543 Improving the Management of Acute Ureteric Colic in A Multi-Centre District General Hospital: A Closed-Loop Audit

Author

U Otite, S Ahmad, C Desai, S A Ehsanullah, and A Bruce

Subjects
medicine.medical_specialty, business.industry, General surgery, Medicine, Surgery, Ureteric colic, Audit, Multi centre, General hospital, business, Closed loop
Abstract

Introduction The British Association of Urological Surgeons (BAUS) released guidance in 2018 regarding the optimum management of acute ureteric colic: a condition which can present as a surgical emergency. Our aim was to review the current practice at our hospital in diagnosing and managing acute ureteric colic and ultimately, implement sustainable change to address any areas of limitations. Method The following data was retrospectively collected for of all patients admitted with acute ureteric colic: investigations performed, medications administered, details of surgical intervention and follow-up. 1st Cycle: March 2017 to February 2018. Intervention: Teaching sessions delivered to staff (including doctors and nurses) in the A&E and urology department. 2nd Cycle: January 2019 to December 2019. Results 268 patients presented to A&E with ureteric colic – 18% increase from previous year. On admission: 60.4% of patients had serum calcium checked, 97.7% had a CT KUB performed within 24 hours and 67.2% were given NSAIDs; this is a 20.4%, 0.4% and 5.2% increase from the previous year, respectively. Only 31.3% of patients had an acute surgical intervention. The average wait time for clinic follow-up was reduced to 41 days following departmental education, but only 26.4% of patients were seen within the BAUS advised 4-week timeframe. Conclusions Re-audit showed distinct improvement in the management of acute ureteric colic. Thus, departmental education strategies have had a positive impact. It is recommended that the reservation of one daily elective theatre slot for an emergency operation and a computerised clinic booking system will further optimise our management in line with BAUS guidance.

Published
2021
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3. Testicular Microlithiasis: Is It a Benign Condition with Malignant Potential?

Author

Vinod H. Nargund, J.A.W. Webb, U. Otite, D.F. Badenoch, and R.T.D. Oliver

Subjects
Adult, Male, Infertility, endocrine system, medicine.medical_specialty, Benign condition, Adolescent, endocrine system diseases, Urology, Testicle, urologic and male genital diseases, Malignancy, Testicular Diseases, Calculi, Testicular Neoplasms, Risk Factors, Prevalence, medicine, Humans, In patient, Child, Aged, Ultrasonography, Gynecology, urogenital system, business.industry, Middle Aged, medicine.disease, medicine.anatomical_structure, Radiology, business, Precancerous Conditions, Testicular microlithiasis
Abstract

To review the findings of testicular ultrasonography (US) in patients referred for testicular symptoms including pain, swelling and infertility, and to determine the prevalence of testicular microlithiasis (TM) and ist relevance to the development of testicular cancer.Records of 3,026 patients referred for testicular US between 1994 and 1999 were evaluated. The indications for testicular US diagnosis, management and relevant histological details were obtained from medical records. Patients with TM had an annual sonographic follow-up unless they had testicular cancer, in which case follow-up repeat US with clinical reviews was more frequent.TM was found in 54 patients (1.77%; median age 34 years, range 12-83 years). The median follow-up was 36 months (range 12-18 months). Sixteen of these patients had testicular malignancy (30%). The remaining 38 patients had hydrocele and epididymal cysts (14), varicocele (7), epididymitis (2) and small testes (8), with 14 patients having no other pathology. One patient with a small testis developed a seminoma while under surveillance. Another patient with metastatic embryonal-cell carcinoma at initial diagnosis was found to have a seminoma 4 years following chemotherapy. The relative risk of testicular tumours in the presence of TM was 13.2 (confidence interval 8.3-21.5).TM can no longer be regarded simply as a benign condition because of its association with testicular malignancy. In our series, 2 patients (5.2%) developed interval testicular cancers during follow-up US. There is no convincing evidence to suggest that TM might be premalignant. In rare instances of radiologically indeterminate cases, biopsy of the testis may be necessary.

