Hussain M. Alnajjar

Hussain M. Alnajjar
University College London Hospitals NHS Foundation Trust | uclh · Department of Urology

BSc (MedSci) MBBS MRCS ChM (Urol) FEBU FRCS (Urol)

About

127
Publications
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Introduction
Mr Alnajjar is a Consultant Urological Surgeon and Andrologist at University College London Hospitals NHS Foundation Trust. He has a special interest in male factor infertility, erectile dysfunction and penile prosthesis surgery, Peyronie's disease and its surgical correction, priapism, genito-urethral oncology (penile cancer and testicular cancer), genital reconstruction, all testicular conditions, low testosterone (hypogonadism), male sexual dysfunction and pelvic pain disorders.

Publications

Publications (127)
Article
Full-text available
Purpose To analyse the risk of inguinal lymph node (ILN) metastases in T1G2 penile cancer stratified by lymphovascular invasion (LVI), perineural invasion (PNI) and tumour size. Methods Retrospective study of men with localised T1G2 penile cancer with non-palpable lymph nodes and no local recurrence during follow-up at six European institutional h...
Article
Priapism is a rare condition that can lead to long-term erectile dysfunction if left untreated. It is one of the few urological emergencies that require prompt medical intervention. Priapism refers to a penile erection that lasts for more than 4 hours and is unrelated to sexual stimulation or orgasm. The aims of immediate intervention for ischaemic...
Article
Objectives: To report the management outcomes of men with ≤20-mm small testicular masses (STMs) and to identify clinical and histopathological factors associated with malignancy. Patients and methods: A retrospective analysis of men managed at a single centre between January 2010 and December 2020 with a STM ≤20 mm in size was performed. Result...
Article
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The aim of this study is to describe the outcomes for a modified glans-resurfacing technique for benign and malignant penile conditions in which the uninvolved glans corona is preserved in order to maintain glans erogenous sensation. A total of 13 patients underwent coronal-sparing glans resurfacing (CSGR), with follow-up every 3 months for ≥2 year...
Article
Background: Pseudoepitheliomatous keratotic and micaceous balanitis (PEKMB) is a clinicopathological entity characterised clinically by micaceous scale on the glans, and histologically by acanthosis, hyperkeratosis and pseudoepitheliomatous hyperplasia. We present a series of eight cases of this rare condition, the first series of more than two ca...
Article
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A range of drugs have a direct role in triggering ischaemic priapism. We aimed at identifying: a) which medications are associated with most priapism-reports; and, b) within these medications, comparing their potential to elicit priapism through a disproportionality analysis. The FDA Adverse Event Reporting System (FAERS) database was queried to id...
Article
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A limited number of studies have described patients on finasteride showing findings which were consistent with Peyronie’s disease (PD). We aimed to detect a pharmacovigilance signal of possible association between finasteride and PD-related clinical features. The Food and Drug Administration (FDA) Adverse Event Reporting System (FAERS) database was...
Article
Objective The main aim of this study was to report the outcomes of azoospermic men with suspicious testicular lesions, undergoing microsurgical sperm retrieval (micro-oncoTESE) at the time of radical/partial orchidectomy. Patients and methods Testicular lesions suspicious for cancer were confirmed on ultrasound scanning. In patients undergoing rad...
Article
Background: Male genital lichen sclerosus (MGLSc) can lead to significant sexual dysfunction and urological morbidity, and is also a risk factor for premalignant disease (penile intraepithelial neoplasia and penile cancer), particularly squamous cell carcinoma. Although the precise aetiopathogenesis of MGLSc remains controversial, accumulated evid...
Article
Introduction A penile prosthesis (PP) may be inserted for erectile dysfunction (ED) and/or urinary management in men with spinal cord injury (SCI). This group of patients is considered high risk for complications due to their reduced mobility and sensation. Objectives To identify the complication and satisfaction rates following PP insertion in pa...
Article
Objective Penile cancer (PeCa) is a rare disease with a global incidence of 36 068 new cases in 2020. This accounts for 0.4% of all male malignancies. The surgical management of penile cancer depends on the location of the tumour and depth of invasion. Here, we review the oncological and functional outcomes of penile-sparing surgery (PPS). Methods...
Article
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Background: Hematospermia, although often found to be a benign condition, can be an alarming sign. Consequently, patients can undergo multiple investigations with no current standardized pathway based on data from large series. The aim of this study was to evaluate the incidence of an underlying pathology and the value of diagnostic investigations...
