David M Quinlan

St Vincent's University Hospital, Dublin, Leinster, Ireland

Are you David M Quinlan?

Claim your profile

Publications (48)86.99 Total impact

  • [Show abstract] [Hide abstract]
    ABSTRACT: Introduction: Renal trauma accounts for 5% of all trauma cases. Rare mechanisms of injuries including sports participation are increasingly common. Rugby-related trauma poses a conundrum for physicians and players due to the absence of clear guidelines and a paucity of evidence. Our series highlights traumatic rugby-related renal injuries in our institution, and emphasize the need for international guidelines on management. Methods: A retrospective review of all abdominal traumas between January 2006 and April 2013, specifically assessing for renal related trauma that were secondary to rugby injuries was performed. All patients' demographics, computerized tomography results, hematological and biochemical results and subsequent management were recorded. Results: Five male patients presented with rugby-related injuries. Mean age was 21 years old. All patients were hemodynamically stable and managed conservatively in acute setting. One patient was detected to have an unknown pre-existing atrophic kidney that had been subsequently injured, and was booked for an elective nephrectomy an 8-week interval. Conclusion: Rugby-related trauma has generated essential attention. This paper serves to highlight this type of injury and the need for defined guidelines on role of imaging and international consensus on timing of return to contact sport, in both professional and amateur settings.
    Current Urology 09/2015; 8(3):133-137. DOI:10.1159/000365704
  • [Show abstract] [Hide abstract]
    ABSTRACT: Objectives: To determine the incidence of 'burnout' among UK and Irish urological consultants and non-consultant hospital doctors (NCHDs). The second objective was to identify possible causative factors and to investigate the impact of various vocational stressors that urologists face in their day-to-day work and to establish whether these correlate with burnout. The third objective was to develop a new questionnaire to complement the Maslach Burnout Inventory (MBI), more specific to urologists as distinct from other surgical/medical specialties, and to use this in addition to the MBI to determine if there is a requirement to develop effective preventative measures for stress in the work place, and develop targeted remedial measures when individuals are affected by burnout. Subjects and methods: A joint collaboration was carried out between the Irish Society of Urology (ISU) and the British Association of Urological Surgeons (BAUS). Anonymous voluntary questionnaires were sent to all current registered members of both governing bodies. The questionnaire comprised two parts: the first part encompassed sociodemographic data collection and identifying potential risk factors for burnout, and the second used the MBI to objectively assess for workplace burnout. To evaluate differences in burnout, 2 × 2 contingency tables and Fischer's exact probability tests were used. Results: In all, 575 urologists responded to the online survey out of a total of 1380 invites, yielding a 42% response rate. All respondents were aged <75 years (median age 45 years), with men representing 87.5% of respondents. In all, 75% of respondents worked in England, followed by the Republic of Ireland (9%), Scotland (8%), Northern Ireland (4%), and Wales (3%). In all, 79% of respondents were consultants, with 13% representing training posts, and 40% of respondents held a professorship/clinical lead position. Respondents' countries of origin included England, Scotland, Ireland, India, Wales, Malaysia, Pakistan and Sri Lanka. Overall, the mean emotion exhaustion (EE) score was 23.5, representing a moderate level of EE. The mean depersonalisation (DP) score was 8.2, representing a moderate level of DP. The mean personal achievement (PA) score was 17.1, representing high levels of PA. In all, 86 respondents (15%) reported self-medication with non-prescription drugs or alcohol to combat signs and symptoms of burnout, while 46 (8%) sought professional help for symptoms of burnout. In all, 460 respondents (80%) felt that burnout should be evaluated amongst members of the ISU/BAUS, and 345 (60%) would avail of counselling if provided. Conclusions: This is the first study to address the issue of burnout across two separate health systems in the UK and Ireland. This study has shown previously undescribed high levels of burnout characterised by EE and DP, with associated significant levels of self-medication amongst a male-predominant cohort. Burnout was attributed to non-surgical administrative/institutional factors, with most respondents reporting support for staff evaluation and the provision of counselling services. This pilot study lends itself to the creation of risk stratification for urologists, and an opportunity to provide educational resources, training/development programmes, and collegial and administrative support pathways.