Published
2001
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4. Endoscopic Bladder Neck Suspension Revisited: Long–Term Results of Stamey and Gittes Procedures

Author

D.F. Badenoch, U. Otite, and A.K. Nigam

Subjects
Reoperation, medicine.medical_specialty, Stress incontinence, Time Factors, Urinary Incontinence, Stress, Urology, Urinary Bladder, Endoscopic surgery, Bladder neck suspension, medicine, Humans, Genuine stress incontinence, Retrospective Studies, medicine.diagnostic_test, business.industry, Endoscopy, Long term results, Middle Aged, medicine.disease, Surgery, Neck of urinary bladder, Patient Satisfaction, Urologic Surgical Procedures, Female, business, Follow-Up Studies
Abstract

To evaluate the long-term results of Stamey's and Gittes' procedures for genuine stress incontinence.72 needle procedures (34 Stamey; 38 Gittes) performed by a single surgeon between 1988 and 1994 were retrospectively reviewed. All patients had genuine stress incontinence on preoperative video-urodynamics. Review was at 3 months and thereafter clinically determined. Update information was gained by a patient satisfaction questionnaire.Data were available for 9 years for the Stamey group (mean 8.4 years) and 6 years for the Gittes' (mean 5.3 years). At 3 months, 93% were dry. There was a gradual attrition with 38% of the Stamey and 14% of the Gittes patients remaining dry or improved at 5 years. At 9 years, only 28% of the Stamey patients maintained their improvement. 26% of the original cohort underwent a second procedure. All patients who had repeat needle operations have failed. 48 questionnaires (67%) were returned. Only 25% of patients expressed satisfaction with their operation.Early success rates with endoscopic bladder neck suspension are replaced by long-term failures. The durability is poor with an ongoing recurrent incontinence rate. Repeat procedures are not worthwhile. Gittes' procedure appears to have an earlier failure rate compared to Stamey's operation.

Published
2000
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5. Contents Vol. 38, 2000

Author

Kazuki Kawabe, Alexandre R. Zlotta, J. Köllermann, J. Steffens, B. Kosharskyy, Ugur Mungan, Frieder Bauss, Denis Chautard, Çetin Harmankaya, Yutaka Ono, Thomas Ebert, Andrew J. G. Simpson, Murat Sade, K.E. Giercksky, Akihiko Okuyama, A.K. Nigam, R. Hiebl, Claude Schulman, O. Naňka, B. Helpap, André T. Guay, G. Dipaola, Shiro Takahara, E.W. Hauck, A. Stenzl, Satoru Takahashi, B. Schönberger, M. Grim, M. Ludwig, Peter J. Goebell, Manfred Wiesel, Murat Dayanc, I. Schroeder-Printzen, U. Otite, U. Kaulfuss, Yasunori Harada, G. Moutzouris, Norio Nonomura, G. Lüdecke, D. Brkovic, Murat Sevinç, C. Arens, Özgür Tan, Véronique Verriele, Claudia M. Carvalho, Yukio Homma, Philippe Colls, Ch. Theodorou, Riyadh F. Talic, W. Weidner, Ziya Kirkali, Markus J. Seibel, A. Katsoulis, W. Månsson, Kazuo Nishimura, Francesco Saverio Camoglio, Gerd Staehler, P. Röttger, Natsuki Takaha, Ch. Katsifotis, S.D. Fosså, Gérard Bertrand, Elaine Darini, S. Loening, A Daver, D. Floratos, K.D. Jacobsen, Jesús B. Perez, Masahiro Nozawa, Tadaichi Kitamura, H. Müller, B.M. Altinkilic, Joachim Dörsam, P. Stournaras, M.W. Köllermann, Yves Fradet, Bernd J. Schmitz-Dräger, Lüfti Tahmaz, Francesco P. Selvaggi, K.-Horst Bichler, Gerhard Forster, Walter Ludwig Strohmaier, Tatsunari Fukui, U. Oehler, Christian Kissling, Luca Giacomello, Ernesto Velásquez, Michele Spalletta, Carlos Dzik, Sven Lahme, Johannes Schmidt, Frans M.J. Debruyne, Kutsal Yorukoglu, S.M. Pecher, S. Bianchi, Wim P.J. Witjes, Katia R. M. Leite, Luciano Nesralhah, Bernardo Garicochea, L. Jarolím, Robert A. Newton, Miguel Srougi, Vincent Bocquillon, Jerilynn P. Jacobson, M. Janský, U.E. Studer, D.F. Badenoch, Alberto Ottolenghi, M. Babjuk, C. Nord, Mete Kilciler, Jean-Yves Soret, T. Hanuš, Ricardo P. Moura, M. Tichý, R. Mills, Luiz H. Camara-Lopes, F.H. Comhaire, U. Feek, T. Balducci, and Yasushi Kondo

