Semi-Automatic Electronic Stent Register: a novel approach to preventing ureteric stents lost to follow up.

Background: Ureteric stents are indispensable tools in modern urology; however, the risk of them not being followed-up once inserted poses medical and medico-legal risks. Stent registers are a common solution to mitigate this risk; however, manual registers are logistically challenging, especially for busy units.

Methods: Western Sydney Local Health District developed a novel Semi-Automatic Electronic Stent Register (SAESR) utilizing billing information to track stent insertions.

Safety, efficacy and predictors of local recurrence after percutaneous radiofrequency ablation of biopsy-proven renal cell carcinoma.

Purpose: To evaluate the safety and efficacy of percutaneous radiofrequency ablation (RFA) for localised renal cell carcinoma (RCC) and examine potential associations between age, gender, tumour size, location, chronic kidney disease, comorbidities, learning curve and local recurrence.

Methods: We retrospectively analysed survival outcomes for patients with biopsy-proven RCC treated by RFA at Westmead Hospital. Complication data were gathered from all patients that underwent renal RFA.

Geographical variation in the management of urolithiasis in Australia.

Background: To examine any geographical variation in the management of urolithiasis amongst the Australian states and territories.

Methods: Retrospective study with data obtained from the Medicare Australia database, the Royal Australasian College of Surgeons and the Urological Society of Australia and New Zealand.

Results: Minimally invasive stone treatment with shock wave lithotripsy (SWL) and ureteroscopy (URS) accounted for the majority of stone treatments in Australia (98%).

Changes in upper urinary tract stone composition in Australia over the past 30 years.

Objectives: To investigate upper urinary tract stone composition rates in Australia To investigate changes in stone composition in Australia over the past 30 years

Patients And Methods: The Institute for Clinical Pathology and Medical Research (ICPMR) database was used to obtain - stone composition statistics from 2009-2011 Historical comparisons of stone composition rates were obtained from previous Australian studies; Rofe; 1981, and Baker; 1993 for epidemiological data from the 1970s and 1980s respectively. Stone composition data was separated into gender and age-groups

Results: From the 791 stones analysed between 2009 and 2011, calcium oxalate remains the dominant type accounting for 64% of stones in our dataset, which compares to 68% from both the 1970s and 1980s. Uric acid stones contributed 16% of contemporary stone compositions, comparable to 16% in the 1970s and 17% in the 1980s.

Evolution of stone management in Australia.

Unlabelled: What's known on the subject? and What does the study add? There is very little contemporary data regarding stone management in Australia. This study assesses the impact of technological advances on stone management practises, and raises questions as to why there is an increasing rate of intervention for stone disease in Australia. Knowledge of management trends as demonstrated in this paper give individual surgeons a guideline for contemporary practise in this country.

Stopping anticoagulation before TURP does not appear to increase perioperative cardiovascular complications.

Objective: To evaluate the impact of stopping anticoagulant medications prior to transurethral resection of the prostate on peri-operative cardiovascular complications.

Methods: Retrospective series (305 patients) undergoing TURP at a tertiary hospital between 2006 and 2010. All men were evaluated in preadmission clinics with defined protocols, with a low threshold for cardiovascular investigation.

Laparoscopic suturing: effect of instrument handling on suture strength.

Background And Purpose: In open surgery, handling of suture at any position other than the end is discouraged because of evidence that handling deforms and weakens the material. The limited operative field of laparoscopic surgery necessitates repeated instrument handling of suture, and the effect of such handling has not been investigated. We assessed the effect of trauma imposed on various suture materials by laparoscopic needle holders and forceps.

Bone formation in the urinary tract: case report.

A case of osseous metaplasia of the ureter presenting as a small upper-ureteral calculus is reported. This rare phenomenon may represent an unusual nucleus for stone formation in the urinary tract. The etiology of this condition is uncertain; we speculate that trauma to the ureter may stimulate osseous metaplasia.

Stone and pelvic urine culture and sensitivity are better than bladder urine as predictors of urosepsis following percutaneous nephrolithotomy: a prospective clinical study.

Purpose: Urosepsis due to manipulation during percutaneous nephrolithotomy (PCNL) can be catastrophic despite prophylactic antibiotic coverage, and negative midstream urine culture and sensitivity testing (C&S). It has been postulated that bacteria in the stone may be responsible for systemic infection. In this prospective study we determined the correlation between different sites of urine sampling, including stones, and also ascertained which is more predictive of urosepsis.

A comparison of the pathology of transitional cell carcinoma of the bladder and upper urinary tract.

Objective: To clarify the histopathological patterns of upper and lower urinary tract transitional cell carcinomas (TCCs), as previous reports suggest that upper urinary tract TCCs have a greater tendency towards high-grade disease than bladder TCCs, of which most are low-grade and low-stage tumours.

Patients And Methods: All patients presenting with TCC of bladder or upper urinary tract between February 1991 and December 2001 at one institution were identified. Further patient information was obtained from the hospital database and case-note review.

Oncological control following laparoscopic nephroureterectomy: 7-year outcome.

Purpose: Proof of the oncological safety of laparoscopic nephroureterectomy (LNU) relies on truly long-term outcome being at least equivalent to that of open surgery. We compared the long-term oncological outcome of laparoscopic versus open nephroureterectomy (ONU) in patients with upper tract transitional cell carcinoma (TCC).

Materials And Methods: Between April 1992 and January 1999, 26 LNUs and 42 ONUs were performed at our hospital for suspected upper tract TCC.

Intracorporeal ribbon gauze in laparoscopic surgery.

Good haemostasis optimizes laparoscopic visibility and performance. The use of suction reduces pneumoperitoneum and collapses the operative space, and the resulting fall in intra-abdominal pressure can increase the rate of bleeding. Therefore, other methods of improving laparoscopic visibility need to be investigated.

Simple technique for identifying the linea alba in lower abdominal incisions.

Background: Identification of the true midline in infra-umbilical longitudinal incisions is often difficult. Traditional methods of identification can be unreliable.

Methods: An alternative technique for identifying the linea alba, based on the attachments of the median umbilical ligament, is presented.