    BJU International 07/2015; DOI:10.1111/bju.13218 · 3.53 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Background: Large annual scientific meetings such as the American Urological Association (AUA) and the European Association of Urology (EUA) have abstract conversion rates into publication of 37%−48%. There are no data on the conversion rates from national meetings of smaller European countries. Our objective was to present the conversion rates and manuscript characteristics of the Irish Society of Urology (ISU) annual meeting over a seven-year period (2005-2011), and to demonstrate the value, viability and sustainability of such a meeting as a model for other small national research programmes.
    Journal of Clinical Urology 06/2015; 8(4). DOI:10.1177/2051415814565200
  • [Show abstract] [Hide abstract]
    ABSTRACT: To evaluate the accessibility, usability, reliability and readability of Internet information regarding transrectal ultrasound (TRUS) guided biopsy of the prostate. The terms "prostate biopsy", "TRUS biopsy" and "transrectal ultrasound guided biopsy of the prostate" were separately entered into the each of the top 5 most accessed Internet search engines. Websites were evaluated for accessibility, usability and reliability using the LIDA tool - a validated tool for the assessment of health related websites. Website readability was assessed using the Flesch Reading Ease Score and the Flesch Kincaid Grade Level. Following the application of exclusion criteria, 82 unique websites were analyzed. There was a significant difference in scores depending on authorship categories (p ≤ 0.001), with health related charity websites scoring highest (mean 122.29 ± 13.98) and non-academic affiliated institution websites scoring lowest (mean 87 ± 19.76). The presence of advertisements on a website was associated with a lower mean overall LIDA tool score (p = 0.024). Only a single website adhered to the National Institutes for Health recommendations on readability. This study demonstrates variability in the quality of information available to Internet users regarding TRUS biopsies. Collaboration of website design and clinical acumen are necessary to develop appropriate websites for patient benefit.
    Current Urology 05/2015; 8(1):32-37. DOI:10.1159/000365686
  • F O'Kelly · RP Manecksha · K O'Flynn · DM Quinlan · M Speakman · JA Thornhill ·

    European Urology Supplements 04/2015; 14(2-2):e484. DOI:10.1016/S1569-9056(15)60477-8 · 3.37 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Introduction: We compare the survival outcomes of patients with clear cell renal cell carcinoma (RCC) treated with adrenal sparing radical nephrectomy (ASRN) and non-adrenal sparing radical nephrectomy (NASRN). Methods: We conducted an observational study based on a composite patient population from two university teaching hospitals who underwent RN for RCC between January 2000 and December 2012. Only patients with pathologically confirmed RCC were included. We excluded patients undergoing cytoreductive nephrectomy, with loco-regional lymph node involvement. In total, 579 patients (ASRN = 380 and NASRN = 199) met our study criteria. Patients were categorized by risk groups (all stage, early stage and locally advanced RCC). Overall survival (OS) and cancer-specific survival (CSS) were analyzed for risk groups. Survival analysis was performed using Kaplan-Meier curves and Cox proportional hazards regression. Results: The median follow-up was 41 months (range: 12-157). There were significant benefits in OS (ASRN 79.5% vs. NASRN 63.3%; p = 0.001) and CSS (84.3% vs. 74.9%; p = 0.001), with any differences favouring ASRN in all stage. On multivariate analysis, there was a trend towards worse OS (hazard ratio [HR] 1.759, 95% confidence interval [CI] 0.943-2.309, p = 0.089) and CSS (HR 1.797, 95% CI 0.967-3.337, p = 0.064) in patients with NASRN (although not statistically significant). Of these patients, only 11 (1.9%) had adrenal involvement. Conclusions: The inherent limitations in our study include the impracticality of conducting a prospective randomized trial in this scenario. Our observational study with a 13-year follow-up suggests ASRN leads to better survival than NASRN. ASRN should be considered the gold standard in treating patients with RCC, unless it is contraindicated.
