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The St George’s Hospital Endourology unit provides comprehensive investigation and management of patients with kidney and ureteric stones. The unit also provides endourological diagnosis management of upper tract urothelial carcinoma (UTUC) and the management of benign and malignant ureteric strictures. The unit has 4 high volume endourology surgeons who are supported by a dedicated endourology specialist nurse.


Governance

We are the tertiary referral centre for the region and also receive national and international referrals. We run a dedicated endourology MDT attended by uroradiology, microbiology and nephrology to ensure patients receive a comprehensive approach to their management. We offer second opinions through this forum for patients and clinicians from around the country.

We have set up a local and regional endourology governance structure involving other units across London and Surrey. We have excellent and efficient links with our partner hospitals in the region. Our aim is to introduce “approved” clinics throughout the region with centralised surgery to improve patient outcomes and governance. Our unit contributes surgical outcome data to the BAUS PCNL national database with the aim of driving forward surgical standards.

Our dedicated specialist nurse provides individually tailored information and advice to prevent stone recurrence and runs a post-operative telephone clinic to ensure continuity of care and a patient point of contact.


Treatments

The Unit offers comprehensive endourology treatment options including:

  • Percutaneous nephrolithotomy (PCNL , mini PCNL).
  • Flexible Ureterorenoscopy and Hol:Yag laser lithotripsy.
  • Extracorporeal Shockwave lithotripsy (ESWL) (delivered at Epsom hospital).
  • Endoscopic diagnostic and therapeutic management of UTUC including NBI surveillance and laser ablation.
  • Balloon dilatation of ureteric strictures.
  • Insertion of silicone (including twin) and metal (Memokath) stents for the management of benign and malignant ureteric obstruction.
  • Endourological management of ureteric trauma.
  • Immediate 24/7 access to interventional radiology with antegrade and rendez vous techniques as well as superselective embolization capabilities.
  • Paediatric stone management including PCNL delivered in conjunction with Paediatric Urologists.

Other services

St George’s has the advantage of the co-location of interdependent services on one site such that high risk patients and their problems can be managed effectively and efficiently due to our good working relations with other specialities including nephrology, microbiology, intensive care and interventional radiology. Patients have access to high risk anaesthetic and intensive care services pre-operatively and we have experience of complex anatomical and bariatric cases. There is excellent support and dedicated teams for patients with learning difficulties and those with complex neurological needs.


Research, Education and Training

The unit is actively involved in research and is a centre for the recruitment of patients into NIHR funded multicentre studies such as SUSPEND, TISSU and PURE (yet to be launched). The unit has supervised research trainees resulting in MD and MSc theses on studies including 3D-CT imaging and PCNL. Other work has led to the implementation of an e-stent register taken up nationally by BAUS.

We offer training in endourology for all levels of including junior CT and ST trainees as well as international post CCT fellows. We have recently introduced a modular PCNL and FURS training schedule for all levels of experience.

The team is actively involved in training at all levels with Clinical Supervisor, Education Supervisor, National Selection, FRCS examiner and International Fellowship examiner roles. This provides invaluable training opportunities and experience for aspiring urologists and endourologists.


Specialist nurse

Kristoffer OhlinClinical Nurse Specialist

  • 020 8725 0163


Contact: Debra Sharman

  • Debra.Sharman@stgeorges.nhs.uk
  • 020 8725 3305