James Lee

Publications (3)4.58 Total impact

• Article: Evaluation of outpatient cystoscopy in urogynaecology.

  James W S Lee, Stergios K Doumouchtsis, Stephen Jeffery, Michelle M Fynes
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  ABSTRACT: Prospective evaluation of outpatient cystoscopy in a Urogynaecology Unit. Prospective observational series. St. George's Hospital, London. Department of Pelvic Reconstructive Surgery and Urogynaecology. A total of 131 consecutive women, who underwent outpatient rigid cystoscopy over a 24-month-period. Prospective data collection included cystoscopic findings, microbiology data, uroflowmetry and radiological results. An Immediate Feedback Questionnaire was completed at the end of the procedure. Success rates of the procedure, cystoscopy findings, requirements for additional investigations, including inpatient cystoscopy and patient satisfaction rates. The mean age was 56.4 years (range 20-87 years). A total 126 women (96.2%) had a successful outpatient cystoscopy. In five (3.8%) women the procedure had to be abandoned because of inability to insert the cystoscope. Eleven women (8.7%) experienced pain but were able to tolerate the discomfort. Fifty-three (42.7%) women had abnormalities detected at cystoscopy. Thirty-seven women had trabeculations. Focal vesical lesions were found in 21 women. Thirty-nine (30.9%) women did not require any additional treatment. Six (6.9%) women were scheduled for repeat cystoscopy under general anaesthetic to facilitate a bladder biopsy. Fifteen women (17.2%) were referred for urodynamics or renal imaging. Three women (3.4%) were referred to a urologist. More than 75% reported high satisfaction with the care they received. Four women had symptoms of UTI and two had positive urinary cultures and required antibiotics. The benefits of outpatient cystoscopy include high levels of tolerability and patient satisfaction, shorter waiting time, quicker implementation of treatment strategies, avoidance of the risks of general anaesthesia and lower procedural cost.
  Archives of Gynecology 10/2008; 279(5):631-5. · 0.91 Impact Factor
• Article: Is Doppler planimetry a valid technique for the evaluation of postpartum urinary bladder volume?

  James W S Lee, Stergios K Doumouchtsis, Michelle M Fynes
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  ABSTRACT: The objective of this prospective study was to evaluate the accuracy of conventional 2D ultrasound (CUS) versus doppler planimetry (DP) in the assessment of postpartum urinary bladder volume compared to a true estimate using urethral catheterisation. Fifty-two women were assessed within 24 hours of delivery. Evaluation of bladder volume was performed using CUS (1-estimate) and DP (6-estimates). CUS had a higher correlation (r=0.796) with the true volume and lower % error than DP in the postpartum group. DP readings were highly reproducible (ICC 0.81) but tended to overestimate the true value especially with smaller volumes. DP was suboptimal for the assessment of the postpartum PVR. Postpartum evaluation using CUS is more accurate in calculating the true urinary volume.
  International Urogynecology Journal 08/2008; 19(7):1019-25. · 1.83 Impact Factor
• Article: A modified technique for the surgical correction of urethral diverticula using a porcine xenograft.

  James W S Lee, Stergios K Doumouchtsis, Michelle M Fynes
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  ABSTRACT: We report a case of urethral diverticulectomy re-enforced with a porcine xenograft to prevent the risk of recurrence or fistula in the presence of a large urethral communication. The use of porcine small intestinal submucosal xenograft (SIS, Surgisis, Cook, Ireland) material has a low graft rejection rate and erosion is rare as the material is degraded after 3 to 6 months. In this case, xenograft achieved tension-free closure of the urethral defect without any postoperative complications.
  International Urogynecology Journal 08/2008; 20(1):117-20. · 1.83 Impact Factor