Abstracts 1

Clinical Oral Presentation COP-01 Improved selection of prostate cancer patients for active surveillance D.Z.P. YONG, T.W. TAN, S.J. CHIA and K.T. CHONG Department of Urology, Tan Tock Seng Hospital, Singapore

Introduction: We aim to compare pathological upgrading and upstaging rates between prostate cancer patients who met the criteria for active surveillance based on the National Comprehensive Cancer Network (NCCN) or European Association of Urology (EAU). Given this information, we also aim to refine our selection of patients for active surveillance. Materials and Methods: 317 men were treated with RP at our tertiary center from 2000 to 2013. 73 patients met the NCCN criteria for active surveillance: cT1–T2a, prostate-specific antigen (PSA) 20 or Gleason score > 6 Bone scan to exclude bone metastases if symptomatic bone pain or PSA > 20 or Gleason score 8 or more Assess preoperative erectile function e.g. IIEF Perioperative management of antiplatelets and anticoagulation Type and screen must be available before the start of surgery Intravenous prophylactic antibiotics to be given in accordance with hospital guidelines Redosing of prophylactic antibiotics if surgery is more than 4 hours Pelvic lymphadenectomy to be performed for D’Amico high-risk cases Chest physiotherapy when back in ward after operation Ambulate on 1st post-operative day for deep vein thrombosis prophylaxis Pelvic floor training to improve continence © 2015 The Authors BJU International © 2015 BJU International | 115, Supplement 3, 1--50

Abstracts 7

them 100% of the time in all patients undergoing robot-assisted laparoscopic prostatectomy (RALP) at Tan Tock Seng Hospital. Methods: From August to December 2013, ten consecutive patients listed for RALP in the department were recruited for the pilot study. Each episode of care began at the point of listing for surgery and ended 8 weeks after surgery. From the 16 BPEs selected, a total of 20 verifiable points were incorporated in the redesigned perioperative pathway. At the end of the episode of care, compliance was measured by an independent team of auditors. The outcomes were compared with a historical cohort of 10 preceding patients who received RALP before the project started. Results: Overall compliance of all applicable audit points across all 10 patients was 82% (142/174 audit points). Median compliance rate for each patient was 80% (range 71%-100%). The compliance rate of each of the 20 verifiable audit points ranged from 10% to 100%, with 10 audit points achieving 100% compliance. None of the patients was readmitted within 30 days of discharge. The mean length of stay during the pilot period was 2.2 days (SD 1.0) compared to 3.5 days (SD 2.1) in the historical cohort. Radiographic leak during cystogram was demonstrated in one patient in the pilot period, compared to 2 patients in the historical cohort. However there was no clinical leak in both groups of patients. There was one (Grade 1) complication in the pilot period compared to two complications (Grade 1 and Grade 2) in the historical cohort. Conclusion: This pilot study demonstrated the feasibility of adopting an evidence-based perioperative pathway for patients undergoing RALP. Outcomes were promising compared to a historical cohort before implementation of the pathway. MP-02 Using Fournier’s Gangrene Severity Index (FGSI) to differenciate outcome predictor between Systemic Inflammatory Response Syndrome (SIRS) patients with upper urological abnormalities and lower urological abnormalities

T.N. BUDAYA*, B. DARYANTO† and B.B. PURNOMO† *Airlangga University, Surabaya, Indonesia; † Brawijaya University, Malang, Indonesia

Introduction and Objectives: The symptoms of SIRS which were initially considered to be ‘mandatory’ for the diagnosis of sepsis. Sepsis syndrome in urology remains a severe situation with a mortality rate as high as 20–40%. There is no consensus on clinical variables for predicting SIRS or sepsis results in urology. This study try to demonstrate the usefulness of Fournier’s Gangrene Severity Index (FGSI) score for differenciating the outcome between Systemic Inflammatory Response Syndrome (SIRS) patients with upper urological abnormalities and lower urological abnormalities. Materials and Methods: The retrospective study of case records from the year 2011– 2014 of SIRS patients with urological abnormalities at Saiful Anwar General Hospital Malang was carried out. SIRS was clinicaly diagnosed based on medical history, physical examination and laboratory findings. The FGSI, was used in our study. This index presents patients vital signs (temperature, heart and respiratory rates) and metabolic parameters (sodium, potassium, creatinine, and bicarbonate levels, hematocrit, and white blood cell count) were collected in Critical Care Unit. Patients with SIRS and urological abnormalities devide to two categories upper urological abnormalities and lower urological abnormalities. FGSI score is devide three categories mild (0–8), moderate (9– 17), severe (>17). The data were assessed according to whether the patient survived or died. Results: 75 of the 203 evaluated patients (mean age 48 years) died. From those 75 patients, 67% were male and 33% were female, 75% with upper urological abnormalities and 25% with lower abnormalities (p < 0.05). From those 203 patients; the results were analyzed with Spearman Correlation Analysis using SPSS 20 software with 95% Confidence Interval (CI). There is a significant relationship between FGSI and outcome of the patient with upper urological abnormalities and lower urological abnormalities (p < 0.05), with correlation coeffisient more high in relationship between FGSI and outcome of the patient with upper urological abnormalities (0.4 vs. 0.1). Conclusions: Fournier’s Gangrene Severity Index is simple and objective to differentiate an outcome predictor between SIRS patients with upper urological abnormalities and lower urological abnormalities.

© 2015 The Authors BJU International © 2015 BJU International | 115, Supplement 3, 1--50

MP-03 Subcentimeter renal calculi in live related donor-excellent results with bench ureteroscopy

P. PUSHKAR*, A. AGARWAL*, S. GULERIA† and S. KUMAR† *Department of Urology, Indraprastha Apollo Hospital, New Delhi, India; †Department of Renal Transplantation, Indraprastha Apollo Hospital, New Delhi, India

Introduction and Objectives: To present our experience in removal of subcentimeter renal calculi from renal allograft by retrograde intra renal surgery. Methods: All prospective renal donor with subcentimeter (

Abstracts of the Singapore Urological Association Meeting: UROFAIR 2015, 12-14 March, 2015, Singapore.

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