Subjects
medicine.medical_specialty, business.industry, Urology, General surgery, medicine, business
Published
2000
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7. Detection of human chorionic gonadotrophin-beta in serum or urine of prostate cancer patients is of no clinical significance

Author

F. Chinegwundoh, Ray K. Iles, Vinod H. Nargund, Suhail Baithun, and U. Otite

Subjects
PCA3, Male, endocrine system, medicine.medical_specialty, Chorionic gonadotrophin, Urinary system, Urology, Urine, Newly diagnosed, Prostate cancer, medicine, Humans, Clinical significance, Chorionic Gonadotropin, beta Subunit, Human, reproductive and urinary physiology, Neoplasm Staging, Gynecology, business.industry, Prostatic Neoplasms, Reproducibility of Results, General Medicine, medicine.disease, Survival Analysis, Prostate-specific antigen, Treatment Outcome, Disease Progression, business
Abstract

The aim of this study was to prospectively evaluate the potential role of elevated urinary/serum human chorionic gonadotrophin-beta (hCGbeta) in prostate cancer prognosis. 104 patients with newly diagnosed prostate cancers were included; 68 patients had organ-confined, 18 had locally advanced and 18 had metastatic disease. A control group consisted of 115 patients presenting with benign prostatic disease. Serum and urinary total hCGbeta was measured prior to treatment and serum PSA was measured at diagnosis. The patients were treated along conventional lines and progression-free survival was assessed. Four patients had elevated serum and 10 had elevated urinary, total hCGbeta. There were no significant correlations between serum/urinary levels of hCGbeta and tumour stage, Gleason score or PSA. In contrast, serum PSA had significant linear correlations with both clinical tumour stage and Gleason score (p = 0.0001). At a median follow-up of 36 months, 22 (21.2%) patients had died while 17 (16.3%) others had progressed. Kaplan-Meier plots and log-rank test revealed no significant difference in progression-free survival between patients with elevated or normal levels of serum and/or urinary total hCGbeta. Clinical tumour stage, grade and PSA were statistically significant prognostic variables. Immunoassay measurement of serum or urinary hCGbeta has no significant role in the clinical management of prostate cancer.

Published
2005

8. Renal cell carcinoma presenting with cardiac failure

Author

M, Piggott, D, Farrugia, U, Otite, R T, Oliver, and T, Crake

Subjects
Heart Failure, Electrocardiography, Arteriovenous Fistula, Humans, Female, Middle Aged, Tomography, X-Ray Computed, Carcinoma, Renal Cell, Magnetic Resonance Imaging, Kidney Neoplasms
Published
2001

9. An unusual cause of tenesmus

Author

L, Chan, U, Otite, and V, Nargund

Subjects
Adult, Male, Anus Diseases, Polycystic Kidney Diseases, Humans, Pain, Choristoma, Defecation, Kidney, Tomography, X-Ray Computed
Published
1999

10. The use of scrotal ultrasonography in male infertility

Author

P. Cannon, P. Maheshkumar, Vinod H. Nargund, U. Otite, and Stephen Gordon

Subjects
Male, Gynecology, medicine.medical_specialty, business.industry, Urology, Scrotal ultrasonography, medicine.disease, Calculi, Male infertility, Andrology, Varicocele, Scrotum, medicine, Humans, business, Infertility, Male, Ultrasonography
Published
2001
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12. Subject Index Vol. 38, 2000