Article
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Objectives: Following tumour positive sentinel lymph node biopsy (+DSNB), completion inguinal lymph node dissection (ILND) is negative in 84-89% of basins. Thus, ILND after +DSNB may be considered overtreatment resulting in substantial morbidity. This study aimed to develop a predictive model for additional inguinal lymph node metastases (LNM) at...
Article
Penile cancer (PeCa) is a rare disease, with a global incidence of 36 068 new cases reported in the 2020 GLOBOCAN database. Narrower excision margins are now acceptable without compromising survival. Glansectomy is commonly performed for invasive PeCa confined to the glans penis. The majority of data on glansectomy are from small single-centre seri...
Article
Penile mucosal melanoma is an aggressive and rare genital malignancy. The aim of the present study was to review the management and outcomes of a homogenous cohort of patients with histologically confirmed penile mucosal melanoma, at a single specialist centre. A retrospective review of an institutional database identified patients with penile muco...
Article
Subfertility is a risk factor for testicular cancers (TT), and conversely, TT may induce subfertility due to local and regional toxic effects. We aimed to identify the association between TT characteristics and pre-orchidectomy azoospermia. A systematic review of the literature was performed according to the PRISMA checklist. Overall, eight non-ran...
Article
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A recent statement from the European-Society-for-Sexual-Medicine has highlighted the limitations of using the rat model for nerve-sparing prostatectomy. The use of young rats with no comorbidities and the early evaluation of the erectile function (EF) are deemed a source of bias. Our aim was to evaluate the long-term consequences in EF of bilateral...
Chapter
Penile prosthesis implantation is the ultimate option for the treatment of end-stage erectile dysfunction (ED). Although recognised intraoperative complications are not frequently reported, recognition of complications intraoperatively provides the best opportunity to minimise patient dissatisfaction, the risk of infection, erosion or later revisio...
Chapter
This chapter includes clinical cases, background, evidence-based practical management options, preventive measures, key-point summaries of retrograde ejaculation and anejaculation and answers to questions patients ask. Ejaculatory dysfunction is a rare cause of male infertility in which spermatogenesis is usually well preserved and sperm function i...
Chapter
Penile cancer (PCa) is a rare disease, and the most common histological subtype is squamous cell carcinoma (SCC). The surgical management of PCa depends on the extent of invasion into deeper penile structures, and penile-preserving options are now the standard of care in specialist centres. Glansectomy can be offered to those with invasive disease...
Article
Introduction MGLSc is an acquired, chronic, inflammatory cutaneous disease that is associated with significant morbidity and squamous cell carcinoma of the penis. Consideration of all of the evidence suggests that chronic exposure of susceptible epithelium to urinary occlusion by the foreskin is the most likely pathomechanism: MGLSc never occurs in...
Article
Introduction: We reviewed the medical and surgical management and long-term outcomes for patients diagnosed with penoscrotal extramammary Pagets disease (EMPD) within an eUROGEN centre. Patients and methods: Retrospective review of cases from an institutional database with biopsy proven penoscrotal EMPD. Results: A total of 10 patients were id...
Article
Objectives To develop an international consensus on managing penile cancer patients during the COVID-19 acute waves. A major concern for patients with penile cancer during the coronavirus disease 2019 (COVID-19) pandemic is how the enforced safety measures will affect their disease management. Delays in diagnosis and treatment initiation may have a...
Article
Background: The option of semen cryopreservation following a diagnosis of testicular cancer shows a variable uptake with the option to cryopreserve before surgery often dependent on the preference of the treating clinician and the fertility laboratory resources available. Objectives: To assess whether the introduction of a patient-centric pathwa...
Article
Background Penile length measurement techniques vary widely in published studies leading to inaccurate and nonstandardized measurements. Aim To review the methodology used to report data in studies evaluating penile length and provide a detailed recommendation in conducting future high-quality research. Methods The MEDLINE database was searched f...
Chapter
Penile cancer is a rare disease that constitutes 0.2% of all male malignancies with the most common age of presentation in the sixth decade. Early diagnosis is key as the disease can result in devastating disfigurement and a five‐year survival rate of approximately 50%. In practice, for suspected inflammatory penile lesions, early biopsy is require...
