The Trust’s Urology service is a comprehensive ‘hub and spoke’ service operating from a wide area of the North East including Sunderland Royal Hospital (the hub) and South Tyneside District Hospital, University Hospital of North Durham, Shotley Bridge Hospital, Chester le Street Hospital and Bishop Auckland General Hospital (the spokes).
Our aim is that all patients will be treated as close to their home as possible, therefore all outpatient, diagnostic, daycase and pre-admission appointments are provided at all sites. It is only the specialist inpatient care that is carried out solely in Sunderland.
Sunderland Royal Hospital has a Urology Treatment centre for outpatients (see detail below), dedicated theatres for inpatient and daycase surgery and two wards. The spoke hospitals offer outpatient and diagnostic urology services and daycase surgery.
Male urology inpatients are admitted to Ward D46 whilst female inpatients are admitted to Ward D47 (which is shared with Gynaecology). If the beds on D46 and D47 are fully occupied then patients will usually be admitted to the Emergency Surgical Assessment Unit (ESAU) in the first instance.
There are 2 dedicated urology theatres run by specially trained nursing staff. Access to additional theatres is also provided should the need arise, and there is also access to digital theatres for laparoscopic work. In addition to this cystoscopies and lithotripsy (for kidney stones) are carried out on day case patients in the Urology Investigations Unit.
As the department covers Durham/Bishop Auckland/South Tyneside as well as Sunderland, patients who come here as emergencies but live somewhere else (eg in Durham) and require follow-up, will be followed up in out-patient clinics by a consultant who covers that area.
Urology Cancer Services
In addition to the general urology work carried out the department is also the cancer centre for the aforementioned geographical areas, offering specialised treatments as follows:
- Prostate cancer – monitoring, hormone therapy, radical retropubic prostatectomy and cryosurgery – patients can be referred for cryosurgery from anywhere in the UK.
- Renal cancer – “keyhole” laparascopic radical nephrectomy and nephroureterectomy are offered in additional to traditional open radical nephrectomy and partial nephrectomy. Renal cryosurgery is also used for some smaller kidney cancers.
- Bladder cancer – Localised disease is treated with bladder washouts with mitomycin or BCG. The department also offers radical cystectomy with ileal conduit formation – laparoscopic surgery is being developed in this area. The Trust run’s a support group for patients who have been diagnosed with bladder cancer. Click here for more information.
- Penile cancer – Sunderland Royal Hospital Urology Department is the regional unit for referral of patients with penile cancer and offers highly specialised treatments – radical penectomy, partial penectomy with reconstruction, lymph node dissection and CO2 laser treatment.
Benign Urological Disorders
- Stone Disease – Stones are treated by percutaneous surgery, ureteroscopic surgery or lithotripsy. Laser fragmentation of stones is now used to increase stone free success rates.
- Functional Urology
- Erectile dysfunction is treated by medications, devices and artificial penile prostheses.
- Incontinence is treated by medications, pelvic floor exercises, sling surgery to support the bladder neck and artificial urinary sphincter placement.
- Overactive bladder treatments include medications, Botox injections and Neuromodulation.
- Urethral strictures are treated by widening the urethra or open surgery.
In addition to the surgeons, to support the patients, the department also has a number of Specialist Nurses who work in a variety of specific areas:
- Nurse cystoscopist – offers a specialised and individualised service caring for patients with bladder cancer from attendance at the haematuria clinic, performing follow up cystoscopies and supporting and helping the patients and their families to cope with living with a diagnosis of bladder cancer
- Peripatetic Urology Specialist Nurse Team – Offering a supportive, specialised, individual service for patients at home. Treatments available at home include Trial Without Catheter, catheter removal, bladder scan, re-catheterisation, administration of Zoladex for prostate cancer patients, teaching patients or their carers to perform Intermittent Self-Catheterisation, and Zoledronic Acid infusion for patients with advanced prostate cancer.
- Research Nurse – co-ordinates and runs all clinical trials carried out with patients in the urology department, in particular urological cancers, and is involved with audit carried out in the department. The research nurse also has a special remit for patients who have had cryosurgery to the prostate gland, and penile cancers, and offers a highly specialized and personalized service.
- Nurse Specialists – offer a specialised service for all patients with a urological cancer. The MacMillan Urology Nurse Specialists are also the Key Workers for cancer patients co-ordinating their care and promoting continuity, contributing to pre-assessment, clinics, day case unit and visiting patients on the wards. They are also a resource, assisting in the nursing care of patients with a urological cancer, facilitating information provision, supporting and counselling, advising and educating staff, patients and their carers, providing a tailor made package of support.
- Stoma Nurse – offers a specialised individualised service for all patients with malignant or benign disease across all hospitals (detailed above), who are considered for cystectomy and ileal loop diversion or bladder augmentation. Hospital and at home follow up care is available to provide support and advice about the disease and use of appropriate appliances. Nurse-led outpatient clinics are being set up in Sunderland and South Tyneside.
Urology Treatment Centre – Sunderland
The UTC offers a comprehensive service comprised of doctor’s outpatient clinics and a range of specialised nurse-led clinics.
- An ultrasound guided prostate cancer screening service is in available with follow up and treatment provided by the specialist nurses, which includes administration of hormone implants (e.g. Zoladex and Prostap injections)
- Assessment and treatment of male erectile dysfunction is a combined service provided jointly between medical and nursing staff. Specialist nurses provide teaching and administration of a variety of treatments.
Nurse-led services also include:
- Bladder pressure studies (urodynamics) which support the diagnosis and treatment of a range of bladder problems (e.g. incontinence, frequency of passing urine)
- Catheterisation clinics include care and changing of indwelling catheters, teaching of self catheterisation and follow up care.
- Administration of cytotoxic chemotherapy and immunotherapy treatments into the bladder for superficial bladder cancer
- The staff in the UTC also provide an advisory and resource service for patients, nurses and medical staff.
Mr Damien Greene Consultant Urologist – 0191 565 6256 ext 42191
Mandy Bates – 0191 565 6256 ext 42101
- Cancer Backup
- The Prostate Cancer Charity
- Cancer Research UK
- The Prostate Cancer Research Foundation
- Kidney Cancer UK
- The Bladder and Bowel Foundation
- Sexual Dysfunction Association
- The Cystitis and Overactive Bladder Foundation
- UK National Kidney Federation