Author

Çetin Harmankaya, Yutaka Ono, B.M. Altinkilic, Christian Kissling, Alberto Ottolenghi, Michele Spalletta, Carlos Dzik, Ernesto Velásquez, Riyadh F. Talic, A Daver, S.M. Pecher, D. Floratos, Johannes Schmidt, H. Müller, Sanzio Bianchi, D. Brkovic, Gerd Staehler, K.-Horst Bichler, Elaine Darini, Tatsunari Fukui, Gerhard Forster, C. Nord, Jesús B. Perez, Tadaichi Kitamura, A.K. Nigam, K.E. Giercksky, B. Schönberger, S. Loening, G. Dipaola, W. Månsson, B. Helpap, Akihiko Okuyama, R. Hiebl, O. Naňka, P. Stournaras, Thomas Ebert, U. Otite, Ziya Kirkali, I. Schroeder-Printzen, U. Kaulfuss, André T. Guay, Shiro Takahara, M. Janský, Claude Schulman, T. Balducci, R. Mills, Luiz H. Camara-Lopes, Norio Nonomura, Kazuki Kawabe, Claudia M. Carvalho, Alexandre R. Zlotta, J. Köllermann, Murat Sade, U. Oehler, A. Katsoulis, Natsuki Takaha, J. Steffens, Andrew J. G. Simpson, Satoru Takahashi, Frieder Bauss, Peter J. Goebell, E.W. Hauck, Philippe Colls, F.H. Comhaire, Ch. Theodorou, Yasushi Kondo, A. Stenzl, B. Kosharskyy, Murat Sevinç, U.E. Studer, Vincent Bocquillon, Ugur Mungan, Denis Chautard, Yves Fradet, Véronique Verriele, Yukio Homma, M. Ludwig, Markus J. Seibel, Bernd J. Schmitz-Dräger, K.D. Jacobsen, M. Grim, Ch. Katsifotis, Kazuo Nishimura, Gérard Bertrand, Francesco Saverio Camoglio, Manfred Wiesel, Murat Dayanc, Luciano Nesralhah, Robert A. Newton, S.D. Fosså, Özgür Tan, U. Feek, Yasunori Harada, M. Babjuk, G. Lüdecke, Miguel Srougi, Wim P.J. Witjes, Bernardo Garicochea, L. Jarolím, M.W. Köllermann, Francesco P. Selvaggi, Katia R. M. Leite, Masahiro Nozawa, Joachim Dörsam, G. Moutzouris, D.F. Badenoch, Sven Lahme, Frans M.J. Debruyne, T. Hanuš, Kutsal Yorukoglu, Jerilynn P. Jacobson, C. Arens, Mete Kilciler, Ricardo P. Moura, M. Tichý, W. Weidner, Luca Giacomello, Jean-Yves Soret, P. Röttger, Lüfti Tahmaz, and Walter Ludwig Strohmaier

Subjects
Gynecology, medicine.medical_specialty, Index (economics), business.industry, Urology, medicine, Medical physics, Subject (documents), business
Published
2000
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13. Acknowledgement to the Reviewers

