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Urinary Tract Calculi VI: Surgical Management01:25

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Procedures for Kidney StonesMedical intervention is necessary when kidney stones or renal calculi are too large to pass spontaneously (typically greater than 5 millimeters) when stones are accompanied by symptomatic infection (such as fever or pyelonephritis), when they impair kidney function, or when they cause persistent symptoms like severe pain, nausea, or urinary retention. Additionally, patients with only one kidney or those who cannot be treated with medical management also require...
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Voiding Cystourethrography (VCUG) and Cystography are specialized radiographic procedures used to examine the structure and function of the bladder and urethra.Voiding Cystourethrography (VCUG)A Voiding Cystourethrogram (VCUG) is a diagnostic imaging procedure that assesses the anatomy and function of the lower urinary tract. It focuses on the bladder, bladder neck, and urethra, helping detect abnormalities such as vesicoureteral reflux (VUR)—the backward or reverse flow of urine into the...
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Uroflowmetry is a non-invasive urodynamic test designed to measure various aspects of urination, including volume, flow rate, and the time to void. This test is crucial for diagnosing and assessing conditions such as bladder outlet obstruction, bladder dysfunction, incomplete bladder emptying, incontinence, and urinary tract blockages caused by benign prostatic hyperplasia (BPH) and urethral strictures.Pre-Test Instructions:Before a uroflowmetry test, patients are typically advised to drink...
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Meaning of Cystoscopic Examination:Cystoscopy is an essential diagnostic tool in urology that is used to assess the structure and function of the genitourinary system. It provides a direct view of the urethra, bladder, and, in some cases, the ureteral openings. This procedure helps detect structural abnormalities, infections, cancers, and blockages in the urinary tract. There are two types of cystoscopy:Flexible cystoscopy is commonly performed in outpatient settings due to its less invasive...
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Related Experiment Video

Updated: Jul 13, 2025

Vessel-sparing Excision and Primary Anastomosis
08:09

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Trends in day-case bladder outflow obstruction surgery: a study using Hospital Episode Statistics.

Joseph B John1,2, William K Gray1, Kieran O'Flynn1,3

  • 1Getting It Right First Time Programme, NHS England, London, UK.

BJU International
|October 13, 2023
PubMed
Summary
This summary is machine-generated.

Day-case surgery for bladder outflow obstruction (BOO) is increasing, with minimally invasive procedures showing high adoption rates. Day-case BOO surgery is safe, with no increased risk of readmission compared to inpatient procedures.

Keywords:
BPHDay-caseLUTSTURPbladder outflow obstruction

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Area of Science:

  • Urology
  • Surgical Innovation
  • Health Services Research

Background:

  • Bladder outflow obstruction (BOO) is a common condition requiring surgical intervention.
  • Day-case surgery offers potential benefits in terms of cost-effectiveness and patient recovery.
  • The adoption and safety of day-case BOO surgery practices in England require contemporary evaluation.

Purpose of the Study:

  • To describe the evolution of day-case surgery for bladder outflow obstruction (BOO) in England.
  • To profile current day-case BOO surgery practices, including operation types and safety outcomes.
  • To analyze trends and variations in day-case BOO surgery rates across English hospitals.

Main Methods:

  • Retrospective analysis of Hospital Episode Statistics and UK Office for National Statistics data (January 2017 - June 2022).
  • Inclusion of 111,043 operations across 117 hospital trusts, categorized by procedure type (TURP, laser, vapour, PUL, bladder neck incision).
  • Multilevel regression modeling to assess the association between day-case surgery and 30-day hospital readmissions.

Main Results:

  • A linear increase in day-case BOO surgery rates from 8.3% to 21.0% was observed between January 2017 and June 2022.
  • Prostatic urethral lift (PUL) and vapour therapy demonstrated the highest day-case rates (80.9% and 38.1%, respectively).
  • Day-case surgery was associated with reduced odds of 30-day readmission overall, with no difference for TURP and reduced odds for LASER operations.

Conclusions:

  • Day-case rates for bladder outflow obstruction surgery have significantly increased in England.
  • Minimally invasive procedures are frequently performed as day cases, while high day-case rates for TURP and laser surgery are concentrated in a few hospitals.
  • Safe and effective day-case pathways for BOO treatment can be established across various surgical modalities.