Index

Note: page numbers in italics refer to figures

abdominal drain air bubble removal from dome 170 parastomal hernia repair 19, 20 clots 212–13 postoperative 40–1 retention 176 urine testing 39 distending 38 abdominal pressure (Pabd) flexible cystoscopy for debris 214 measurement 233 guidewires 215, 216 abdomino-perineal (AP) resection 233 prolapse 244 air cystoscopy 214 stitching into uterus at emergency Allis forceps, Nesbit’s procedure 187 caesarean section 38 alpha blockers, chronic pelvic pain bladder neck incision, holmium laser syndrome 243 enucleation of 151, 152 Amplatz sheath bladder outlet obstruction 240, 247 migration prevention during bladder stones, holmium percutaneous nephrolithotomy cystolitholapaxy 156 98, 99 bladder symptoms securing in morbidly obese management 244 patients 102 ureteric stent-related 147, 148 Anderson-Hynes dismembered robotic- bladder tumours assisted laparoscopic pyeloplasty flat superficial 173, 174 (RALP) 74 resection 175 androgen deprivation, prostate of multiple 171 cancer 247–8 transitional cell carcinoma 173, 174 antibiotics, chronic pelvic pain tumour edge biopsy 172 syndrome 242 see also transurethral resection of anti-inflammatory agents, chronic pelvic bladder tumour (TURBT) pain syndrome 243 bladder wall integrity, methylene autologous slings 201 blue 38 Boari flap balanitis xeroticaCOPYRIGHTED obliterans (BXO) 239 MATERIALbladder distention 38 balloon port 51 ureteric injury 31–2, 33 bean bag, patient position for renal Boston shouldered stent 119, 120 laparoscopy 52–3 Buck’s fascia, Nesbitt’s procedure 185 benign prostatic hyperplasia 247 bungee manoeuvre, bladder epididymectomy 183, 184

Top Tips in Urology, Second Edition. Edited by John McLoughlin, Neil Burgess, Hanif Motiwala, Mark J. Speakman, Andrew Doble and John D. Kelly. © 2013 John Wiley & Sons, Ltd. Published 2013 by John Wiley & Sons, Ltd.

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caesarean section, bladder stitching digital rectal examination 224, 226 into uterus 38 dorsal vein complex (DVC) calyceal puncture 105 laparoscopic 75 Carter Thomason needle 88 robotic-assisted radical catheter, three-way for bladder clot prostatectomy 87 evacuation 213 dual-lumen catheter 124, 125 caval thrombectomy, nephrectomy 21 dutasteride 240 children pinhole scope for ureteric elderly women, anterior approach procedures 169 pyeloplasty 29–30 urethral strictures 167 Ellick evacuator 176 cholangiogram catheters, laparoscopic Endo Catch bag 75 pyeloplasty 66 robotic-assisted radical chronic prostatitis/chronic pelvic pain prostatectomy 81, 82, 88 syndrome 241–3, 246 Endo Close device 205, 206 minimally invasive radical complications 239 prostatectomy 79 dressing 207, 208, 209 robotic-assisted radical rate 239 prostatectomy 76–7, 78 round-bodied needles 211 endocavity balloon, transperineal clips, inferior vena cava small hole 58, 59 biopsy 229 Clutton sound dilator 161–2 Endoloop 60 Coloplast malleable 192 endopyelotomy 247 colposuspension 201 epididymal cyst, enucleation 221 computed tomography (CT) urogram, epididymectomy, bungee ureteric injury 31 manoeuvre 183, 184 continence, eroded transvaginal tape 200 epidural catheter, use in flexible Covidien Blunt Tip Trocar 51 ureteroscopy 126 cryoanalgesia for 217–18 cutaneous fistula 40 faecal fistula 40 cystectomy 10, 11 finasteride 240 laparoscopic radical 91 Flex-arm 70 minimally invasive radical 91, 93 flexible cystoscope, vesicourethral pneumoperitoneum maintenance in anastomosis 5–6 females 92 robotic-assisted radical 91, 93 assessment 239 salvage 12 cutting in circumcision 205, 206 cystoscope 17F integral 163–4 gauze sporran, circumcision dressing flexible 208, 209 bladder clot sucking 212 germ cell tumours, radical debris in bladder 214 orchidectomy 35 local anaesthetic instillation 232 Gerota’s fascia 53, 55 lubricating gel 232 glans droop, following penile prosthesis suprapubic catheter changing insertion 181–2 230, 231 guidewires guidewire backloading 145 backloading 145 ureteric stent insertion 141 bladder 215, 216 cystoscope sheath, Boston shouldered displaced suprapubic catheter 177 stent insertion 119, 120 flexible cystoscope for suprapubic cystoscopy catheter changing 231 air 214 insertion into ureter 146 paediatric 167 percutaneous nephrolithotomy 100 dual-lumen catheter use 124, 125 dartos layer 186 use of multiple tracks 104–5 deep hole, short suture length 27–8 placement in urethroplasty 36 dental mirror, vesicourethral ureteric stent insertion 133, 138, 143 anastomosis 5–6 ureteroscopy 130 Dextrostix, urine testing from surgical flexible 13, 121, 122 drain 39 insertion into ureter 146

