Nick Watkin

Nick Watkin
St George's Healthcare NHS Trust · Urology

MA MCHir, BMBCh FRCS

About

289
Publications
35,696
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4,085
Citations
Additional affiliations
January 2001 - present
St George's Healthcare NHS Trust
Position
  • Consultant

Publications

Publications (289)
Article
Objectives We present a summary of penile cancer, its epidemiology, risk factors, and possible clinical presentations. We discuss a range of penile lesions that indicate an underlying penile malignancy. We also consider some nonmalignant penile lesions that may be confused with penile cancer. Data Sources Sources of information include original re...
Article
TPS7 Background: Penis cancer is a rare but potentially fatal disease. A limited body of evidence exists on which to base the majority of management decisions for patients with regional nodal metastases. Five-year survival for patients with a single involved inguinal lymph node treated with surgery alone is approximately 80%, whilst it ranges from...
Article
Full-text available
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
Full-text available
Background Bulbar urethral stricture is a common cause for urinary symptoms in men and its two main treatment options both have drawbacks with little evidence on their relative cost-effectiveness. Current guidelines on the management of recurrent bulbar urethral stricture have been predominantly based on expert opinion and panel consensus. Objecti...
Article
Purpose of review: Penile sparing surgery (PSS) is considered the standard of care in penile cancer where appropriate, as preservation of the penis may enable the patient to maintain urinary and sexual function. This review will focus on the latest developments over the past two years. Recent findings: In this review, we discuss the latest findi...
Article
Objectives To identify incidence and risk factors for upstaging from cN1 to pN2/N3 at inguinal lymphadenectomy (ILND) for penile cancer (pSCC). Our secondary objective is to assess survival outcomes and associations for cN1 patients undergoing ILND. Subjects/patients and methods Patients with pT≥1cN1cM0 pSCC who underwent bilateral ILND and had co...
Article
Context Urethral stricture disease (USD) is initially managed with minimally invasive techniques such as urethrotomy and urethral dilatation. Minimally invasive techniques are associated with a high recurrence rate, especially in recurrent USD. Adjunctive measures, such as local drug injection, have been used in an attempt to reduce recurrence rate...
Article
Objective This study aimed to provide real-world data on the multidisciplinary management of metastatic penile squamous-cell carcinoma (mpSCC) patients and their survival outcomes, particularly those who receive best supportive care (BSC). Methods A retrospective analysis of 1720 patients, managed via a supra-regional penile-specialist multidiscip...
Article
Purpose: Our primary objective is to detail the incidence, site, and timing of pSCC recurrence after ILND. Methods: Retrospective analysis of 551 patients who underwent ILND for pSCC, from 2000 to 2017. The primary outcome was pSCC recurrence after ILND. Recurrences were identified and stratified by site. Timing of recurrence was determined. Mul...
Article
With the passage of time, there has been a major paradigm shift in the surgical management of penile cancer from radical to organ preserving penile surgical techniques, with closer surgical margins which offer good oncological, cosmetic and functional outcomes with improved physical and psychosexual well-being. This article aims to provide an updat...
Preprint
Full-text available
Background: Bulbar urethral stricture is a common cause for urinary symptoms in men and its two main treatment options both have drawbacks with little evidence on their relative cost-effectiveness. Current guidelines on the management of recurrent bulbar urethral stricture have been predominantly based on expert opinion and panel consensus. Objecti...
Article
Full-text available
PurposeRed cell distribution width (RDW) measures red cells’ size variability. Metastatic penile cancer displays poor chemotherapy response. As no validated prognostic predictor exists, we investigated whether RDW correlates independently with survival outcomes in metastatic penile cancer treated by chemotherapy.Methods Electronic chemotherapy file...
Article
Objective: To present the long-term adjuvant radiotherapy outcomes of patients with pN3 squamous cell carcinoma of the penis (SCCp) treated at two UK centres. Patients and methods: We conducted a retrospective audit of all pN3 SCCp patients, deemed suitable for adjuvant therapy by a specialist multidisciplinary team at St George's and Leeds Hosp...
Article
Background Data on the impact of human papillomavirus (HPV) infection status and outcomes for perioperative treatments for patients with lymph node–involved penile squamous-cell carcinoma (PSCC) are lacking. Objective To analyze the benefit from perioperative radiotherapy (RT) for PSCC according to HPV infection status. Design, setting, and parti...
Article
Full-text available
Background Men who suffer recurrence of bulbar urethral stricture have to decide between endoscopic urethrotomy and open urethroplasty to manage their urinary symptoms. Evidence of relative clinical effectiveness and cost-effectiveness is lacking. Objectives To assess benefit, harms and cost-effectiveness of open urethroplasty compared with endosc...
Article
Objectives: To date, no validated prognostic tool is available in patients with penile squamous cell carcinoma (pSCC) and inguinal lymph node metastases (ILNM). We aimed to develop and externally validate a risk calculator for prediction of any cancer recurrence in ILNM pSCC patients. Materials and methods: The development cohort included 234pts...
Article
Background Urethral stricture affects 0.9% of men. Initial treatment is urethrotomy. Approximately, half of the strictures recur within 4 yr. Options for further treatment are repeat urethrotomy or open urethroplasty. Objective To compare the effectiveness and cost-effectiveness of urethrotomy with open urethroplasty in adult men with recurrent bu...
