ObjectivesTo analyse the trends in the number of deaths attributable to urolithiasis in England and Wales over the past 15 years (1999-2013). Urolithiasis has an estimated lifetime risk of 12% in males and 6% in females and is not perceived as a life-threatening pathology. Admissions with urinary calculi contribute to 0.5% of all inpatient hospital stays, and the number of deaths attributable to stone disease has yet to be identified and presented. Materials and MethodsOffice of National Statistics data relating to causes of death from urolithiasis, coded as International Classification of Diseases (ICD)-10 N20-N23, was collated and analysed for the 15-year period from 1999 to 2013 in England and Wales. These data were sub-categorised into anatomical location of calculi, age, and gender. ResultsIn all, 1954 deaths were attributed to urolithiasis from 1999 to 2013 (mean 130.3 deaths/year). Of which, 141 were attributed to ureteric stones (mean 9.4 deaths/year). Calculi of the kidney and ureter accounted for 91% of all deaths secondary to urolithiasis; lower urinary tract (bladder or urethra) calculi contributed to only 7.9% of deaths. The data revealed an overall increasing trend in mortality from urolithiasis over this 15-year period, with an increase of 3.8 deaths/year based on a linear trend (R 2 = 0.65). Overall, the number of deaths in females was significantly higher than in males (ratio 1.5:1, P < 0.001); kidney and ureteric calculi causing death had a female preponderance (1.7:1, female:male); whereas calculi of the lower urinary tract was more common in males (1:2.2, female:male). ConclusionsStone disease still causes death in the 21st century in England and Wales. This trend of increasing deaths must be placed in the context of the concurrent rising incidence of urolithiasis in the UK and the number of stone-related hospital episodes. The primary cause of death relating to complications of stone disease for each individual case should be further investigated to facilitate prevention of complications of urolithiasis.

Introduction Isiris α™ (Coloplast®) is an innovative single-use disposable flexible cystoscope with an integrated ureteric stent grasper designed specifically to remove ureteric stents. It allows clinicians to remove ureteric stents easily on the wards or in clinics without the need of arranging a routine and dedicated flexible cystoscopy appointment for patients. We evaluated Isiris α’s practical use and cost analysis against traditional reusable endoscopes. Method We compared the cost of removing ureteric stents using Isiris α™ in 10 patients prospectively versus traditional flexible cystoscopes in 10 patients retrospectively. The costs of the equipment, medications, reprocess machines, and utility costs were consulted from the relevant departments and companies. As for labour cost, we have sourced British Medical Association (BMA) and Royal College of Nursing (RCN) websites. Results From our study, it costs £260.65 and £123.41 on average to remove a ureteric stent using Isiris α™ and traditional flexible cystoscope respectively (p<0.001). Stent removal in the endoscopy department was delayed in 60% of patients, on average 6.4 days, compared to 0% of patients using Isiris α™ (p = 0.048). Conclusion Although Isiris α™ is shown to be a more expensive option to remove ureteric stents based on our analysis, it still provides clinicians flexibility and ease in removing ureteric stents in the outpatient clinic, reducing the pressure and demand for dedicated flexible cystoscopy slots in the endoscopy department.

A 66-year-old Caucasian man with a background of prostate cancer presented with a progressive history of nausea, reduced appetite, shortness of breath and a distended abdomen. Radiological imaging revealed a left-sided renal mass and gross ascites suggestive of metastatic renal cell carcinoma (RCC). Subsequent histological examination and immunostaining of renal mass biopsy revealed features characteristic of metastatic moderately differentiated to a focally poorly differentiated, large duct type of prostatic adenocarcinoma.

Mahmalji (2020) The role of Rezūm ™ team ablation of the prostate in the treatment of patients with acute urinary retention secondary to benign prostatic hyperplasia. A single center, single surgeon case series and literature review,