Surgical Procedures for Core Urology Trainees

193 Pages·2018·4.438 MB·English

by  Sanchia Goonewardene, Raj Persad (eds.)

Surgical Procedures
for Core Urology
Trainees
Sanchia Goonewardene
Raj Persad
Editors
123
Surgical Procedures for Core Urology
Trainees
Sanchia Goonewardene • Raj Persad
Editors
Surgical Procedures for
Core Urology Trainees
Editors
Sanchia Goonewardene Raj Persad
East of England Deanery Southmead Hospital
Princess Alexandra Hospital North Bristol NHS Trust
Harlow Bristol
United Kingdom United Kingdom
ISBN 978-3-319-57441-7 ISBN 978-3-319-57442-4 (eBook)
https://doi.org/10.1007/978-3-319-57442-4
Library of Congress Control Number: 2017956939
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Preface
Welcome to Surgical Procedures for the Core Urology Trainee!! Thank you for
reading this book. The aim of this book is to give junior urologists in training, the
world around, an idea of how to do core urology procedures. This includes what to
do pre-operatively, surgical indications and techniques, what to do post-operatively,
and complications that may occur.
The concept of this book came to me as a young urologist going through a hard
time. I had already been through the armamentarium of urology textbooks and
guidelines that gave me the clinical knowledge, yet there was no book available that
would give me the practical experience that usually you only get with time and
training.
This drove me crazy. Not a day went by I wished I had a book that would tell me
how to do basic procedures. Over the next few years, this book was developed. We
are very lucky to have the best experts in the UK write chapters for this, and also
trainees. Understanding how to do a procedure, and also how to manage complica-
tions that can occur, is key to being successful in your career.
We hope you enjoy this book!!
Harlow, UK Sanchia Goonewardene
Bristol, UK Raj Persad
v
Acknowledgements
For my co-editor and mentor, Prof. Raj Persad, Bristol.
For all the amazing authors in this book, who gave so willingly of their time and
academic ability.
For my team at Springer—I am grateful for this chance.
For Gladstone’s Library, always giving me a sanctuary to write.
For friends, family, work family, training programme director and my rotary
family, who consistently support my academic endevours.
For anyone else who should be here.
vii
Contents
1 Basics of Rigid Cystoscopy and Techniques of Suprapubic
Catheter Insertion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
Luke Wang, Weranja Ranasinghe, and Peter Wong
2 The Endoscopic Management of Urethral Strictures . . . . . . . . . . . . . 11
P.J.R. Shah
3 Ureteroscopy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19
Faiz Motiwala and Raj Kucheria
4 Ureteric Stenting . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 33
Faiz Motiwala
5 Core Urology for Surgical Trainees: PCNL
(Percutaneous Nephrolithotomy) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 41
David R. Webb
6 Surgical Management of Common Andrological Emergencies . . . . . 49
O. Kalejaiye, A. Raheem, and D. Ralph
7 Renal Transplant and Vascular Procedures . . . . . . . . . . . . . . . . . . . . . 57
Benedict Phillips and Bimbi Fernando
8 Transurethral Resection of Bladder Tumours . . . . . . . . . . . . . . . . . . . 71
Tatenda Nzenza, Weranja Ranasinghe, and Peter Wong
9 Transrectal Ultrasound-Guided Transrectal and Transperineal
Prostate Biopsy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 79
Helena Gresty and Kasra Saeb-Parsy
10 Brachytherapy for Prostate Cancer . . . . . . . . . . . . . . . . . . . . . . . . . . . 87
Ricardo Soares, Santiago Uribe-Lewis, Jennifer Uribe,
and Stephen Langley
11 Transurethral Resection of the Prostate and Other Techniques
in BPH . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 99
David Dryhurst and Gordon Muir
ix
x Contents
12 Minimally Invasive Non-ablative Treatments for LUTS . . . . . . . . . . 105
David Dryhurst and Gordon Muir
13 Penile Prosthesis Surgery . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 109
O. Kalejaiye, Amr Abdel Raheem, and D. Ralph
14 The Management of Peyronie’s Disease . . . . . . . . . . . . . . . . . . . . . . . 119
Fabio Castiglione, David J. Ralph, and Giulio Garaffa
15 Surgical Sperm Retrieval . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 135
O. Kalejaiye, A. Raheem, and D. Ralph
16 Inguino-Scrotal Surgery . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 141
O. Kalejaiye, Amr Abdel Raheem, and D. Ralph
17 Role of Molecular Diagnostics in Prostate Cancer . . . . . . . . . . . . . . 151
Alexander Van Hoof, Weslyn Bunn, Amanda Klein,
and David M. Albala
18 Open Radical Inguinal Lymphadenectomy . . . . . . . . . . . . . . . . . . . . 179
Vivekanandan Kumar
Index . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 185
About the Authors
Sanchia S. Goonewardene, MBChB (Hons.Clin.SC), BMedSc(Hons), PGCGC,
Dip.SSc, MRCS (Ed and Eng) MPhil. qualified from Birmingham Medical

