Background: Recent changes in practice standards and remuneration to UK Trusts have been refined to penalise institutions for patient readmission within 30 days of discharge. The purpose of this study was to determine if the target rate of less than 6.5% was attained within the setting of a district general hospital (DGH) and also to comment on readmission trends. Materials and methods: A retrospective study was performed over 12 months examining all unplanned readmissions to hospital 30 days following discharge from Urology. Elective as well as emergency cases were audited. Results: A total of 4124 patients were treated and discharged by the department over 12 months. One hundred and eighty-four (4.4%) patients were readmitted: 93 (51%) patients following acute presentations and 91 (49%) following elective procedures. The commonest causes for unplanned readmission were haematuria, 29 cases (16%), acute urinary retention, 28 cases (15%) and ureteric colic, 25 cases (14%). Readmission rates following flexible cystoscopy and TRUS biopsy were 1% and 3%, respectively. Only six of 70 patients (9%) were readmitted following TURP. Five (3%) of the 184 readmissions required a second procedure. Conclusion: Our department met the predetermined standard in achieving an unplanned readmission rate of less than 6.5%. This study also highlighted the need for discharge policies for common acute presentations.

Objective: Despite a substantial body of literature on prisoner health and the management of specific conditions that affect incarcerated persons, there remains a paucity of data pertaining to the specific urological needs of prisoners. Additionally, no study has documented the impact of prison referrals on a department of urology. Materials and methods: A year-long prospective study was performed in a university hospital recording all contact made by detained persons with the department of urology. Results: A total of 77 clinical encounters were made by 47 detained patients from seven different institutions over 12 months. All patients were male. The most common reason for urological consultation was investigation of lower tract symptoms, but a total of 18 separate complaints were recorded, including acute trauma. Conclusions: The presence of several places of detention impacts significantly on a department's workload. Management of persons detained under Home Office Licence in a general hospital poses several challenges, including confidentiality and security issues, privacy and patient concerns and prison personnel secondments. The transient nature of the prisoner population can pose difficulties for planned admissions and outpatient follow-up.

A 26-year-old female presented with a history of cyclical incontinence following a ventouse assisted delivery. Initial investigations revealed an endometrial deposit in her bladder, which following further investigations revealed a vesicouterine fistula necessitating formal open repair.

Deep venous thrombosis (DVT) remains a serious and common complication of surgical procedures and is therefore an issue of importance for all urologists. In the UK, pulmonary embolism (PE) following DVT in hospitalised patients causes 32,000 deaths each year. DVT and PE represent the outcome of venous thromboembolism (VTE). The total cost for management of VTE in 2005 was approximately ₤640 million. Early risk assessment and optimising modifiable risks are paramount in order to reduce the incidence of VTE. In this article we review common risk factors for VTE and emphasise specific risk factors for urological procedures. The perioperative management of urological patients who are chronically anticoagulated is discussed. We review the literature regarding anticoagulation and its relevance to all urological procedures and mention the problems associated with new anticoagulant agents. All urologists should be familiar with the new range of anticoagulant agents due to the increasing number of patients taking them.