The urology department provides a modern and comprehensive urology centre for the Teesside area.
- Laser ablation/resection in the treatment of benign prostatic hyperplasia (NEW at Friarage Hospital)
- Complex urological cancer surgery
- Male and female bladder dysfunction
- All aspects of stone disease (endourology)
- Management of transplantation patients
- Laparoscopic surgery
- Management of spinal injury patients
Complex urological cancer surgery
The urology department at The James Cook University Hospital treats urological cancers including the bladder, prostate, kidneys and testicles.
We also assess patients with penile cancer, which are managed in supra-regional centre at Sunderland Royal Infirmary.
All patients diagnosed with cancer are reviewed at regional multidisciplinary uro-oncology meeting with central review of imaging and pathology. We offer the following complex cancer surgery:
- Cystectomy with and without bladder reconstruction
- Radical prostatectomy
- Radical nephrectomy and nephrone-sparing kidney surgery
- Retroperitoneal lymphnode dissection for germ cell tunours
- Specialist nursing support
Sister Patricia McClurey provides counselling and support for prostate cancer patients. Intravesical BCG and stoma support is offered by Sister Lynn Mudd. Specialist bladder cancer and stone nurse appointments will be made this summer.
Male and female bladder dysfunction
Our department is fully-equipped for dealing with both male and female bladder dysfunction.
Men with lower urinary tract symptoms undergo uroflow and residual assessment as well as fill in IPSS questionnaire. We offer prostatic surgery in cases of bladder outflow obstruction resistant to medical management.
Fluoroscopy-assisted urodynamic assessment of the bladder dysfunction is standard.
We offer Botox injections into detrusor and bladder augmentation for resistant overactive bladder.
Sister Jo Begley performs intravesical oxybutynin and Cystistat installations as well as clean intermittent self-catheterisation tuition.
We perform full range of surgery for stress incontinence in both males and females after trial of pelvic floor exercises, including peri-urethral injection techniques, TVTs, male slings and artificial sphincter insertion.
We are a major stone centre, providing laser, pneumatic, ultrasonic and extra-corporeal shock wave lithotripsy as well as percutaneous kidney stone surgery. The tracks for the latter are inserted both under fluoroscopic and ultrasonic guidance in close corroboration with our uro-radiologist, Dr Geoffrey Naisby.
We offer assessment and treatment for patients with andrological problems, including erectile dysfunction, Peyronie’s disease and testosterone deficiency.
Sister Jo Begley extends andrology service to intra-cavenosal vaso-active therapy, vacuum device use and other advanced andrology options. Penile prosthesis insertion is provided by the department in cases of erectile dysfunction resistant to conservative measures.
Management of transplantation patients
The transplantation services are provided at Freeman Hospital, Newcastle, however we manage any urological complications of the kidney transplants. We work in close cooperation with renal medicine department which is greatly facilitated by weekly nephrourology x-ray meeting.
Laparoscopic urological surgery is a new and exciting development. It offers to patients quicker recovery and return to work, as well as being oncologically sound. Laparoscopy is now routine for most of the kidney cancer patients and becoming so for the rest of conditions.
Management of spinal injury patients
Urology service to spinal injury patients is part of the spinal injury and rehabilitation centre, one of the eight in the UK. The service starts with urodynamic assessment of the neuropathic bladder with subsequent selection of the best bladder management, aiming for safety of the upper tracts, freedom from incontinence and urinary infections. The range of interventions includes Botox and intermittent catheterisation, augmentation cystoplasty, artificial sphincter insertion and continent diversion.
The spinal injuries urology service is greatly aided by our spinal outreach sisters, trained also in bowel and erectile dysfunction management in spinal patients.
Patients with certain types of renal stone disease respond well to lithotripsy treatment. Lithotripsy is a non-invasive treatment for kidney stones; it requires no form of anaesthesia and is carried out as a day case procedure.
Previously this treatment has been offered only monthly as the hospital had to hire a lithotripsy machine for one day a month limiting treatment spaces, however,
James Cook has recently purchased a permanent lithotripsy machine. This will enable the hospital to provide a gold star, timely treatment pathway for patients. Patients referred into the Urology department for management of stone disease will be assessed for suitability for lithotripsy treatment at the patient’s first outpatient appointment.
There is a general consensus by urology consultants, that day case lithotripsy is favoured more as a treatment than conventional surgery, as it is recognised as best practice. This is supported as the treatment is organised and performed by a consultant endo-urologist 3-4 sessions weekly. We are aiming to increase our treatment availability from 126 slots per year to 630, enabling patients to be treated speedily.