School with Honours in Clinical Science and a BMedSc Degree in Medical Genetics
and Molecular Medicine. After that she completed her Foundation training at the
Royal Centre for Defence Medicine, where she received the West Midlands Deanery
Award. Her Core General Surgery training was completed in Coventry and
Warwickshire where she gained a Diploma in Surgical Science and MRCS (UK).
She has worked as Urology registrar at Guys and St Thomas Hospitals, London, and
the Royal Free Hospital and UCL.
She has over 200 publications to her name with 2 papers as a number 1 most cited
(Biomedical Library) and has significantly contributed to the Urological Academic
World—she has since added a section to the European Association of Urology
Congress on Prostate Cancer Survivorship and Supportive Care and is an associate
member of an EAU guidelines panel on Chronic Pelvic Pain. She is also an alumni
of the Urology Foundation. She has supervised a thesis with Kings College London
and Guys Hospital (BMedSci Degree gained first class, students’ thesis score 95%).
Recently she has also been invited to the Editorial board of the World Journal of
Urology and is a review board member of JORS and BMJ Case Reports. Additionally,
she has also just been invited to the International Continence Society Terminology
Panel on Pelvic Floor Dysfunction. She is also Editor in Chief of the International
Journal of Radiographic Imaging and Radiation Therapy. Most recently she has been
appointed to East of England Deanery for training in Urology.
In her spare time, she enjoys working for Rotary International.
Raj Persad, M.B.B.S., M.D., F.R.C.S., F.E.B.U. is a research active academic

urologist who has been at the forefront of surgical Uro-Oncology innovation and
research for over 25 years. His achievements include over 250 peer-reviewed papers,
5 books and £6m in research grants and awards. He is/has been chief investigator for
major portfolio clinical trials, and his research programmes range from translational
laboratory biomarkers studies to medical robotics innovation. He has had editorial
positions with mainline urology and medical journals and is/has been on interna-
tional and national cancer guidelines committees including CRUK and NICE.
One of his passions is surgical training both home and abroad and he has taught,
examined and trained surgeons in Africa, the Caribbean and Eastern Europe.
xi
Basics of Rigid Cystoscopy 1
and Techniques of Suprapubic
Catheter Insertion
Luke Wang, Weranja Ranasinghe, and Peter Wong
Rigid Cystoscopy
Indications
Rigid cystoscopy is one of the most commonly performed procedures in urology.
Routinely performed in operating room setting under general anaesthesia, it pro-
vides direct visualization of the urethra, bladder and access to the upper urinary
tract. Common indications for the procedure are summarised in Table 1.1.
Compared to flexible cystoscopy, rigid cystoscopy is performed largely for thera-
peutic purposes. Frequently, bladder lesions or larger tumours are biopsied, fulgu-
rated or resected through rigid cystoscopy. Access to the upper urinary tracts allows
treatment of ureteric stones, tumours and placements of ureteric stents, as well as
retrograde pyelography for assessment of the upper tracts.
Equipment
Basic setup for rigid cystoscopy requires an endoscope, light source and irrigation
fluid. Irrigation fluid includes normal saline, glycine or sterile water. In the absence
of an endoscopic camera the surgeons views the image directly through the optical
eyepiece at the proximal end of the instrument.
Cystoscopes are manufactured in a variety of sizes expressed in French (Fr)
gauge. One French gauge denotes an instrument circumference of 1/3 mm. Rigid
L. Wang
Department of Surgery, Austin Health, University of Melbourne, Melbourne, VIC, Australia
W. Ranasinghe (*) • P. Wong
Box Hill, Department of Urology, Eastern Health, Melbourne, VIC, Australia
© Springer International Publishing AG 2018 1
S. Goonewardene, R. Persad (eds.), Surgical Procedures for Core Urology
Trainees, https://doi.org/10.1007/978-3-319-57442-4_1