Majid Shabbir

• Guy's and St Thomas' NHS Foundation Trust

Objective To develop a core outcome set for male infertility trials. Design A two-round Delphi survey and consensus development workshop were undertaken with healthcare professionals, researchers and clinicians globally. Subjects 334 participants from 39 countries participated in the Delphi Survey, while 44 participants from 21 countries participat...

Study question: Can a core outcome set be developed through a global consensus to standardize outcome selection, collection, comparison, and reporting in future male infertility trials? Summary answer: A minimum dataset, known as a 'core outcome set', has been developed for randomized controlled trials (RCTs) and systematic reviews evaluating pote...

Objective To determine the success rate of oncological microdissection testicular sperm extraction (onco‐microTESE) in patients with testicular cancer (TC) with azoospermia and severe oligoasthenoteratozoospermia (OAT; <1 million/mL sperm) and to explore any factors that may predict success. Patients and Methods Case series of outcomes from all co...

Objective The study aims to assess current international clinician attitudes, practices and barriers towards fertility assessment and preservation in patients undergoing radical inguinal orchidectomy (RIO) for testicular cancer. Materials and methods An international online survey of urologists and urologists in training who perform RIO for testic...

Across health care, clinicians are increasingly using patient-reported outcome measures (PROMs) to give a voice to patients and to help standardize the assessment of patients for comparison purposes. With this increasing use, the limitations of these PROMs should not be underestimated within the diverse population that we treat.

Introduction Intracavernosal injections (ICI) are the second line treatment of erectile dysfunction (ED). To reduce the risk of complications, primarily priapism, the first administration has traditionally required face-to-face appointments. With a move to remote working, the safety and feasibility of an instructional video for the first self-admin...

Background & Objectives Onco-microsurgical testicular sperm extraction (Onco-microTESE) allows the microsurgical extraction of testicular sperm from the unaffected regions of the tumour-bearing testis at the time of radical orchidectomy. We report the case of a 36-year-old hypogonadotropic male with a testicular tumour and non-obstructive azoosperm...

Study question: We aim to develop, disseminate and implement a minimum data set, known as a core outcome set, for future male infertility research. What is known already: Research into male infertility can be challenging to design, conduct and report. Evidence from randomized trials can be difficult to interpret and of limited ability to inform cl...

Focus on quality of life after prostate cancer is vital to improve patient care. Improved assessment and proactive management of post-treatment functional outcomes is essential. Many aspects of the patients’ aftercare need to be improved in order to set up a clear path following prostatectomy. These improvements will enable a timely and efficient e...

Primary localised amyloidosis of the urethra is a rare entity with only 50 cases reported in the literature. The deposition of fibrillary proteins can lead to a range of symptoms. Importantly, the clinical and cystoscopic features may mimic urethral malignancy (haematuria, voiding difficulties, and a palpable urethral mass), and so thorough investi...

Subfertility in testicular cancer is common and often overlooked. Baseline fertility assessments are essential before intervention to allow implementation of a patient-centred pathway to maximise fertility preservation without delaying oncological treatment and to significantly improve a patient's quality of life.

Objective In the last decade non-technical skills (NTS) have emerged as a vital area for improvement within surgery. This study aims to develop and evaluate a Non-technical Skills for Urological Surgeons (NoTSUS) training curriculum and assessment scale.Methods This international, longitudinal and observational study began with a 3-round Delphi met...

Introduction: Our study analysed previous studies employing Positron Emission Tomography with co-registered Computer Tomography (PET/CT) in andrological patient evaluation and assessed the differences in 2-[18 F]F-fluoro-2'-deoxyglucose (FDG) uptake between 3 groups: healthy testes, benign and malignant testicular pathology. Methods: MEDLINE and...

The British Association for Sexual Health and HIV (BASHH) UK guideline for the management of epididymo-orchitis has been updated in 2020. It offers advice on diagnostic tests, treatment and health promotion principles in the effective management of epididymo-orchitis. Empirical treatment should be started in patients with objective swelling and ten...

Objectives: To determine the safety of urological admissions and procedures during the height of the COVID-19 pandemic using "hot" and "cold" sites. The secondary objective is to determine risk factors of contracting COVID-19 within our cohort. Patients and methods: A retrospective cohort study of all consecutive patients admitted from March 1 t...

Salvage therapy for prostate cancer is indicated in the context of disease recurrence. The options for salvage depend on the initial treatment modality used. The primary aim is oncological clearance. All treatments for prostate cancer run the risk of affecting sexual function, and salvage therapy can lead to further impairment. Here we will explore...

