The impact of acute urological admissions on the surgical workload in a general hospital.

Urological services remain underdeveloped in the existing Irish Hospital network. Outside of the main teaching centres patients frequently present to their local hospital with acute urological problems and are referred to specialist units following preliminary investigations. Over six months we examined the impact of emergency urological presentations on the general surgical workload in an acute general hospital. A total of 54 of patients were admitted with urological presentations representing 6.7% of total surgical admissions. The average length of stay was 4.9 days and a total of 24.5% were transferred to urological units for inpatient treatment. Urology outpatient referrals were required for 40%. This paper illustrates the impact of urological admissions on peripheral hospitals and the need to expand urological services in regional hospitals to reduce the amount of patients transferred to tertiary centres for routine urological procedures.

Procidentia: a reversible cause of hydronephrosis in an 80-year-old woman.

We describe an unusual presentation of hydronephrosis in an 80-year-old woman who was managed conservatively after transfer to a specialist unit. This case highlights the role of accurate history taking and a focused physical examination in elderly female patients presenting with renal failure and hydronephrosis.