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Alan Woodward

Publications and source records attributed to Alan Woodward.

3 recordsLinked to original sources

Randomized controlled trial comparing prolene hernia system and lichtenstein method for inguinal hernia repair.

BACKGROUND: There are no data regarding the long-term outcomes of prolene hernia system (PHS) mesh in the published reports. The aim of the study was to compare the short-term and long-term outcomes of the PHS mesh with the Lichtenstein mesh technique. METHODS: Sixty-four patients with inguinal hernia were randomized to undergo either a PHS or a Lichtenstein repair under local anaesthesia as a day case. Early outcome measures were duration of surgery, pain scores, analgesic requirements, time to return to work, driving and full activity. Long-term outcome measures were chronic groin pain and recurrence. RESULTS: Mean duration of surgery in the PHS group was 36 min (SD +/- 11) versus 34 min in the Lichtenstein group (SD +/- 8; P = 0.3). There was no significant difference in analgesic requirements (P = 0.65). Overall mean pain score was 3.5/10 versus 2.5/10 (P = 0.1). Mean time to return to work was 42 versus 30 days (P = 0.3), returning to driving was 20 versus 14 days (P = 0.2) and full activity was 21 versus 22 days (P = 0.8). Chronic groin pain developed in four patients in the PHS group (12.9%) and in five patients in the Lichtenstein group (15.1%; P > 0.05). One patient developed recurrent herniation in the PHS group. The median follow up was 4.2 years (range, 4-4.6 years). Patient satisfaction was very high with both the techniques. CONCLUSION: There is no significant difference in the early and long-term outcomes between PHS and Lichtenstein hernia repairs. The PHS technique involving preperitoneal dissection is well tolerated and easy to carry out under local anaesthesia.

Female↗

A 5-year audit of 778 neonatal renal scans (Part 1): perplexing pyelectasis and suggested protocol for investigation.

In this 5-year review of 778 neonatal renal scans seen in an Obstetric Hospital, most infants were referred because of antenatal ultrasound findings, 92% with fetal pyelectasis. The results were classified according to the ultrasound findings. The majority of neonates (76%) had a normal postnatal scan. A number had vesicoureteric reflux (VUR) found on a micturating cystourethrogram. Persistant mild to moderate pyelectasis or hydronephrosis (15%) proved to be a normal variant in many infants, but had a similar appearance to those with an early obstructive cause (1%). Pyelectasis has proved to be a poor predictor of VUR. A protocol outlining paediatric management for neonates with persisting pyelectasis is included. There were 59 infants (8%) with a miscellaneous group of renal anomalies, many with a characteristic antenatal ultrasound appearance suggesting the diagnosis. These infants have been separately reported and illustrated (Part 2). Overall, 13% of infants were found to have significant findings of obstruction, VUR or miscellaneous anomalies affecting management.

Clinical Protocols↗

A 5-year audit of 778 neonatal renal scans (Part 2). Miscellaneous anomalies in 59 infants: a pictorial presentation.

In this 5-year review of 778 neonatal renal scans seen in an obstetric hospital, Mercy Hospital for Women, Melbourne, most infants were referred because of antenatal ultrasound findings. Ninety-two percent of these had fetal pyelectasis. The results were classified on the ultrasound findings. The majority of neonates (76%) had a normal postnatal scan. A number had vesicoureteric reflux found on micturating cystourethrogram. Persisting mild/moderate pyelectasis or hydronephrosis (15%) proved to be a normal variant in many infants, but had a similar appearance to those with an early obstructive cause (1%). There were 59 infants (8%) with a miscellaneous group of renal anomalies, many with a characteristic antenatal ultrasound appearance suggesting the diagnosis. Review of these 59 infants illustrates the anomalies seen and reports the associated investigations and subsequent outcome in most cases.

Abnormalities, Multiple↗