Importance: Contracting COVID-19 peri-operatively has been associated with a mortality rate as high as 23%. Using hot and cold sites has led to a low rate of post-operative diagnosis of COVID-19 infection and allowed safe continuation of important emergency and cancer operations in our centre. Objective: The primary objective was to determine the s...

Objectives To develop and validate the Urethroplasty Training and Assessment Tool (UTAT) using Healthcare Failure Mode and Effect Analysis (HFMEA) for training and assessment of urology trainees learning this urethral reconstruction technique, as urethroplasty is the ‘gold standard’ treatment for long and recurrent urethral strictures and with a va...

Objective To determine those patient groupings, based on volume and risk, whose optimal urethral reconstructive management might be provided by a reorganisation of UK reconstructive surgeons. Methods Between 2010 and 2017, ~689 men/year were enrolled onto an online audit platform collecting data about urethral reconstruction in the UK; this accrua...

Male infertility is a major health burden worldwide. In the United Kingdom, the diagnostic and treatment pathway for male factor fertility is fragmented with wide variance in management and funding protocols. There is now a focus on potential overtreatment of couples with IVF and failure to treat male factors before considering assisted reproductiv...

Scrotal pathology is commonly encountered by the urologist. Problems range from acute presentations due to trauma, torsion, or acute infection to chronic inflammatory conditions with chronic pain which can be difficult to manage. This chapter addresses the management of testicular trauma and inflammatory conditions relating to the testis. Various t...

A systematic review and meta-analysis was performed to determine the relationship between testosterone therapy and risk of recurrence in testosterone-deficient survivors of curatively treated high-risk prostate cancer. Primary outcome was the risk of biochemical recurrence (BCR) in 109 high-risk patients in 13 included studies (1997-2017). Biochemi...

Objectives The aim of the present paper was to determine the impact of testicular cancer (TC) and its treatments on fertility and to review the current management options for the infertile patient with TC, both before diagnosis and after treatment, with the aim of providing practical recommendations to update contemporary guidelines and standardize...

Objectives To determine the frequency of spermatogenesis in patients with testicular cancer and to assess for any predictors of spermatogenesis. Patients and Methods We retrospectively reviewed 103 testicular germ cell tumours (TGCTs) in men who underwent radical orchidectomy conducted at Guy's Hospital, London, between 2011 and 2015. Primary outc...

Male genital emergencies relating to the penis and scrotum are rare and require prompt investigation and surgical intervention. Clinicians are often unfamiliar with the management of these conditions and may not work in a specialist centre with on‐site expertise in genitourethral surgery. A series of consensus statements have been developed by an e...

Male genital emergencies relating to the penis and scrotum are rare and require prompt investigation and surgical intervention. Clinicians are often unfamiliar with the management of these conditions and may not work in a specialist centre with on-site expertise in genitourethral surgery available. The aim of these consensus statements is to provid...

Male genital emergencies relating to the penis and scrotum are rare and require prompt investigation and surgical intervention. Clinicians are often unfamiliar with the management of these conditions and may not work in a specialist centre with on-site expertise in genitourethral surgery available. A series of consensus statements have been develop...

Male genital emergencies relating to the penis and scrotum are rare and require prompt investigation and surgical intervention. Clinicians are often unfamiliar with the management of these conditions and may not work in a specialist centre with on-site expertise in genitourethral surgery available. A series of consensus statements have been develop...

Objectives: To assess male circumcision for the prevention of HIV acquisition in heterosexual and homosexual men using all available data. Previous meta-analyses suggest that circumcision is effective at reducing the risk of HIV acquisition amongst heterosexual men but the effect amongst homosexual males remains under debate. Subjects and methods...

Developments in assisted reproductive techniques (ART) have transformed the management of male factor infertility and the advent of intracytoplasmic sperm injection (ICSI) in 1993 was a landmark in the management of the infertile male. While this has been an undoubted success, it has led to a shift away from understanding and correcting the potenti...

Urology is associated with pathology of the urogenital tract. It encompasses pathology relating to the kidneys, ureters, bladder, prostate, penis, urethra and testis. Urologists manage a wide variety of conditions ranging from cancers of each of the main organs to trauma and congenital malformations. They also manage benign conditions such as renal...

Objective: The aim of this study was to report surgical and functional outcomes in patients who underwent immediate penile fracture repair following location of the tunical tear with ultrasonography. Methods: Patients’ clinical notes from September 2005 to October 2015 were reviewed. The inclusion criteria were the documented presence of an albugin...

Penile cancer is rare, accounting for approximately 1% of all male malignancies. Poor awareness of the condition, associated with fear and embarrassment in those who develop it often leads to delay in presentation. This can result in the need for more emasculating surgery, with poor cosmetic and functional outcomes and significant distress. Advance...