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urethral catheter 215–16 kidney ultrasound 237 urethral stricture 166, 168, 215 knots, throwing 27, 28, 65 urethrotomy 168–9 gynae/obstetric theatre emergency laparoscopic nephrectomy 70 call 37–8 balloon-tipped trocar in obese patient 67 HARMONIC wave scalpel 7–8 bleeding 70 Hassan technique, modified exit site closure in obese patient 68 securing of peritoneum 47, 48–50 extra ports 71 in super-obese patients 45–6 Flex-arm 70 holmium cystolitholapaxy 156 port sites 69 holmium laser enucleation of radical and renal artery dissection 73 prostate 151, 152–4 renal vein improved control 72 with holmium cystolitholapaxy 156 retroperitoneal 70 morcellation 155 laparoscopic prostatectomy 75 hydrocoele 220 dorsal vein complex 75, 87 radical 85 ice sludge technique for renal robotic-assisted 87 hypothermia 25, 26 wrong plane 85 ileal conduit laparoscopic pyeloplasty 30, 62, 66 dual-lumen catheter use 124, 125 robotic-assisted 74 formation in parastomal hernia laparoscopy repair 18–20 approach 56 spout creation 13 bag use 57 ureteric stent exchange over ileal– bleeding 56, 61 ureteric anastomosis 136 conversion 61 Wallace anastomosis 132 haemostasis at low pressure 57, 61 ileal–ureteric anastomosis, ureteric stent injuries 57 exchange over 135, 136 instruments 56, 61–2 iliac fossa port 53, 54 preparation 56, 61 incontinence suturing 63–5 autologous slings 201 see also port placement eroded transvaginal tape 200 laser enucleation of prostate 151, 152–4 synthetic suburethral tape 201 with holmium cystolitholapaxy 156 inferior vena cava, small hole 58, 59 morcellation 155 instruments, laparoscopy 56, 61–2 laser treatment International Prostate Symptom Score renal pelvic stones 128 (IPSS) 240 ureteric stones 127 intracorporeal perforation, penile Ligaclips, inferior vena cava small implantation 191–2 hole 58, 59 intravesical pressure 237 ligation, secure of foreshortened large veins 22 JJ stent lignocaine changing 121–2 cryoanalgesia for prostate insertion 143 biopsy 218 paired for retroperitoneal fibrosis pain relief for epididymo-orchitis 219 139, 140 Littlewoods retractor 45, 46 see also ureteric stent local anaesthetic Johannes forceps, inferior vena cava cryoanalgesia for prostate biopsy small hole 58 217, 218 gel instillation for urethral ketamine abuse 238 catheterisation/flexible kidney function, preservation 237 cystoscopy 232 kidney stones injection through skin 223 dual-lumen catheter use pain relief for epididymo-orchitis 219 124, 125 lock-out valve, Nesbit’s procedure 189 flexible ureterorenoscopy 107 loin pain 246 fragmentation 111, 112–13 lower urinary tract symptoms (LUTS) Peditrol use 110 progression 240 renal pelvic 128 severe with ketamine abuse 238

