Mark Lynch Clinical Lead Urology, Croydon University Hospital Consultant, St George’s Hospital Mlynch100@doctors.org.uk Mark.lynch@croydonhealth.nhs.uk.

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Presentation transcript:

Mark Lynch Clinical Lead Urology, Croydon University Hospital Consultant, St George’s Hospital Mlynch100@doctors.org.uk Mark.lynch@croydonhealth.nhs.uk Mark.lynch@stgeorges.nhs.uk

Croydon Urology – the future July 2013 July 2014 M Lynch Consultant Interview Job plan for further Consultant July 2015 SGH integration July 2015+ Urology centre?

Lower Urinary Tract Symptoms BPH (50%) Prostate cancer (16%) Other pathology

BPH

BPH Epidemiology: Autopsy Epidemiology: Clinical 23% men aged 41-50

BPH Epidemiology: Less common Higher income groups Western / industrialized countries Less common Alcohol and cirrhosis Far East (Japan, China, Korea)

AUA / IPSS Symptom Score

BPH Assessment Variability Symptom score Quality of life Drug therapy Surgery Examination – neurology PSA ??

BPH Complications Renal failure Bladder calculi Infection Incontinence Retention Haematuria

BPH Management Watch and wait Pharmacology Surgery TURP - TURiS

Medical Therapy Conservative measures Bladder diary Alpha blockers 5 alpha reductase inhibitors Combination therapy

Bladder Diary

Bladder Diary

BPH DRE Routine bloods MSU

AUA / IPSS Symptom Score

Bladder Diary

LUTS Advice Medication Review

CUH – Here to help! LUTS clinic IPSS Flow-rate Information documents Decision making clinic for surgery Medical management strategy for primary care