Implementation of this protocol for reduced preoperative fasting achieved an appreciable reduction in fasting times and enhanced patient comfort. Patient safety was not compromised. Further modifications of our protocols are necessary to meet the international best practice. We recommend its implementation across all surgical groups in our institution.

Dipstick (reagent strip) and microscopic urine analysis for haematuria was performed prospectively on 1000 consecutive urine samples taken from urological out-patients. Haematuria was present in 185 samples (18.5%) and absent in 687 (68.7%) using both tests; 98 samples (9.8%) had dipstick haematuria that was not confirmed by microscopy and 30 samples (3%) had microscopic haematuria that was missed on dipstick urine analysis. Dipstick urine analysis had a sensitivity of 86.1% and a specificity of 85%. This study confirms that reagent strip testing for haematuria has both false positive and false negative results and indicates that cytoscopy should be considered in all patients with suspected haematuria.

The role of retrograde ureterography in the management of pelviureteric junction (PUJ) obstruction remains controversial and it has recently been reiterated that visualisation of the entire ureter on the affected side is mandatory owing to the high incidence of other ureteric abnormalities.In a review of 1 19 consecutive adult pyeloplasties carried out over a 9-year period, only 2 ureteric abnormalities were found in association with PUJ obstruction (duplex ureter/3-cm proximal stricture). Other anatomical abnormalities included aberrant vessels, fascia1 bands and renal anomalies. Most secondary abnormalities were undiagnosed prior to surgery and all were easily dealt with per-operatively. . Retrocaval ureter: a case diagnosed pre-operatively and treated successively by a plastic operation. Br. J . Urol., 21,209-214. Britton, K. E., Nawaz, M. K., Whiffield, H. N. ef d. (1987). Obstructive uropathy : comparison between parenchymal time index and frusemide diuresis. Br. J. Urol., 59,127-132. Cockrell, S. N. and Hendren, W. H. (1990). The importance of visualising the ureter before performing a pyeloplasty. J . Urul., 144,588-592. English, P. J., Testa, H. J., Gosling, J. A. etd. (1982). Idiopathic hydronephrosis in children. A comparison between diuresis renography and upper urinary tract morphology. Br. J . Urul., Gordon, I., Mialdea-Fernandez, R. M. and Peters, A. M. (1988). Pelviureteric junction obstruction. The value of a postmicturition view in 99m Tc DTPA diuretic renography. Br. J. Urul., 61,409-412. 54,603-607.

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