    European Urology Supplements 04/2015; 14(2):e818. DOI:10.1016/S1569-9056(15)60807-7 · 3.37 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Prostate cancer staging MR examinations commonly include abdominal sequences to assess for non-regional (common iliac or para-aortic) nodal metastasis. In our experience the diagnostic yield of this is limited, but incidental findings are frequent, often necessitating further investigations. The aim of this study is to assess the diagnostic utility of abdominal sequences in routine prostate cancer MR staging studies. Findings on abdominal sequences of consecutive MRI prostate studies performed for staging newly diagnosed prostate cancer between September 2011 and September 2013 were reviewed with respect to adenopathy and additional incidental findings. Results were correlated with Gleason grade and serum prostate-specific antigen (PSA) level in each case. 355 MRI prostate examinations were reviewed. 4 (1.1%) showed enlarged non-regional lymph nodes. Incidental findings were found in 82(23.1%) cases, neccessitating further investigation in 45 (12.7%) cases. Enlarged non-regional nodes were associated with higher PSA level and Gleason grade (p=0.007, p=0.005 respectively). With a combined threshold of PSA>20ng/mL and/or Gleason grade ≥8 the sensitivity, specificity, PPV and NPV were 100, 60, 3 and 100% respectively for predicting the presence of non-regional adenopathy. Routine abdominal sequences are of very low yield in routine prostate cancer MR staging, frequently resulting in incidental findings requiring further work-up and should be reserved for high-risk cases. Our experience supports the use of an abdominal staging sequence in high-risk cases only. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.
    European journal of radiology 03/2015; 61(6). DOI:10.1016/j.ejrad.2015.02.023 · 2.37 Impact Factor
  • Source
    G J Nason · F O'Kelly · D Bouchier-Hayes · D M Quinlan · R P Manecksha ·
    [Show abstract] [Hide abstract]
    ABSTRACT: Social media is the interaction among people in which they create, share or exchange information and ideas in virtual communities and web-based networks. This year, the Irish Society of Urology (ISU) expanded its involvement in social media with a preregistered Twitter hashtag (#ISU14) for the annual meeting. The aim of this study was to highlight the use of Twitter at an annual national meeting held in 2014. The Symplur healthcare analytics website was used to prospectively examine traffic related to the 2014 ISU Annual Meeting. This feature was used to generate statistics for the number of impressions, unique tweets (excluding retweets) and distinct contributors who used the indexing hashtag #ISU14. Individual tweets were assessed using the conference hashtag on the Twitter website. The total number of attendees at the conference was 119, and 99 individuals participated in Twitter using the conference hashtag (#ISU14). 31 % of attendees participated in tweeting at the conference. Over the course of the conference, a total of 798 unique tweets were generated, creating over 665,000 impressions in cyberspace. 590 (73.9 %) tweets were generated from attendees at the conference, while 26.1 % of tweets were from virtual followers. 702 (87.9 %) tweets were from urologists and 439 (55 %) tweets were of scientific nature. Tweet activity peaked during the guest lectures on both days. Twitter use at the ISU has been shown to facilitate interaction between delegates and allows users to follow as well as participate from afar.