Article
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The purpose of this study was to explore men's motivations and experiences of attending a penile cancer support group and critically analyse whether participating in the support group has an impact on their psychological well‐being. Eleven men attended a focus group facilitated by a cancer nurse specialist and a group facilitator. This was held in...
Article
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Background Two million non-emergency surgeries are being cancelled globally every week due to the COVID-19 pandemic, which will have a major impact on patients and healthcare systems. Methods During the peak of the pandemic in the United Kingdom, we set up a multicentre cancer network amongst 14 National Health Service institutions, performing uro...
Article
Detection of positive nodes in men with moderate-risk to high-risk penile cancer and impalpable inguinal nodes is an important step in the therapeutic pathway. Detection using dynamic sentinel node biopsy with patent blue dye and radioisotope is associated with false negatives; indocyanine green might offer an alternative adjunct to improve detecti...
Article
Full-text available
Objective: Ejaculatory duct obstruction (EDO) is an uncommon but potentially treatable cause of male factor infertility. However, there are limited data on transurethral resection of the ejaculatory ducts (TURED) as a treatment option. A systematic review was therefore conducted to assess its efficacy and identify patient subgroups that benefit fr...
Article
Introduction: Penile intraepithelial neoplasia (PeIN) is a histological term for precancerous penile lesions. PeIN is important due to the high morbidity and mortality associated with progression to penile squamous cell carcinoma (PSSC). But PeIN is rare, contributing to a limited evidence-base for the relative efficacy of available treatment optio...
Article
Background: Radical orchidectomy in patients who are subsequently diagnosed with benign testicular tumours represents an overtreatment due to the deleterious effects on endogenous testosterone, fertility and body image. For these reasons, the option of partial orchidectomy should be considered in certain groups of patients. Patients with bilateral...
Article
Full-text available
Ischaemic priapism (IP) is characterised by a persistent, painful penile erection lasting for >4 h. Many causes of IP have been identified including haematological dyscrasias (particularly, sickle cell disease), drugs and rarely malignancy. There are also a large proportion of men, in which no aetiology is identified. Identification of men at risk...
Article
Introduction Priapism is rare yet has the potential to inflict significant suffering on patients, often with lasting consequences such as erectile dysfunction, corporal muscle necrosis, and a loss of sexual function. Although rare, it is a pathology that has received little focus in the literature, particularly that caused by malignancy, and it is...
Chapter
Erectile dysfunction (ED) is the consistent inability to achieve or maintain an erection sufficient for satisfactory sexual activity. ED has implications for healthcare provision, particularly as men are living longer with higher expectations with regard to sexual health.
Article
The final clinical session of the British Association of Urological Surgeons (BAUS) annual meeting is the Updates and Highlights session, where the most important advances in the main urological sub-specialities are summarised and presented by sub-specialist experts representing each BAUS section. The aim of the session is to disseminate knowledge...
Article
Purpose of review: The aim of this article is to provide an overview of the current literature specific to surgery for localized penile cancer including novel reconstructive techniques.Centralization of penile cancer services in many European countries and in particular the United Kingdom has resulted in an increased proportion of men undergoing o...
Article
Full-text available
Background: To describe a novel 'Batman' scrotectomy technique and present our single centre experience in the management of secondary scrotal lymphoedema in penile cancer patients. Methods: A retrospective review of the medical records of penile cancer patients with extensive and bothersome penoscrotal lymphoedema failing conservative therapy b...
Article
Introduction and objectives: Adult undescended testicles (UDTs) often present to fertility specialists with subfertility or azoospermia and with either an intra-abdominal or inguinal testicle(s). Performing an orchidopexy followed by a surgical sperm retrieval (SSR) is a potential option to retrieve spermatozoa. A microdissection TESE (mTESE) proc...
Article
Full-text available
Purpose of review: Tissue engineering and regenerative medicine has emerged as a new scientific interdisciplinary field focusing on developing new strategies to repair or recreate tissues and organs. This review gathers findings on erectile dysfunction and, Peyronie's disease from recent preclinical and clinical studies under heading of stem-cell...