Author

Wim P.J. Witjes, Bernardo Garicochea, L. Jarolím, T. Balducci, Yves Fradet, Bernd J. Schmitz-Dräger, Jerilynn P. Jacobson, Ugur Mungan, Denis Chautard, U. Kaulfuss, M.W. Köllermann, Jesús B. Perez, Tadaichi Kitamura, D. Brkovic, Francesco P. Selvaggi, C. Arens, Philippe Colls, B. Kosharskyy, P. Stournaras, A.K. Nigam, A Daver, D. Floratos, Ch. Theodorou, Luca Giacomello, Vincent Bocquillon, Elaine Darini, Yasushi Kondo, A. Stenzl, C. Nord, Manfred Wiesel, D.F. Badenoch, S. Bianchi, Kazuo Nishimura, U. Oehler, W. Månsson, Katia R. M. Leite, I. Schroeder-Printzen, B. Schönberger, Christian Kissling, K.D. Jacobsen, Ziya Kirkali, Tatsunari Fukui, Ernesto Velásquez, K.E. Giercksky, M. Janský, Johannes Schmidt, Lüfti Tahmaz, T. Hanuš, M. Grim, U. Otite, G. Dipaola, Walter Ludwig Strohmaier, Akihiko Okuyama, Özgür Tan, R. Hiebl, Andrew J. G. Simpson, Claude Schulman, E.W. Hauck, G. Moutzouris, B.M. Altinkilic, Gérard Bertrand, Murat Sade, U.E. Studer, Natsuki Takaha, Miguel Srougi, Mete Kilciler, Francesco Saverio Camoglio, H. Müller, M. Ludwig, Michele Spalletta, Carlos Dzik, Yutaka Ono, Peter J. Goebell, K.-Horst Bichler, Gerhard Forster, S.M. Pecher, Ricardo P. Moura, M. Tichý, Claudia M. Carvalho, A. Katsoulis, Markus J. Seibel, Yasunori Harada, Thomas Ebert, Alberto Ottolenghi, G. Lüdecke, Luciano Nesralhah, Robert A. Newton, R. Mills, Luiz H. Camara-Lopes, Jean-Yves Soret, F.H. Comhaire, U. Feek, Murat Dayanc, Masahiro Nozawa, Joachim Dörsam, Sven Lahme, Gerd Staehler, S. Loening, Riyadh F. Talic, Satoru Takahashi, M. Babjuk, O. Naňka, Véronique Verriele, Yukio Homma, Ch. Katsifotis, Norio Nonomura, Murat Sevinç, S.D. Fosså, Çetin Harmankaya, Frans M.J. Debruyne, Kutsal Yorukoglu, Kazuki Kawabe, Alexandre R. Zlotta, J. Köllermann, J. Steffens, W. Weidner, Frieder Bauss, P. Röttger, B. Helpap, André T. Guay, and Shiro Takahara

Subjects
medicine.medical_specialty, business.industry, Urology, Family medicine, Acknowledgement, Medicine, business
Published
1998
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17. Serum aminoterminal propeptide of type 1 procollagen (PINP) levels are a measure of extent of disease and a prognostic indicator in metastatic prostate cancer

Author

K. Jefferson, Vinod H. Nargund, Frank Chinegwundoh, U. Otite, B. Barass, Rajendra Persad, Mohamed Enver, and Ray K. Iles

Subjects
Oncology, medicine.medical_specialty, Prostate cancer, Procollagen peptidase, business.industry, Urology, Internal medicine, medicine, Measure (physics), Extent of disease, business, medicine.disease, Protein precursor
Published
2003
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18. 59. Prostate cancer imaging with 99Tcm-J591 monoclonal antibody against prostate specific membrane antigen

Author

S. Elnaas, H. Jan, S. J. Mather, D. Ellison, A. Canizales, U. Otite, N. H. Bander, Stephen Gordon, Keith E. Britton, and V. H. Nargund

Subjects
PCA3, Prostate cancer, J591 monoclonal antibody, business.industry, medicine, Cancer research, Glutamate carboxypeptidase II, Radiology, Nuclear Medicine and imaging, General Medicine, medicine.disease, business
Published
2001
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19. Detection of human chorionic gonadotrophin-beta in serum or urine of prostate cancer patients is of no clinical significance.

Author

Otite U, Baithun S, Chinegwundoh F, Nargund VH, and Iles RK

Subjects
Disease Progression, Humans, Male, Neoplasm Staging, Prostatic Neoplasms mortality, Prostatic Neoplasms pathology, Prostatic Neoplasms therapy, Reproducibility of Results, Survival Analysis, Treatment Outcome, Chorionic Gonadotropin, beta Subunit, Human blood, Chorionic Gonadotropin, beta Subunit, Human urine, Prostatic Neoplasms blood, Prostatic Neoplasms urine
Abstract