    Irish Journal of Medical Science 03/2015; 184(3). DOI:10.1007/s11845-015-1277-6 · 0.83 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Introduction: Renal cell carcinoma (RCC) represents about 3% of adult malignancies in Ireland. Worldwide there is a reported increasing incidence and recent studies report a stage migration towards smaller tumours. We assess the clinico-pathological features and survival of patients with RCC in a surgically treated cohort. Methods: A retrospective analysis of all nephrectomies carried out between 1995 and 2012 was carried out in an Irish tertiary referral university hospital. Data recorded included patient demographics, size of tumour, tumour-node-metastasis (TNM) classification, operative details and final pathology. The data were divided into 3 equal consecutive time periods for comparison purposes: Group 1 (1995-2000), Group 2 (2001-2006) and Group 3 (2007-2012). Survival data were verified with the National Cancer Registry of Ireland. Results: In total, 507 patients underwent nephrectomies in the study period. The median tumour size was 5.8 cm (range: 1.2-20 cm) and there was no statistical reduction in size observed over time (p = 0.477). A total of 142 (28%) RCCs were classified as pT1a, 111 (21.9%) were pT1b, 67 (13.2%) were pT2, 103 (20.3%) were pT3a, 75 (14.8%) were pT3b and 9 (1.8%) were pT4. There was no statistical T-stage migration observed (p = 0.213). There was a significant grade reduction over time (p = 0.017). There was significant differences noted in overall survival between the T-stages (p < 0.001), nuclear grades (p < 0.001) and histological subtypes (p = 0.022). Conclusion: There was a rising incidence in the number of nephrectomies over the study period. Despite previous reports, a stage migration was not evident; however, a grade reduction was apparent in this Irish surgical series. We can demonstrate that tumour stage, nuclear grade and histological subtype are significant prognosticators of relative survival in RCC.
    03/2014; 8(3-4):125-32. DOI:10.5489/cuaj.1721
  • J F Sullivan · J C Forde · P Daly · W Shields · F O'Kelly · D M Quinlan · D P Hickey ·
    [Show abstract] [Hide abstract]
    ABSTRACT: Renal artery aneurysms (RAA) are the second most common visceral artery aneurysm. In cases of rupture they pose a significant and emergent surgical challenge. Extracorporeal arterial reconstruction and autotransplantation is often necessary in certain complex cases that are not amenable to aneurysm repair in vivo. We report a case of a 35 year old female with a RAA in a solitary functioning kidney, requiring ex vivo reconstruction and autotransplantation to the iliac vessels.
    Irish medical journal 02/2014; 107(2):50-1. · 0.51 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: PURPOSE To assess the value of PIRADs scoring in predicting positive biopsy in patients with previous negative biopsy and elevated PSA, where the repeat biopsy is MR directed, trans-rectal ultrasound guided. METHOD AND MATERIALS HIPAA compliant, IRB approved study. 52 patients (mean age 64 years, range 52-76), with previous negative prostate biopsy and elevated PSA (mean =14.4 , range =7-34.4 ) underwent combined targeted and 12 sample sectoral biopsy over a 14 month period. Each patient’s MRI was retrospectively reviewed, blinded to biopsy result and each area of abnormality on MRI was scored according to PIRADs scheme, with separate T2, DWI, and overall scores per lesion. RESULTS Positive biopsy was obtained in 24/52 patients (overall yield of 46%). Predictive values based on most suspicious lesion overall per patient. PIRADs scores 1-5 (clinically significant cancer highly unlikely, unlikely, equivocal, likely, highly likely respectively). The positive predictive values of T2 PIRADS scores of 1,2,3,4 and 5 were,0, 33,33, 58 and 100% respectively. The positive predictive value of DWI PIRADS score of 1,2,3,4 and 5, was 0,N/A(no scores of 2), 0, 42 and 57% respectively. Only patients with overall score of 3-5 were biopsied, the positive predictive value of overall PIRADs score of 3, 4, 5 was 14, 57 and 100% respectively. CONCLUSION PIRADs provides a useful framework for reporting likelihood of prostate cancer, facilitating communication and guiding expectation of clinicians and patients in the setting of MRI assessment for occult prostate cancer and targeted biopsy. CLINICAL RELEVANCE/APPLICATION In patients with raised PSA and previous negative prostate biopy, the use of MRI can help target repeat biopsy and predict the likelihood of a positive result.