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lubricating gel instillation for urethral germ cell tumours 35 catheterisation/flexible non-absorbable transfixion suture 35 cystoscopy 232 Otis urethrotomy 165

marcain 225–6 pain Martius fat pad 199, 200 cryoanalgesia for prostate Mayo scissors, curved 47, 49 biopsy 217–18 mesh repair ketamine abuse 238 bladder erosion 202 relief in epididymo-orchitis 219 recurrent cystocoele/rectocoele 195, reduction 210 196–8 parastomal hernia repair 16, 17, 18–20 mesocolon, posterior surface 53, 55 drain 19, 20 methylene blue mesh 19, 20 bladder wall integrity 38 sutures 19 salvage cystectomy and Parietene Progrip mesh 16, prostatectomy 12 17, 195, 198 Millin’s prostatectomy 9 Peditrol use during morcellation, laser enucleation of ureterorenoscopy 108, 109, 110 prostate 155 pelvic neuromuscular dysfunction 243 pelvic pain syndrome, chronic 241–3 needle holders, laparoscopic suturing multimodal therapy 243 64, 65 phenotypic approach to needles, round-bodied 211 classification 242 nephrectomy pelviureteric junction vascular control during caval anterior approach pyeloplasty 29–30 thrombectomy 21 mobilisation 58 see also laparoscopic nephrectomy obstruction 247 nephrolithotomy see percutaneous penile implantation nephrolithotomy (PCNL) dilation 191–2 nephrostomy tube intracorporeal perforation 191–2 encrusted 36 penile prosthesis, glans droop following removal of Amplatz sheath after insertion 181–2 placement 102 percutaneous nephrolithotomy self-retaining for post-PCNL (PCNL) drainage 101–2 Amplatz sheath Nesbit’s procedure 187–9 migration prevention 98, 99 lock-out valve 189 removal after placement of Peyronie’s disease 185–6 nephrostomy tube 102 sutures 188–9 securing in morbidly obese neurourology 237 patients 102 NIH Chronic Prostatitis Symptom calyx puncture for access 97 Index 242 dual-lumen catheter use 124, 125 multiple guidewire use 104–5 obesity nephrostomy tube Amplatz sheath securing 102 encrusted 36 balloon tipped trocar for laparoscopic removal of Amplatz sheath after nephrectomy 67 placement 102 laparoscopic nephrectomy post-procedure drainage 101–2 balloon tipped trocar 67 safety wires 100, 101 exit site closure 68 securing the tract 101 modified Hassan technique 45–6 self-retaining nephrostomy tube for suprapubic catheter changing 230–1 drainage 101–2 oesophageal manometry peritoneum, finger access 51 catheter 233 periurethral bulking 201 open prostatectomy Peyronie’s disease, Nesbit’s intraoperative bleeding reduction procedure 185–6 7–8 , physiological 239 retropubic 9 phytotherapy, chronic pelvic pain orchalgia, chronic 246 syndrome 243 orchidectomy, radical pinhole scope 123, 168–9

