Team photo from left to right: Frank Kueppers, Giovanni Losco, Kevin Bax, Louise Rouse, Jane MacDonald, Stephen Mark, Nick Buchan and George Acland.
The Te Whatu Ora Waitaha Canterbury Urology Service is based at Christchurch Hospital with an additional service at the Burwood Spinal Unit. The nine urologists that form the Urology Service offer urological expertise and treatment to adult and paediatric patients for the largest range of urological conditions of any service in New Zealand.
As a group of consultants, we make a point of doing things together and achieving standardisation. Our department has led New Zealand in many innovations in how we run a publicly-funded surgical service. The Urology Service is unique in that it is an ACU, an Autonomous Clinical Unit. This allows us to hold our own budget. As a result of this, you will find that there is a greater emphasis on cost saving and improved efficiency. Each dollar saved with greater efficiencies can be put back into the service, creating a better patient-focused service that is enjoyable to work in.
Within Urology here at Christchurch Hospital, we have four specialist uro-oncologists, who have subspecialty interests in robotic and minimally invasive surgery in the treatment of prostate cancer. We have two specialist paediatric urologists, who also treat paediatric patients across the South Island. The other subspecialties offered by the Urology Service include reconstruction, pelvic organ prolapse, incontinence, erectile dysfunction, spinal injury management and the treatment of kidney stones. We are accredited by The Royal Australasian College of Surgeons (RACS) and the Urological Society of Australia and New Zealand (USANZ) for urological training.
The Urology Service is split into a green team and a blue team, although they function as a single unit. The team structure provides a sense of belonging and clarity for those in training and the consultants as to the correct line of communication and responsibility. Our urologists are supported by four registrars, one shared relief registrar (shared with Paediatric Surgery) and currently one house officer. There are two trainee and two non-trainee positions filled by registrars considering a career in Urology.
Our patients are cared for in the Urology Unit in Parkside West here at Christchurch Hospital by our highly experienced team of nurses.
Urology works closely with other surgical and medical services, particularly Nephrology, Radiology, Oncology and Gynaecology. We hold weekly Tuesday afternoon meeting sessions where medical staff attend meetings with other services to discuss interesting cases and issues of significance. The meetings rotate on a four-weekly rota and include a Morbidity and Mortality (Audit) meeting, a special A2 monthly audit meeting, Radiology and Oncology sessions, the Pelvic Floor MDM, training sessions, a journal club and the business meeting.
In 2022 the Urology Service saw 2,300 new and almost 8,500 follow-up outpatients, of which over 3,000 were telehealth events. 1,370 operations were performed with a mix of radical treatments for both bladder and prostate cancer (6%), nephrectomies (7%), TURBTs and TURPs (19%) and treatment for stones (23%).
Urology focuses on the surgical and medical diseases of the male and female urinary tract system and the male reproductive organs. It incorporates both operative and non-operative treatments for urological problems of men, women and children. Urology includes the kidneys, ureters, bladder, prostate, urethra, testes and more. If you need help to urinate or to reproduce, urologists are likely involved.
Urology also deals with some of the most sensitive parts of health, including sexual function, fertility, urinary continence and gender identity. For this reason, urologists are well-versed in having complex, quality of life conversations and delivering compassionate care.
Urology is a unique blend of clinical medicine and surgery that appeals to many in the medical profession. Urologists are able to counsel patients on lifestyle modifications for their bladder issues or kidney stones, perform cystoscopies and biopsies in clinic, or have the opportunity to perform long and complex surgeries. Cases are varied both procedurally and in complexity and use the latest technology. There is a subspecialty to suit everyone’s preference, from removing cancer to improving continence and everything in between.
Maintaining a strong workforce is important in being able to continually provide first class care for our patients. The opportunities within Urology are varied and plentiful. We have a proud history of a number of our house surgeons and non-training registrars being successful with gaining a position on the USANZ training programme in urology. Our department is supportive of prospective trainees and there are plentiful research opportunities available for improving training applications.
By training in our service, you will gain a breadth of experience unlike any other training position in Australia and New Zealand. As well as a busy uro-oncology and endo-urology service, we also offer neuro-urology at the Burwood Spinal Unit, paediatric urology, female and functional urology and reconstructive urology. There are a number of interesting cases undertaken in the private sector of which you are welcome to attend – robotic radical prostatectomy and partial nephrectomy, artificial urinary sphincters, penile prosthetics and sacral neuromodulation are examples.
There is significant support available to those training within our service. Our Supervisor of Training meets regularly with the trainees throughout the year, and there is continual support and supervision provided by all the consultants. Training new doctors is a core component of our service, as we recognise the importance of highly trained staff. Training is provided across all aspects of patient management and treatment. We are actively involved in the teaching of medical students, house officers, registrars and nursing students.
Here in Urology, we regard training as an integral part of our daily work in all our patient interactions and care management. Our trainees are provided many opportunities where they will receive first class experience across the breadth of urological treatment and management that we offer. The weekly rota has been established to give each trainee a balance of theatre sessions and outpatient clinics.
Vocational training in urology is undertaken by the Royal Australasian College of Surgeons. Once this training is complete, the doctor is made a Fellow of the College (FRACS).
The Urological Society of Australia and New Zealand administers the SET program in Urology through RACS. For details of training requirements, please refer to their website (USANZ - Home Page).
The Canterbury Urology Research Trust (CURT) was set up in 1997 by the Christchurch urologists of the time. It has established a strong international reputation. At any one time, it runs a number of both pharmaceutical industry and clinician-led trials.
The Urology Service also uniquely established an Audit Facilitator position to support the department’s strive for improvement and continued patient-focused care. This role provides information for clinical research and audit purposes.
The Urology Service here at Christchurch Hospital has been active in publishing research. There is a strong affiliation with research bodies across the region. The service is also closely associated with the University of Otago, Christchurch.
All our consultants provide strong support for RMOs. Regardless of the team you are assigned to, our urologists are always available to answer queries or concerns, whether this is remotely or in-person.
For all training or progress issues and questions, the Supervisor of Training will be the first point of contact. They are there to ensure you have what you need to succeed within your time in Urology and to gain the most from your experience. It is beneficial for all to let them know as soon as possible of anything required so that changes can be made.
We recognise the importance that teaching has in our service and the care we provide to our patients, so please make sure you communicate your needs to the team so they can support you.
Mr Giovanni Losco
Clinical Director, Department of Urology
Christchurch Hospital, Private Bag 4710
Christchurch, New Zealand
Phone: (+64 3) 378 6472
Email RDST: recruitment@cdhb.health.nz