    Radiological Society of North America 2013 Scientific Assembly and Annual Meeting; 12/2013
  • [Show abstract] [Hide abstract]
    ABSTRACT: To identify the incidence and features of significant incidental findings discussed at our departmental multidisciplinary team meeting (MDM). The improved quality of radiological imaging has resulted in increased rates of incidental findings. Although some may be trivial, many have clinical significance and early diagnosis and treatment may be beneficial. A retrospective analysis was performed of all cases discussed at the MDM between January 2012 and February 2013. Cases were divided into two groups - Group 1 consisted of patients whose initial imaging was performed for a urological presentation which resulted in a synchronous finding; Group 2 consisted of patients who were referred with a synchronous urological finding for discussion following investigation of an initial benign urological condition or a non-urological condition. 696 patients were discussed at 53 MDMs. 109 (15.7%) patients had incidental findings. 61 (56%) of these were in Group 1. 16 (26.2%) were synchronous malignant diagnoses, 25 (41%) were benign and 20 (32.8%) were indeterminate. 48 (44%) patients in Group 2 - 40 (83.3%) were renal in origin and 30 (75%) of these proceeded to surgery. The median tumour size was 3.2 cm (Range: 1.2 cm-10 cm). One patient had radio-frequency ablation. Two were referred for palliative care. Seven patients are under ongoing surveillance - the median size of these lesions is 3.6 cm (Range: 2.1 cm-8.3 cm). A substantial workload is generated from the investigation of incidental findings discussed at MDM - these now represent the majority of the caseload for renal cancer surgery.
    The surgeon: journal of the Royal Colleges of Surgeons of Edinburgh and Ireland 11/2013; 12(6). DOI:10.1016/j.surge.2013.08.004 · 2.18 Impact Factor
  • M E Kelly · B B McGuire · G J Nason · G M Lennon · D W Mulvin · D J Galvin · D M Quinlan ·
    [Show abstract] [Hide abstract]
    ABSTRACT: Bowel preparation was established as part of the pre-operative course for patients undergoing ileal conduit formation since the late 1970's. Rationales for its use include reduction in infection and wound complications, technically easier anastomosis and earlier return to bowel function. However, recent reports have challenged this practice. Traditionally antibiotics were also administered for several days prior to surgery with the assumption that bacterial load was reduced. Modification of antibiotic protocols resulted from evidence-based findings. Furthermore, publications emphasizing the benefit of Enhanced Recovery Protocols/Programmes (ERP) have become contemporary. An online multiple-choice questionnaire (via Monkey Survey(®)) was administered to all consultant urologists in Ireland. This national cross-sectional study evaluated the use of bowel preparation and antibiotic prophylaxis prior to urinary diversion. In addition, we also assessed consultant urologists' awareness of ERP and their views on the introduction and implementation of such a national program. Of the 41 consultant urologists surveyed, 80.4% (n = 33) responded. 63.6% routinely used bowel preparation. Klean Prep(®) was the most commonly used bowel preparation. 80.9% of urologists admit their patient's one-day pre-operatively for bowel preparation, with 87.8% using antibiotic prophylaxis at anesthesia induction, and 18.1% continuing the antibiotics for 24-48 h post-operatively. Although 74% of consultants are aware of ERP, only 66.6% are in favor of their national implementation. The majority of Irish urologists use bowel preparation prior to ileal conduit formation. Substantial recent evidence has emerged showing no difference in infective complications or anastomotic leakage when bowel preparation was not used. National guidelines would be beneficial regarding the use of bowel preparation, antibiotic prophylaxis and ERP for urinary diversion surgery.