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pneumoperitoneum quality of life 247 cystectomy 92 preservation 237 modified Hassan technique quercetin 243 47, 48–50 Pollack catheter 132 rectal balloon, rectum pollen extract 243 identification 93 port placement 56 rectal injury test 83 extra for laparoscopic nephrectomy 71 rectal perforation insertion identification 84 finger access to peritoneum 51 rectal injury test 83 modified Hassan technique risk reduction 93 47, 48–50 rectal pressure 233 position rectal prolapse 233 laparoscopic nephrectomy 69 rectocoele repair 195, 196–8 renal laparoscopy 53, 54 rectum identification in robotic-assisted prepuce radical cystectomy 93 assessment 239 5-alpha reductase inhibitor 240 cutting in circumcision 205, 206 chronic pelvic pain syndrome 243 preputioplasty 239 renal artery prostate dissection during laparoscopic radical biopsy 224–6 nephrectomy 73 cryoanalgesia 217–18 ligation 24 modified transrectal 227, 228 renal hypothermia, ice sludge chronic infection 241–3 technique 25, 26 enlarged median lobe 3–4 renal laparoscopy laser enucleation 151, 152–4 patient position 52–3 with holmium cystolitholapaxy 156 plane identification 53–5 morcellation 155 port position 53, 54 massage 241 renal vein, improved control in transrectal ultrasound 224–6 laparoscopic nephrectomy 72 transurethral vaporisation 159 renoscopy, flexible in stone see also transurethral resection of the fragmentation 111, 112–13 prostate (TURP) resectoscope prostate adenoma, intraoperative clot retention in bladder 176 bleeding reduction 7–8 flat superficial transitional cell prostate cancer, hormone therapy carcinoma of bladder 173 247–8 non-irrigating 165 prostatectomy retroperitoneal fibrosis, paired JJ Millin’s 9 stents 139, 140 open robotic forceps 86 intraoperative bleeding robotic-assisted laparoscopic pyeloplasty reduction 7–8 (RALP) 74 retropubic 9 robotic-assisted radical cystectomy radical (RARC) 91, 93 anastomotic leak management 90 nerve sparing 93 minimally invasive 79 robotic-assisted radical prostatectomy retropubic 5–6 (RARP) 76–7, 78, 80, 87 ureteric injury risk minimising 3–4 assistant availability 88 salvage 12 Endo Catch bag 88 see also laparoscopic prostatectomy; relocation 81, 82 robotic-assisted radical Ethicon Vicryl foil use 89 prostatectomy (RARP) lens fogging prevention 89 prostatitis, chronic 241–3 robotic arm freeing 88 multimodal therapy 243 robotic camera lights 89 psychological problems 245 rollerball 159 pyeloplasty antegrade wire placement 66 Sachs urethrotome 129 anterior approach 29–30 safety wires see guidewires laparoscopic 30, 62, 66 salvage cystectomy and robotic-assisted 74 prostatectomy 12