Article
5088 Background: PSCC patients (pts) with palpable inguinal lymph node (ILN) disease have a poor overall survival (OS). Multimodal perioperative treatments are usually offered despite the lack of clinically meaningful efficacy. Pending the availability of novel effective systemic therapy, the optimization of conventional treatments in better select...
Article
5585 Background: PSCC is a rare tumor and the administration of guidelines-based therapies is still problematic in real-world practice. Survival outcomes remain suboptimal in patients (pts) with ILN involvement. Multinational analyses of real-world patterns are needed. Methods: Within an international, multicenter database of 965 PSCC pts who recei...
Article
Objectives: To identify predictors of poor overall survival (OS) among penile squamous-cell carcinoma (pSCC) patients with clinical inguinal lymphadenopathy (cN+) in order to define the best candidate for neoadjuvant chemotherapy (NAC). Materials and methods: Using an international, multicenter database of 924 pSCC patients, we identified 334 cN...
Article
1 Background: ILNM PSCC patients (pts) have heterogeneous outcomes. We aimed to identify risk factors of early recurrence in order to optimize the selection of pts for adjuvant (adj) therapies (tx). Methods: In a multicenter database of 924 pts who underwent ILN dissection, we identified 311 ILNM pts. Pts treated with neoadj chemo (CT) and/or radio...
Article
2 Background: PSCC patients (pts) with palpable inguinal lymph node (ILN) disease have a poor overall survival (OS). For them, use of neoadjuvant chemotherapy (NAC) is recommended in guidelines, but limited data are available to inform pt selection. We aim to identify predictors of poor OS in clinically ILN-positive (ILN+) pts to define the optimal...
Article
Urethral stricture disease is a commonly presenting problem to the urologist. Any condition that damages the urethral epithelium or underlying spongy tissue has the potential to cause a stricture. Patients with a urethral stricture can present either acutely or chronically with a range of urinary symptoms. An understanding of urethral stricture dis...
Article
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...
Article
Objective To review the use of ultrasound imaging in the diagnosis of testicular rupture and in relation to current guidelines. Methods Data was retrospectively collected for all patients diagnosed with testicular rupture at a major trauma centre between 2011 and 2018. Data included patient demographics, mechanism of trauma, specific findings on u...
Article
Full-text available
Penile squamous cell carcinoma is a rare malignancy with various distinct histological subtypes, each with distinct appearances, histotypic specific associations with human papillomavirus (HPV) and clinical behaviour. Despite a wealth of pathological knowledge, there still remains a limited understanding of the fundamental molecular drivers that go...
Article
Objective: To evaluate the prognostic impact of lymph node yield(LNY) on survival outcomes for penile squamous cell carcinoma. Materials and methods: A total of 532 patients who underwent inguinal lymph node dissection (ILND) across tertiary referral centers from Europe, China, Brazil and North America were retrospectively evaluated. From this c...
Article
Full-text available
The historic international penile cancer trial InPACT is now open and accruing patients in the UK and USA. The trial is geared to answer important questions for patients with evidence of inguinal lymph node disease at presentation. This clinical trial update provides an overview of the study and progress to date.
Article
Objectives To improve the prognostic allocation of patients with penile squamous-cell carcinoma (PSCC) receiving regional lymph node dissection (LND). Patients and methods An international, multicenter, retrospective study was performed on patients with PSCC who received regional LND, with or without perioperative therapy, from 1980 to 2017. We fi...
Article
512 Background: Advances in prognostic allocation of pts with PSCC receiving regional LND are needed, along with an assessment of the role of perioperative treatments. Methods: An international, multicenter, retrospective database was queried for all pts with PSCC who had received inguinal ± pelvic LND from 1980 to 2017. We classified or re-classif...
Chapter
Functional disorder of penis and urethra are quite prevalent. These include erectile dysfunction (ED), ejaculatory disorders, priapism, and Peyronie disease. ED is usually multifactorial and requires careful evaluation and management decisions. This ranges from oral pharmacotherapy to insertion of a penile prosthesis. Ejaculatory disorders, especia...
Chapter
In this chapter, the common inflammatory disorders of the penis and urethra are discussed. Inflammation of the glans and prepuce (balanoposthitis) is classified as acute or chronic. Acute causes include bacterial and fungal infection and the sexually transmitted infections, herpes, syphilis, and trichomonas vaginalis. The chronic causes include lic...
Article
Objectives: To determine whether phosphatidylinositol-4,5-bisphosphate 3- kinase, catalytic subunit alpha (PIK3CA) copy number gain in penile cancer has prognostic value and association with histopathological parameters, HPV and clinical outcome. Methods: PIK3CA copy number status (CNS) was assessed with fluorescence in-situ hybridisation in tis...
Article
Full-text available
Background Therapeutic targeting of the PI3K-AKT-mTOR pathway may benefit patients with advanced penile squamous cell carcinoma (PSCC). Objectives To determine the prevalence of PIK3CA copy number gain and correlate this with the activity status of PI3K-AKT-mTOR pathway in pre-malignant penile intraepithelial neoplasia (PeIN) and invasive PSCC. M...
Preprint
Full-text available
ABSTRACT: Context: Management of men with penile squamous cell carcinoma (PSCC) who have high-risk features following radical inguinal lymphadenectomy (ILND) remains controversial. European Association of Urology guidelines state that adjuvant inguinal radiotherapy (AIRT) is “not generally recommended”. Despite this, many centres continue to offer...