Objective• To review the literature and make practical recommendations regarding the conservative management of renal trauma. Patients and Methods• Relevant articles and guidelines published between 1980 and 2014 were reviewed.• Graded recommendations were constructed by a multi-disciplinary panel consisting of urologists, radiologists, and infectious disease physicians. • These recommendations underwent formal review and debate at the Western Australian USANZ 2013 state conference, and were presented at the USANZ 2014 annual scientific meeting.

Australia has a large migrant population with variable fluency in English. Interpreting services help ensure that healthcare services are delivered appropriately to these populations. However, the use of professional interpreters in hospitals is expensive. There are also issues with service availability and convenience. Mobile devices containing software with translating abilities have promising potential to improve communication between patients and hospital staff as an adjunct to professional interpreters. It is highly convenient and inexpensive. There are concerns about the accuracy of the interpretation done with such software and more research needs to be carried out to support or allay these concerns. For now, clinically important and medicolegal related interpretation should be undertaken by professional interpreters whereas less crucial tasks may be performed with the help of interpreting software on mobile devices. Australia has a large community of migrants with first generation Australians making up 27% of the population in 2011.1 Although 51% of migrants who arrived before 2007reported to be fluent in English, 53% spoke a language other than English at home and 2.6% did not speak English at all. 1 Of the migrants who arrived more recently, only 43% were reportedly fluent in English while 3.1% did not speak English at all.1 Interpreting services are therefore important in ensuring healthcare services are delivered optimally to patients who are unable to speak English. However, there are various issues affecting the proper use of interpreting services such as availability and cost. Mobile technology enabled with interpreting software could potentially solve these issues. The objective of this article is to highlight these issues during the care of a non-English speaking patient with a complex past medical history and how mobile technology played a role as an adjuvant option of improving communication with the patient. Case HistoryA 37-year-old Persian speaking patient from Iran arrived in Australia as an asylum seeker. He had a past history of perineal radiotherapy for a perineal malignancy as a boy in Iran. He also had major abdominal surgery secondary to a motor vehicle accident approximately 12 years earlier.He presented to the hospital with a blocked Mitrofanoff appendicovesicostomy conduit and perineal vesicocutaneous fistulas. The urology team admitted him for computed tomography and magnetic resonance imaging, a diagnostic cystoscopy and conduitography for surgical planning. He had a cystectomy and ileal conduit urinary diversion performed at a later date.The team used a professional Persian interpreter during the initial encounter to help with history taking, obtaining consent for insertion of a 12Fr indwelling catheter into the Mitrofanoff appendicovesicostomy and consent for the above investigations. Once the team decided to perform a cystectomy and ileal conduit formation, the plan was discussed with the patient with the help of a professional interpreter and informed consent for the...

Objectives To quantify and examine the causes of delays in the diagnosis and initial treatment of patients with bladder cancer in Western Australia. Subjects and Methods All attendances at a one‐stop haematuria clinic at a public tertiary‐level hospital in Western Australia between May 2008 and April 2014 were reviewed retrospectively. All patients diagnosed with a bladder tumour over this period were identified. These patients and their general practitioners were contacted retrospectively and invited to participate in telephone interviews, with additional data collected from clinical records as required. Waiting times to presentation, referral, assessment, and initial treatment were established for patients who presented with visible haematuria. Results Of 1 365 attendances, 151 patients were diagnosed with a bladder tumour and 100 of these were both suitable and agreed to participate in the study. For patients with visible haematuria the median (range) waiting time from initial bleeding to surgery was 69.5 (9–1 165) days. This was comprised of a median (range) pre‐referral waiting time of 12 (0–1 137) days, assessment waiting time of 23.5 (0–207) days, and treatment waiting time of 20 (1–69) days. Reasons for prolonged waiting times included poor public awareness, patient fear and anxiety, delayed and non‐referral from primary care, administrative delays, and resource limitations. Conclusion Many patients experience significant delays in the diagnosis and treatment of their bladder cancer in Western Australia, and this probably reflects national trends. These concerning data warrant consideration of how delays can be reduced to improve outcomes for these patients.

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Metastatic primary testicular carcinoid tumor remains a very rare condition. We report the first case of metastatic primary testicular carcinoid tumor where along retroperitoneal lymph node dissection excision of the Inferior Vena Cava was also performed. The rarity is further emphasised by the presence of a contralateral testicular dermoid cyst. Given the features of the tumor were not in keeping with the traditional predictors of metastases (primary tumor >7.3 cm, poor differentiation and the presence of carcinoid syndrome) this case adds valuable addition to the relatively limited literature available on this rare condition.