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Satinsky clamp transurethral resection of the prostate avoiding dislodging 23 (TURP) 247 renal artery ligation 24 balloon catheter traction 157–8 saw palmetto 243 urethral catheter passing scrotal skin, round-bodied needles 211 after 161–2 Seldinger kit plastic dilators, displaced urethral stricture 165 suprapubic catheter 177 transurethral vaporisation of the serous fluid from cutaneous fistula 40 prostate 159 short vessels transvaginal tape closure with Endoloop 60 eroded 199–200 ligation 22 mesh eroding the bladder 202 Simms speculum 202 midurethral tension-free 201 skin, local anaesthetic injection 223 tri-radiate grasper 131 spermatic cord, lignocaine trocar, balloon tipped in obese injection 219 patient 67 spinal needle sheath 227, 228 tunica vaginalis, hydrocoele SST deformity 181 resection 220 stapling device, cystectomy 10, 11 Storz dolphin-nosed forceps 63 ultrasonography stress urinary incontinence 201 kidneys 237 suburethral tape, synthetic 201 see also transrectal ultrasound superior port 53 UPOINT 242, 243 suprapubic catheter ureter changing difficult/encrusted 230–1 closure with Endoloop 60 displaced 177 course 116 surgical drain ureteral access sheath, large mid/upper clear fluid 39 ureteric stones 114 parastomal hernia repair 19, 20 ureteric catheter 202 postoperative 40–1 ureteric injury urine testing 39 gynae/obstetric theatre emergency surgical interventions 247 call 37 sutures incision 37 Amplatz sheath migration prevention lower third 31–2, 33–4 during percutaneous risk minimising in radical nephrolithotomy 98, 99 prostatectomy 3–4 circumcision 205, 206 vasculature 32 laparoscopic prostatectomy 75 ureteric obstruction, Peditrol use Nesbit’s procedure 188–9 108, 110 non-absorbable transfixion for radical ureteric orifices, cannulation 3–4 orchidectomy 35 ureteric stent 62 robotic-assisted laparoscopic bladder symptoms 147, 148 pyeloplasty 74 Boston shouldered stent 119, 120 short in deep hole 27–8 changing 121–2 suturing cystoscope use 141 laparoscopic 63–5 difficult view optimisation 133–4 throwing knots 27, 28, 65 dimensions 141 Sympa-Cath 215 exchange over ileal–ureteric anastomosis 135, 136 tissue spreading 86 guidewires 133, 138, 143 transobturator tape, midurethral insertion 137, 141, 143 tension-free 201 flexible cystoscope use 138 transperineal template biopsy 229 paired JJ stents for retroperitoneal transrectal ultrasound 224–6 fibrosis 139, 140 anaesthetic needle 224–5 pelvicalyceal system anatomy 142 bleeding 226 placement 116–17, 118 local anaesthesia 225–6 pusher 141 patient position 224 string 142 transurethral resection of bladder tumour stuck 141 (TURBT) 133 ureteric injury 32 primary 172 ureteric stricture 129

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ureteric stones urethral defect, synthetic sling 199–200 basketing 144 urethral dilator, displaced suprapubic flexible ureteroscopy 116 catheter 177 large mid/upper 114 urethral stricture 166 lasering 127 assessment 169 retropulsion prevention 116, 117 guidewires 166, 168, 215 triradiate grasper 131 internal optical urethrotomy 168 ureteric strictures, dilatation 163 paediatric 167 ureterorenoscopy transurethral resection of the flexible 107 prostate 165 Peditrol use 108, 109, 110 ureteric stent 129 stone fragmentation 111, 112–13 ureteroscopy 129 rigid 108, 109, 110 urethral catheter passing 215 ultra thin 123, 168–9 urethroplasty, guidewire placement 36 ureteroscopy 130–1 urethrotomy basketing of stones 144 extended bridge 133, 134 focusing 130 guidewire 168–9 guidewires 130 internal optical 168 insertion into ureter 146 urethral stricture 129 passing 130 urinary retention 247 preliminary diagnostic urinary tract damage, ketamine cystoscopy 130 abuse 238 white balancing of image 130 urine withdrawing 130 from cutaneous fistula 40 ureteroscopy, flexible 121–2 evacuation 237 dual-lumen catheter use 124, 125 testing from surgical drain 39 epidural catheter use 126 urodynamics 233, 237 guidewires 13, 121, 122 urostomy, prefashioning 14, 15 right collecting system post uterus, prolapse 244 cystectomy 132 ureteric stones 116, 131 vagina, opening during female ureteroscopy, rigid 114, 115–17, 118 cystectomy 92 ureteroscopy, semi-rigid VaporTrode 159 difficulty 131 vascular clamp suction of renal pelvic avoiding dislodging 23 stones 128 renal artery ligation 24 urethral stricture 129 urethra epididymectomy 183 male 222 tension-free reversal 190 mobilisation for Nesbit’s Venflon catheter 216 procedure 185–6 vesicourethral anastomosis urethral catheter leak 90 guidewires 215–16 radical retropubic prostatectomy 5–6 introducer 160 local anaesthetic instillation 232 Wallace anastomosis 132 lubricating gel 232 Weck Hem-o-Lok clip 70, 72 passing across stricture 215 minimally invasive radical passing post transurethral resection of cystectomy 91 the prostate 161–2 tissue spreading 86

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