The Staffordshire Urology Clinic have been invited to attend a Men’s Health education event at Leek Golf club at 7.30pm on 3rd April 2012. Issues for discussion include, prostate problems including cancer, erection problems, testicular swellings including cancer, kidney problems, blood in the urine and bladder problems including bladder cancer.
Mr Golash is widely recognised as an expert at (laparoscopic) keyhole kidney surgery. He has helped a number of local surgeons to introduce this type of surgery to their hospitals. His latest project is to help a surgeon in Dumfries, Scotland, where patients have to either have traditional major cutting open surgery, or travel hundreds of miles and wait months for keyhole surgery. A surgeon from Dumfries has made a number of visits to Stoke, to observe the surgery, and Mr Golash has so far made 1 trip to Scotland, to ensure that the surgery is introduced safely.
Positive margin rates (PSM) after radical prostatectomy performed by Christopher Luscombe of the Staffordshire Urology Clinic have been consistently about 15% over the last 5 years. This compares with a national average of 38% reported in an article in the medical journal British Journal of Urology International last month. The article describes research carried out on the British Association of Urological Surgeons complex procedures database; a database that all Urology Consultants in the UK are encouraged to report details of operations that they perform to. PSM are associated with a much higher rate of cancer recurrence after radical prostatectomy, although many men are still cured even with a PSM, and the lower the rate the better. Our PSM results of only 15% are taken from this database and our further analysis of this database for operations performed in the last 5 years shows that a PSM rate of only 15% is the lowest in the Midlands, although reporting by many surgeons is not comprehensive.
National results from this database for 2012 have just been published (click here).
The standard treatment for patients with suspected kidney cancer is to remove the complete kidney. This is known as radical nephrectomy and is almost always done keyhole at the Staffordshire Urology Clinic. However, there is a risk of future kidney failure if one kidney is removed in this way, especially if there is already evidence that the kidney to be preserved is not working perfectly. For this reason it may be suggested that some tumours could be better by only removing the part of the kidney containing the tumour. This has the advantage of preserving as much functioning kidney tissue as possible, but is a much more demanding surgical procedure, with higher risks of complications (in particular there are increased risks of bleeding, urine leak and damage to the kidney; all which may lead to the kidney needing to be removed either at the time of surgery or at a later date). There is also the risk of cancer returning in the remaining, preserved part of the kidney, which may need further treatment.
Despite this being a very demanding procedure even through a large cut and open operation, our surgeons often successfully perform this partial kidney removal laparoscopically (keyhole), which is even more complex. Performing this procedure keyhole has been shown to be equally as effective at cancer cure compared to an open operation, but allows a much quicker recovery. It can be performed purely using keyhole instruments (top video)…..
…….or with the assistance of inserting 1 hand through a small hole (called Hand Assisted Laparoscopic nephrectomy, also known as HAL Nephrectomy) , which doubles as the hole required to remove the tumour (lower video). In our opinion this latter technique has many advantages, although it does require a slightly larger hole and therefore leaves a slightly larger surgical scar.
Partial removal of the kidney can also be used for treatment of a non-functioning or painful part of the kidney in selected cases.
If you would like to discuss keyhole prostate removal then please contact 01782 382507 and book a consultation with Mr Anurag Golash or Mr Christopher Luscombe.
Vasectomy can be reversed to restore fertility. It is not always successful and the longer it has been since vasectomy the less successful it becomes. Our Consultants often use magnification to improve the surgery and have approximately a 90% success rates (first time reversal) at restoring sperm to the semen.
We reviewed the last 33 first time vasectomy reversal procedures performed by Mr Luscombe up until the end on 2017. We identified 25 patients who had provided post vasectomy reversal semen samples; of these 22 were positive for sperm. Of the 8 that did not provide semen samples some had already communicated a successful pregnancy. Thus, the patency rate is between 88% and 91%. This compares favourable to an average patency rate of 89.4% reported in a review of 6633 patients from the world literature. This review was reported by Herrel et al and published in the Journal Urology (2015 ).
After an initial consultation the Staffordshire Urology Clinic can arrange a vasectomy reversal for £3053 (correct 23/01/2013, but may change so please confirm directly with the Hospital). If you would like to discuss Vasectomy with one of our consultants please contact 01782 382507 and book an appointment.
Vasectomy (commonly known as “the snip”) is a very common and successful form of contraception. It involves a short operation on the testicles to cut segments out of the tubes that carry sperm from the testicles to the body. The operation is often performed under local anaesthetic, but can be done under general anaesthesia if necessary.
After an initial consultation the Staffordshire Urology Clinic can arrange a Local Anaesthetic Vasectomy or a General Anaesthetic Vasectomy. If you would like to discuss these options with one of our consultants please contact 01782 382507 and book an appointment.