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Urology

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Outpatient Department

The Outpatient Department is next to the Urology Ward. Doctors and nurses work alongside each other running clinics and providing advice for patients and professionals. As well as the consultant-led clinics there are nurse-led clinics for:

• pre-assessment
• urodynamics
• trial without catheter
• intermittent self-catheterisation
• bladder chemotherapy/immunotherapy
• continence management  
• bladder and prostate cancer follow-up
• prostate biopsies.

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Urology Ward

Our patients range from those needing routine care to those undergoing radical bladder, prostate or renal surgery. A team of eight consultants plus one locum operates Monday to Friday. Emergencies are admitted directly to the unit or via the Emergency Department.

Our urologists specialise in:

• the management of urological malignancy
• urinary tract stones
• female urology
• transplantation
• reconstructive surgery.

A large amount of clinical and laboratory research is being undertaken in urology. One particularly exciting area is a  study of the use of High Intensity Focused Ultrasound (HIFU) in the non-invasive treatment of tumours.

The SHARP (Study of Heart and Renal Protection) study aims to assess the effects of cholesterol-lowering therapies, and the renal unit and the university are part of the international studies in this field. Similarly, the transplant unit has contributed to a number of studies on immunosuppressive regimes. The transplant unit is also a centre for pancreatic islet transplantation

• Oxford Transplant Centre

Referring via Choose & Book

• Urgent and routine referrals: these should always be referred via the Choose & Book system
• Haematuria – all patients with haematuria are treated as urgent but not all are suspected cancer. 
• Patients <40 with macroscopic haematuria should be referred via Choose & Book and an ultrasound scan should be booked via the GP; following these investigations, urologists will book  further imaging in the form of CTU/IVU.
• Patients <50 with microscopic haematuria should be referred via Choose & Book.  An ultrasound scan should be requested at this stage via the GP.  If these investigations are normal and the haematuria is persistent then the GP should request an IVU.
• Patients >50 with microscopic haematuria and patients >40 with macroscopic haematuria should be referred via the 2WW as stated below.

Referring via Choice Bureau (for GPs not using Choose & Book)

Use Choice Bureau for the following.

• Routine patients should always be booked via the Choice Bureau.
• Urgent patients should be sent directly to the department addressed as Dear Doctor and marked urgent.

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2 Week Wait (2WW) patients (for patients with suspected cancer)

2 Week Wait referrals should be faxed to the 2 Week Wait Bureau to ensure they are booked into the appropriate clinic slots as soon as possible. Use the 2 Week Wait Bureau for the following.

• Haematuria – patients with haematuria and suspected cancer.
• Patients >40 with macroscopic haematuria should be referred via the 2 Week Wait Bureau.  An appointment will be booked in the one stop haematuria clinic on Monday afternoon when they will also get a CT scan along with their flexible cystoscopy.  Results of both these tests will be given to the patient before leaving hospital.  In the absence of a urinary tract infection you should also take a PSA blood test.
• Patients >50 with microscopic haematuria should be referred via the 2 Week Wait Bureau and you should also request an ultrasound scan.  A PSA blood test should also be carried out in the absence of a urinary tract infection.  If these investigations turn out to be normal and the haematuria persists then you should book an IVU. 
• One stop prostate cancer clinic.  This clinic is a one stop clinic where patients who you suspect may have prostate cancer can be seen by a consultant and if necessary go on to have a prostate biopsy on the same day.

Direct referral

Common conditions

Common conditions seen in the Department of Urology.

• Prostate problems including raised PSA  
• Scrotal problems including lumps and scrotal swelling
• Foreskin problems
• Urinary tract infections
• Urinary tract stones
• Incontinence
• Urethral problems
• Neuropathic bladder
• Bladder instability
• Kidney/renal problems
• Loin pain
• Stones
• All suspected urological cancers
• Haematuria
• Male infertility
• Download referral guidelines for common conditions (Word)

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Horton General Hospital

• Outpatients:  one consultant (weekly) and a locum (bi weekly).
• Theatres:  one consultant (weekly) and one consultant (bi weekly).

The team at the Churchill Hospital

• Susie Leach
  Service Manager
• Carolyn Nelson
  Administration and Patient Access Manager
• Fax for the above: 01865 226086

The team at the Horton General Hospital

• Mr Jeremy Crew
• Mr Amar Manandhar (Locum)
• Mr Simon Brewster

Documents

• Investigation into adult (>18 years old) haematuria in Oxfordshire in primary and secondary care (pdf)
• Complete haematuria pathway (pdf)
• Acute loin pain protocol February 2009 (pdf)