Biomedical subjects

Frank I Chinegwundoh

Publications and source records attributed to Frank I Chinegwundoh.

3 recordsLinked to original sources

PubMed2006

The management of aspirin in transurethral prostatectomy: current practice in the UK.

INTRODUCTION: Stopping aspirin prior to transurethral prostatectomy (TURP) may minimise peri-operative blood loss, but it may also increase the risk of a significant cardiovascular event. There are no guidelines on the management of aspirin in TURP. This study sought to determine the variation in the peri-operative management of transurethral prostatectomy (TURP) patients that are taking aspirin. MATERIALS AND METHODS: A questionnaire was sent to 444 consultant urologists in the UK from a list obtained from the British Association of Urologists. This resulted in 290 anonymous replies (65%), of which 287 were suitable for analysis. RESULTS: Of these 287 urologists, 178 (62%) ask patients to stop aspirin prior to TURP. Aspirin is stopped 9.8 days (median, 10 days; range, 2-30 days) prior to surgery, and recommenced 8.8 days (median, 7 days; range, 1-42 days) after surgery. In those that stop aspirin, 62% will stop aspirin in all patients, regardless of the indication, and 40% will cancel a TURP if aspirin use has inadvertently continued. Of the 287 urologists, 109 (38%) do not stop aspirin. CONCLUSIONS: There is a wide variation in the management of aspirin in TURP patients in the UK. Aspirin is being stopped in patients at high risk of serious cardiovascular disease, often for longer than necessary. There is a need for multidisciplinary guidelines to reduce variation in practice.

Aspirin↗

PubMed2004

Upper tract surveillance in primary bladder cancer follow-up.

OBJECTIVE: To determine if there is national variation in regimens of upper urinary tract surveillance in patients with primary bladder cancer. METHODS: A questionnaire was sent to 470 consultant urologists from a British Association of Urological Surgeons list in the UK; 301 anonymous replies were received. Two replies were incomplete and therefore the results of 299 questionnaires (64%) were analysed. RESULTS: Of the 299 surgeons, 19 (6%) use no form of upper urinary tract surveillance; 162 (54%) use surveillance in selected patients, i.e. those with carcinoma in situ (47%), multiple bladder tumours at first presentation (39%) and after cystectomy (70%), and 118 (39%) use upper tract surveillance on all patients with a history of bladder cancer. The median (range) screening interval was 24 (12-60) months and surveillance continued for a median of 10 (2 to indefinite) years, continuing for an indefinite period in 33%. CONCLUSIONS: Most urologists use upper tract surveillance in patients with bladder cancer but there is wide variation in the duration and interval for which it continues, and in the type of patient selected for surveillance. Some patients at high risk of upper tract tumour are not being screened. Asymptomatic upper tract tumours may not be diagnosed because the intervals between surveillance are too long, and the duration for which it continues inadequate. There is a need for multidisciplinary national guidelines to reduce variation in practice.

Carcinoma in Situ↗

PubMed2004

Virtual cystoscopy from computed tomography: a pilot study.

OBJECTIVE: To assess the feasibility of virtual cystoscopy reconstructed from helical computed tomography (CT) obtained using an intravenous contrast agent, and to correlate the findings with flexible (FC) and rigid cystoscopy (RC) in patients with bladder tumours. PATIENTS AND METHODS: Eighteen patients (16 men and two women, mean age 72 years, range 59-80) with haematuria and found to have a bladder tumour on FC were included in a pilot study. Contrast-enhanced helical CT scans were taken and based on these datasets, virtual cystoscopy (VC) images were reconstructed by a radiologist unaware of the findings at cystoscopy. All patients had RC and a biopsy taken. The VC images were compared with the findings from FC and RC. RESULTS: At FC, VC and RC, 32, 34 and 36 lesions were identified, respectively; 33 (92%) of the abnormal lesions at RC were correctly identified at VC. At VC, all lesions of >4 mm were identified but only one of three <4 mm was seen. There were two false-positive finding at VC; VC correctly identified 17 (94%) of 18 abnormal bladders. Only 25% of the ureteric orifices were seen. Carcinoma in situ and urethral tumours were not visualized. CONCLUSION: CT-based VC has a high sensitivity for detecting bladder lesions and is comparable with FC; it may have a potential role as a single imaging tool for haematuria. Further larger studies are required to assess its clinical role.

Aged↗