    The surgeon: journal of the Royal Colleges of Surgeons of Edinburgh and Ireland 10/2013; 13(3). DOI:10.1016/j.surge.2013.09.010 · 2.18 Impact Factor
  • Source

    International Journal of Surgery (London, England) 10/2013; 11(8):732. DOI:10.1016/j.ijsu.2013.06.774 · 1.53 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Purpose: There is growing conflict in the literature describing the effect of delayed treatment on outcomes following radical prostatectomy. There is also evidence to suggest progression of low-risk prostate cancer to develop higher grades and volumes of prostate cancer during active surveillance. It is unknown as to what affect a delay in referral of those men with abnormal screened-PSA levels have on subsequent Gleason grade. Methods: We identified 350 men through our rapid access prostate clinic who underwent TRUS biopsy for abnormal age-related PSA and/or abnormal clinical examination. Clinicopathological findings were compared for those with positive versus negative TRUS biopsies, and for those with initial delays in referral (<12 months, 12-18 months, and >18 months). We used ANOVA and Student's t-tests amongst other statistical tools to examine significance of clinical findings. Results: Of the 350 men who underwent TRUS biopsy, those with a delay in referral of 12 months or more were significantly associated with higher PSA titers, clinically palpable disease and likelihood of diagnosis with prostate cancer. A delay of 18 months or more led to a significantly higher risk of being diagnosed with a leading grade 4 prostate cancer, which was further supported using PSA velocity as a diagnostic tool (change >0.4 ng/ml/year). Conclusion: We recommend that repeated asymptomatic abnormal age-related PSA readings and/or abnormal clinical examination in the screened population be referred without delay to a urologist for further assessment, enrolment into an active surveillance program or definitive subsequent treatment.
    The Prostate 09/2013; 73(12). DOI:10.1002/pros.22628 · 3.57 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Fracture of the penis is a rare urological emergency which occurs as a result of abrupt trauma to an erect penis. There is paucity of data regarding long-term sexual function or erectile potency following fracture of the penis. The aim of this study is to objectively assess the overall sexual function following fracture of the penis. A retrospective analysis of 21 penile fractures was performed. A voluntary telephone questionnaire was performed to assess long term outcomes using three validated questionnaires-the Erection Hardness Grading Scale, the International Index of Erectile Function (IIEF-5) and the Brief Male Sexual Function inventory (BMSFI). The mean age was 33.1 years (range: 19-63). The median follow up was 46 months (range: 3-144). All fractures were a result of sexual misadventure and all were surgically repaired. There were two concomitant urethral injuries. Seventeen patients were contactable. Fourteen patients demonstrated no evidence of erectile dysfunction (ED) (IIEF-5>22), 1 patient reported symptoms of mild ED (IIEF-5, 17-21) and one patient reported mild to moderate ED (IIEF-5, 12-16). No patients reported insufficient erection for penetration (EHGS: 1 or 2). Regarding the overall BMSFI, 13 (83%) patients were mostly satisfied or very satisfied with their sex life within the previous month. In a small surgical series of men with penile fracture managed within a short time frame from presentation, we demonstrate erectile potency is maintained. Long-term overall sexual satisfaction is promising.
    Canadian Urological Association journal = Journal de l'Association des urologues du Canada 07/2013; 7(7-8):252-7. DOI:10.5489/cuaj.199 · 1.92 Impact Factor
  • John Brennan · Fardod O'kelly · David M Quinlan ·
    [Show abstract] [Hide abstract]
    ABSTRACT: Abstract Spontaneous abscess of the corpus cavernosum is an extremely rare presentation. This is the first documented case of corpus cavernosal abscess caused exclusively by organisms from the Streptococcus milleri group, which have previously been described as being associated with abscess formation. This report outlines the case of a 56-year-old alcoholic male with no risk factors who presented with an 8-day history of penile pain, swelling and sepsis. A diagnosis of abscess of the right corpus cavernosum was confirmed by magnetic resonance imaging. Management required intravenous antibiotics, penile exploration, incision and drainage. Streptococcus constellatus and Streptococcus intermedius were isolated. The aetiology, diagnosis, management and microbiology of this unusual presentation are discussed, and the few previously documented cases of abscess of the corpus cavernosum are reviewed.
