ObjectiveAlthough medical expulsive therapy (MET) is shown to be effective for ureteric calculi, the optimum duration and the stone size suitable for MET are not well established yet. The objectives of the study were to determine the optimum duration and maximum stone size suitable for MET.ResultsAll patients with radiologically confirmed uncomplicated ureteric calculi treated with MET using tamsulosin over a period of 6 months in the outpatient setting were followed up. There were 213 patients. 165 were men. Mean age was 42 years. At presentation 42 stones were in upper ureter (19.7%), 51 in mid ureter (23.9%), 120 in lower ureter (56.3%). The majority (82.7%) of stones were less than 10 mm. Seven stones (3.3%) were over 15 mm. Ninety-two (43.2%) patients had spontaneous passage of stones within 6-weeks of MET. Another 38.9% passed the stone within the next 6-weeks. Thirty-eight patients (17.8%) required surgery. Uncomplicated ureteric stones up to 10 mm can be given a trial of MET using tamsulosin which can be extended up to 12-weeks with a success rate over 92%. This may have substantial clinical and fiscal benefits by reducing the number of interventional procedures especially in resource-poor settings.Electronic supplementary materialThe online version of this article (10.1186/s13104-017-2974-1) contains supplementary material, which is available to authorized users.

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IntroductionOne of the core indicators of monitoring universal access to safe, affordable surgical care is access to timely, essential surgery. Analysing the waiting time for elective operations is one way to determine access to surgical services in a country. Aims of this study were to determine the access to surgical services in a urology unit of Sri Lanka by analysing waiting time for elective surgical operations and to determine whether waiting time is related to income categories and social classes.

Introduction Laparoscopic appendicectomy (LA) is considered as the mainstay of treatment in acute appendicitis. LA is a basic laparoscopic procedure and therefore can be used as a training tool for surgical trainees. It is considered an index operation for junior surgical trainees. This study aims to assess whether LA is safe to be carried out by a junior surgical trainee. Methodology The study was conducted at a tertiary care unit in Colombo. Data were collected retrospectively. A total of 152 LA (including those which were converted to open appendicectomy) performed between January 2018 to May 2019, by surgical trainees (both junior and senior) were included. Gender, age, initial investigation findings, intraoperative findings, operative time, hospital stay, postoperative complications and histology data were analysed. Findings were compared in two groups-operated by junior and senior surgical trainees. Results One hundred and three surgeries were performed by junior trainees while 49 were performed by senior trainees. There was no significant difference in complicated appendicitis (21.4% vs 34.7%), operative time (71m vs 68m), conversion rate (12.6% vs 16.3%) and hospital stay (3d vs 3d) between these two groups. The overall complication rate was 3.9%. Conclusion Our findings were comparable to previously published data and no statistically significant difference was noted between the two trainee groups in terms of operative finding, hospital stay and postoperative complications. The results suggest that LA can safely be performed by the junior surgical trainees with acceptable outcomes.

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