Papillary cystadenomas of the epididymis are known to occur in association with Von Hippel–Lindau (VHL) disease. The development of a papillary cystadenocarcinoma, its malignant counterpart, is rare with only a few sporadic cases reported in the literature. Metastatic deposits are exceedingly uncommon; in fact, only a single case report has documen...

Malignant priapism secondary to penile metastases is a rare condition. This term was originally used by Peacock in 1938 to describe a condition of painful induration and erection of the penis due to metastatic infiltration by a neoplasm. In the current literature there are 512 case reports. The primary tumor sites are bladder, prostate and rectum....

Premalignant lesions present a particularly unique challenge in penile cancer. They can be difficult to distinguish from other benign dermatoses and have an uncertain natural history. A tendency for delayed presentation, with an all too common history of long-term self management, or unsuccessful treatment, often results in a relatively treatable p...

Peyronie's disease was described by Francois de la Peyronie in 1743, a battlefield surgeon and Commander of the Medical Corps of Louis XIV. The prevalence in the general population varies from 0.39-3.4%, but increases to 7.1% in patients between 50-69 years of age, with a reported prevalence rate of 20.3% in men with diabetes. The disease has two d...

Lower urinary tract symptoms associated with benign prostatic hyperplasia (BPH-LUTS) are a highly prevalent problem, and with considerable burden to quality of life. Evidence has emerged that a strong correlation exists in men suffering both BPH-LUTS and erectile dysfunction (ED). Phos-phodiesterase type 5 inhibitors (PDE5i) have been shown to be h...

Penile cancer is a rare disease, accounting for ∼1% of all malignancies in men. Poor awareness of the condition among the public and clinicians often causes long delays in diagnosis and treatment, which may result in the development of advanced disease that might require extensive and emasculating surgery. In the UK, the development of supraregiona...

Erectile dysfunction (ED) has a significant effect on a man's quality of life. However, phosphodiesterase (PDE-5) inhibitors such as sildenafil, tadalafil and vardenafil have provided effective treatment and changed the public perception of ED. Successful outcomes with penile prostheses are dependent on surgical expertise and careful management of...

In this article, the authors outline a contemporary management algorithm for penile cancer, with emphasis on developments in organ‐sparing surgical techniques and inguinal lymph node detection and management. Copyright © 2013 John Wiley & Sons

The outcome of penile cancer is proportional to the stage at presentation. Strategies aimed at primary prevention would have a clear advantage, both for the individual and in terms of health economics. A number of preventative measures could be employed, including circumcision, smoking cessation, education on hygiene and human papillomavirus (HPV)...

Our knowledge of penile cancer and its treatment has advanced greatly over the last decade. The advent and development of new penile preserving treatments have achieved a better balance between excellent, reliable oncological control, and a good cosmetic and functional result. It has substantially reduced the impact of the disease and its treatment...

What's known on the subject? and What does the study add? The European Association of Urology guidelines identify lichen sclerosus (LS) as a strong risk factor for penile squamous cell carcinoma (pSCC). However, this statement is based on the findings of case–control studies (Level of Evidence 2a) and a direct causal relationship between LS/balanit...

The spectrum of conditions affecting the penile skin is varied and ranges from simple, benign dermatoses to premalignant and malignant conditions. Recently, improved understanding of the aetiology and natural history of these conditions has shaped new treatment paradigms and a functional knowledge of dermatology, urology and genitourinary medicine...

Patients may present with a variety of different dermatological conditions affecting the penis, ranging from rashes and red patches to ulcers or problems with the foreskin. The majority of penile dermatoses are benign and harmless lesions, which can be managed with simple conservative measures. However, a small number of patients may present with p...

Micropenis in adults is defined as a stretched length of <7.5 cm. Many aetiologies exist, including congenital and endocrinological causes as well as pathological conditions, such as penile lichen sclerosus, trauma and genital cancer. The resulting reduction in functional penile length can lead to considerable psychosexual morbidity. Furthermore, t...

We assessed the oncological outcome of penile conserving surgery and identified parameters predicting local recurrence, including resection margins. A total of 179 patients with invasive penile cancer treated with organ sparing surgery at a tertiary center between 2002 and 2010 fulfilled our study criteria. Demographic, histopathological, managemen...

The surgical management of penile cancer has changed significantly over the last decade. Progression in the understanding of this rare malignancy, by pooling of expertise and resources in specialist centres, has challenged the conventional radical surgical approach to penile cancer. While such surgery was effective, the emasculating nature of this...