The aim of this study was to prospectively evaluate the potential role of elevated urinary/serum human chorionic gonadotrophin-beta (hCGbeta) in prostate cancer prognosis. 104 patients with newly diagnosed prostate cancers were included; 68 patients had organ-confined, 18 had locally advanced and 18 had metastatic disease. A control group consisted of 115 patients presenting with benign prostatic disease. Serum and urinary total hCGbeta was measured prior to treatment and serum PSA was measured at diagnosis. The patients were treated along conventional lines and progression-free survival was assessed. Four patients had elevated serum and 10 had elevated urinary, total hCGbeta. There were no significant correlations between serum/urinary levels of hCGbeta and tumour stage, Gleason score or PSA. In contrast, serum PSA had significant linear correlations with both clinical tumour stage and Gleason score (p = 0.0001). At a median follow-up of 36 months, 22 (21.2%) patients had died while 17 (16.3%) others had progressed. Kaplan-Meier plots and log-rank test revealed no significant difference in progression-free survival between patients with elevated or normal levels of serum and/or urinary total hCGbeta. Clinical tumour stage, grade and PSA were statistically significant prognostic variables. Immunoassay measurement of serum or urinary hCGbeta has no significant role in the clinical management of prostate cancer., (Copyright 2006 S. Karger AG, Basel.)

Published
2006
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20. Investigation of acute flank pain: how do practices of U.K.and Irish urologists compare with those of transatlantic and continental European colleagues?

Author

Otite U, Parkin J, Waymont B, Inglis JA, and Philp NH

Subjects
Acute Disease, Contrast Media, Flank Pain etiology, Humans, Infusions, Intravenous, Surveys and Questionnaires, Tomography, Spiral Computed statistics & numerical data, Ultrasonography statistics & numerical data, United Kingdom, Urography statistics & numerical data, Flank Pain pathology, Practice Patterns, Physicians' statistics & numerical data
Abstract

Background and Purpose: Noncontrast-enhanced spiral CT (NESCT) is more accurate and reliable than intravenous urography (IVU) in diagnosing the cause of acute flank pain. This study aimed to determine the impact of current literature on the choice of imaging modality used to investigate acute flank pain within the UK and the Republic of Ireland., Materials and Methods: A questionnaire regarding the preferred investigation for acute flank pain was sent to all consultant urologists registered as British Association of Urological Surgeons members., Results: Of the 548 consultants from 210 institutions surveyed, 293 (54%) from 171 (81.4%) institutions returned their questionnaires. Intravenous urography is used in the majority of institutions (146; 85.4%) for investigating acute flank pain. Only 18 (10.5%) use NESCT, while 4.1% use ultrasonography. Among those using IVU as the investigation of choice, the main reason given was limited CT services (82.4%). Others included familiarity with IVU features (51.2%), limited availability of radiologists for out-of-hours reporting of CT (26%), more rapid procedure (20.8%), lower cost (20%), and lower radiation exposure (19.6%). Only 52.4% of consultants using IVU would prefer NESCT if both were equally available., Conclusions: Urography remains the commonest modality for the investigation of acute flank pain in the UK and Ireland primarily because of limited CT services and greater familiarity with the images. Given the opportunity, only half of consultant urologists would select NESCT in preference to IVU, suggesting that improving the availability of CT services alone may not lead to practice paralleling that of our transatlantic and continental European colleagues.

Published
2005
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23. Renal cell carcinoma presenting with cardiac failure.

Author

Piggott M, Farrugia D, Otite U, Oliver RT, and Crake T

Subjects
Arteriovenous Fistula etiology, Carcinoma, Renal Cell diagnosis, Carcinoma, Renal Cell surgery, Electrocardiography, Female, Heart Failure diagnosis, Heart Failure surgery, Humans, Kidney Neoplasms diagnosis, Kidney Neoplasms surgery, Magnetic Resonance Imaging, Middle Aged, Tomography, X-Ray Computed, Carcinoma, Renal Cell complications, Heart Failure etiology, Kidney Neoplasms complications
Published
2000

24. An unusual cause of tenesmus.

Author

Chan L, Otite U, and Nargund V

Subjects
Adult, Choristoma diagnosis, Humans, Male, Pain etiology, Polycystic Kidney Diseases diagnosis, Tomography, X-Ray Computed, Anus Diseases etiology, Choristoma complications, Defecation, Kidney, Polycystic Kidney Diseases complications
Published
1999
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