Study Type – Symptom prevalence (retrospective cohort)
Level of Evidence 2b OBJECTIVE To determine the incidence of acute presentation of urinary calculi (UC) in Auckland, New Zealand, during the period 1999–2007, and whether there was any significant seasonal variation. PATIENTS AND METHODS The details of all UC within the population presenting acutely to public hospitals in Auckland between 1999 and 2007 were collected using clinical coding searches International Classification of Disease 10th revision (Australian Modification) N132 and N20. Climatic variables for the Auckland region were obtained from the National Institute of Water and Atmospheric Research, New Zealand. The mean atmospheric temperature, hours of sunshine and humidity data were calculated monthly for this period. RESULTS During the study there were 7668 acute presentations of UC in the Auckland region. A Poisson regression model showed that the number of presentations was significantly related to temperature (P < 0.001) and hours of sunshine (P = 0.004) but not humidity (P = 0.14). For each degree increase in temperature the number of presentations increased by 2.8% (95% confidence interval 1.3–4.3%). For each 1‐h increase in sunshine, the number of presentations increased by 0.2% (0.06–0.33)%. CONCLUSION The acute presentation of UC in Auckland, New Zealand, varies significantly with temperature and hours of sunshine. Humidity was not a significant factor.

XGP is a rare chronic inflammatory condition that appears to be overrepresented by Maori and Pacific islanders in our cohort when compared with the overall patient pool. Surgical treatment is associated with significant morbidity but remains the only definitive option. Obesity and other conditions associated with metabolic syndrome may coexist at the time of presentation and may be contributing factors to the development of XGP and poor outcomes associated with it.

RESULTSBefore RRP 38% men had a flow rate of £ 10 mL/s, suggesting obstruction. At the first review (median 2 months) there was an increase in flow rate (median 16.8 vs 11.6 mL/s, P < 0.001) and at the 6-, 14-and 20-month visits this improved further, to 20, 21 and 24 mL/s, respectively. Before RRP 56% of men had moderate or severe symptoms, with an IPSS of ≥ 8. At 2, 6, 14 and 20 months the proportion of men with an IPSS of ≥ 8 decreased to 26%, 14.5%, 18% and 14% ( P < 0.001); 20% developed stricture/stenosis and initially these men had a decrease in flow rate and a higher IPSS. Their symptoms improved when the stricture was treated. CONCLUSIONSTwo-fifths of men with prostate cancer undergoing RRP have bladder outlet obstruction, as defined by a flow rate of <10 mL/s and bothersome symptoms. This study showed that there is a very significant increase in flow rate and decrease in IPSS after surgery. RRP offers improved voiding function and urinary symptoms, and the possibility of curing the cancer. KEYWORDSprostate cancer, radical prostatectomy, urinary symptoms OBJECTIVETo evaluate the change in flow patterns and urinary symptoms before and after radical retropubic prostatectomy (RRP). PATIENTS AND METHODSBetween 1994 and 1998 one surgeon undertook RRP in 125 men. Urinary flow rates and the International Prostate Symptom Score (IPSS) were recorded before and at each visit after RRP; only voids of >150 mL were included. Strictures and bladder neck stenoses requiring surgical intervention were noted. Statistical significance was determined using Student's t or the chi-squared test.

ObjectiveTo analyse the outcomes of emergency ureteroscopy (URS) cases performed in Auckland City Hospital. MethodsWe conducted a retrospective review of all emergency URS procedures performed at Auckland City Hospital between 1 January 2010 and 31 December 2011. Data on patients, stones and procedures were collected and analysed. Emergency URS failure was defined as fragments >3 mm or the need for a repeat procedure. ResultsA total of 499 URS procedures were identified. Of these 394 (79%) were emergency procedures. The mean (SD; range) patient age was 48 (16; 13-88) years. In all, 83% of emergency URS cases had an American Society of Anesthesiologists (ASA) score of 1 or 2, 25% of stones were >9 mm, with a mean (SD) size of 8 (4) mm, and 285 procedures (72%) were successful. These patients were younger (47 vs 51 years), were more likely to have an ASA score of 1 (103 patients in the successful treatment group vs 26 in the failed treatment group), had smaller stones (7 vs 9 mm) and were more likely to have distal stones (P < 0.05). A total of 20 complications (5%) were recorded including six false passages and three mucosal injuries, one of which required radiological intervention, and 50 patients (13%) re-presented, for pain (76%), bleeding (10%) or infection (14%). ConclusionWe showed that emergency URS is a feasible approach for the routine management of acute ureteric colic with a low complications rate. A subgroup of younger, healthier patients may benefit the most from the procedure.