UroRenal and Vascular

Director: Associate Professor Laurence Harewood

Services​

The UroRenal, Vascular Clinical Institute groups together surgical specialties in the areas of endocrinology, nephrology, urology and vascular surgery.

Activity

Conditions treated

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​	​Endocrinology   Diabetes Growth disorders Hormonal conditions Pituitary disorders Polycystic ovary syndrome Reproductive endocrinology Thyroid conditions   Nephrology   Acute renal failure Chronic kidney disease Electrolyte disturbances Hematuria Hypertension Kidney disease Kidney stones Proteinuria	​Vascular   Abdominal aortic aneurysm Acute limb ischaemia Aortic dissection Carotid stenosis Peripheral arterial occlusive disease Varicose veins Urology   Benign prostate enlargement Bladder cancer Bladder dysfunction Bladder stones Erectile dysfunction Kidney cancer Kidney stone disease Prostate cancer Testicular cancer Urinary incontinence

​​​Clinical In​stitute Executive

The UroRenal & Vascular Clinical Institute Executive Members are:​​

• Mr Noel R Atkinson

• Dr Anastasia Chrysostomou
• Dr Jason Chuen
• A/Prof Ian Fraser
• A/Prof Nathan Lawrentschuk
• Mr Daniel Moon
• A/Prof Declan Murphy
• Dr Walter Plehwe
• Dr Siddharth Rajakumar
• Mr Paul Ruljancich​

Highlights

Epworth Healthcare performed the first robotic-assisted procedure in Australia in 2003, and now performs over 1000 robotic procedures/year, with the broadest array of robotic surgical procedures of any Australian centre. This revolutionary technology offers advanced key-hole surgery with 3D, high definition digital vision and wristed instruments, to enable a surgeon to perform complex surgery through only a small number of 5-10mm incisions. Robotic surgery is currently performed at Epworth in the following areas:

• Urology
• Gynaecology
• Cardiac surgery
• Gastric surgery
• Colorectal surgery
• ENT

Our performance

Prostate cancer is the most commonly diagnosed cancer and the second leading cause of male cancer deaths among Australian males. Men presenting with localised prostate cancer disease are faced with many treatment options.​

Because of the many combinations of management available to men with prostate cancer, the

Prostate Cancer Registry (PCR) was established at Monash University. Its role is to monitor and allow benchmarking of quality of care by institutions and individual surgeons and radiation oncologists in the care of prostate cancer patients.

 

Epworth participates in the PCR as a way of monitoring the care we provide. The PCR monitors 10 indicators of care. Many of these indicators allow comparison of hospital results with acceptable levels of care. For those measures that do have a benchmark, Epworth’s hospitals perform well. ​

Since the inception of the Prostate Cancer Outcomes Registry (PCOR) the Epworth has contributed a total of 5741 patients making it the largest contributor of cases by any institution.   Epworth Freemasons contributed 2246 patients (second largest contributor in total of all notifications by all institutions),  Epworth Richmond 1812 patients (4^th largest contributor) and Epworth Eastern 1683 patients (5^th largest contributor.)

 

In the outcomes measured and reported, the results from Epworth Hospitals was consistently were better or at the average standard.​

• The surgical margin outcomes of Robotic Radical Prostatectomy are a good indicator of the quality of the surgery.  A positive margin is when cancer is up the edge of where the prostate has been cut out.  A positive surgical margin therefore may indicate that cancer has been left behind.  The long term outcome for these patients is not as good as when the surgical margin is negative.  Hence the lower the surgical margin the better.​
• Epworth Freemasons consistently achieved a very low positive margin rate in all three categories of low, intermediate and high risk cancer.
  
• Epworth Richmond had excellent low positive margin rates in intermediate and high risk cancer.
  
• Epworth Eastern also achieved low positive margin rates in all three categories.
  
• Two of the potential negative outcomes for Robotic Radical Prostatectomy for Cancer of the Prostate are issues with continence and erections post operatively.  In all cases the outcomes of the Epworth hospitals are either below or at the average standard.
  
• Epworth Freemasons achieved a low incidence of both urinary bother and sexual bother post operatively
  
• Epworth Richmond achieved similarly a low incidence of both urinary and sexual bother.
  
• Epworth Eastern achieved a low urinary bother rating and a satisfactory sexual bother outcome.
  
• One of the major concerns after Radiation therapy for Prostate Cancer is and irradiation effect on the bowel (rectum).  This can lead to bothersome bowel symptoms.   All three Epworth hospitals carrying out radiation therapy achieved a low or satisfactory outcome.
  

If you have any queries regarding the data on this page, please email ClinicalProfile@epworth.org.au

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