    Scandinavian Journal of Urology 03/2013; 47(6). DOI:10.3109/21681805.2013.776105 · 1.25 Impact Factor
  • D P Joyce · A Z Thomas · F O'Kelly · D Malone · D Quinlan ·
    [Show abstract] [Hide abstract]
    ABSTRACT: Management of the surgically unfit patient with symptomatic cholelithiasis can be fraught with difficulty. We describe the case of on such gentleman in whom percutaneous transhepatic cholecystoscopy was used to completely fragment a large gallbladder calculus through the use of a nephroscope and Swiss lithoclast Master.
    Irish medical journal 03/2013; 106(3):88-9. · 0.51 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: BACKGROUND: Recent evidence has suggested that the introduction of rapid access prostate cancer programs has led to a more streamlined pathway for patients, and was designed to ultimately reduce referral delays AIMS: To identify the initial impact of the introduction of the rapid access prostate clinic on Gleason grading within the prostate cancer cohort, as well as the impact of distance from a tertiary referral center on subsequent Gleason grading METHODS: A prospective database was maintained from those men attended the rapid access prostate clinic in St. Vincent's University Hospital. Data relating to demographics, biopsy results, retrospective PSA readings, and subsequent treatment pathways were all recorded and analyzed. Statistical significance was taken at p < 0.05 RESULTS: Prospective data from the rapid access prostate clinic illustrated similar results in patient demographics, Gleason grade and choice of treatment outcomes to other published institutions, however, for the first time demonstrate emerging evidence of the effect of the rapid access prostate clinic leading to a downward shift in Gleason grade over a 2-year period, as well as data showing an inverse correlation between leading Gleason grade and distance from our tertiary referral center CONCLUSION: These results suggest that the introduction of the rapid access prostate clinic has initially begun to demonstrate an initial downgrading in Gleason scoring patterns. Our data also reflects a poorer Gleason score in those patients living further away from the rapid access prostate clinic. This may be in part attributed to a surge in referrals of those patients previously managed outside a tertiary institution, and suggests that patients should undergo prompt referral following suspicion for prostate cancer.
    Irish Journal of Medical Science 02/2013; 182(3). DOI:10.1007/s11845-013-0920-3 · 0.83 Impact Factor
  • N F Davis · K M O'Connor · D M Quinlan ·
    [Show abstract] [Hide abstract]
    ABSTRACT: Urethral duplication is a rare congenital anomaly with less than 200 cases reported. It predominantly occurs in males and is nearly always diagnosed in childhood or adolescence. It is defined as a complete second passage from the bladder to the dorsum of the penis or as an accessory pathway that ends blindly on the dorsal or ventral surface. We present the case of a 54-year-old patient with incomplete urethral duplication. Urethral duplication commonly occurs in the sagittal plane with one urethral channel lying dorsal to the other. Symptoms vary from completely asymptomatic to urinary incontinence which can lead to a mucopurulent discharge from a low grade urinary tract infection. Other symptoms include double stream (most common complaint) and intermittent urinary discharge.
    Irish Journal of Medical Science 09/2012; 181(3):345-7. DOI:10.1007/s11845-009-0417-2 · 0.83 Impact Factor

Publication Stats

180 Citations
86.99 Total Impact Points


  • 2003-2015
    • St Vincent's University Hospital
      Dublin, Leinster, Ireland
  • 2014
    • Beaumont Hospital
      Dublin, Leinster, Ireland
  • 2013
    • Dublin Dental University Hospital
      Dublin, Leinster, Ireland
  • 2004-2013
    • St. Vincents University Hospital
      Dublin, Leinster, Ireland
  • 2010
    • St. James's Hospital
      Dublin, Leinster, Ireland
  • 2003-2005
    • St. Vincent Hospital
      Green Bay, Wisconsin, United States