Stella L Ivaz

University College London | UCL · UCL Medical School

Objectives: The widespread use of ultrasonography for the investigation of common urological conditions, such as infertility or pain, has resulted in an increased incidence of incidental non-palpable testicular masses. The majority of these are expected to be benign therefore a conservative approach, either active monitoring or organsparing approac...

Background: The transition from the preclinical to clinical years is an important liminal moment in the professional development of a medical student. Certain attitudes and behaviours have been observed as threshold concepts as part of this transformation. We proposed to address these threshold concepts using a simulation-based approach.

Penile urethral strictures have been managed by a staged surgical approach. In selected cases, spongiofibrosis can be excised, a neo-urethral plate created using buccal mucosa graft (BMG) and tubularized during the same procedure, performing a "two-in-one" stage approach. We aim to identify stricture factors which indicate suitability for this two-...

Cowper's syringoceles are uncommon, usually described in children and most commonly limited to the ducts. We describe more complex variants in an adult population affecting with varying degrees of severity, the glands themselves, and the complications they may lead to. One hundred consecutive urethrograms of patients with unreconstructed strictures...

Pelvic Fracture Urethral Injury – the Nature of the Causative Injury Correlates Strongly with Surgical Treatment and Outcome It is well recognised that pelvic fracture urethral injury (PFUI) is related to the nature of the pelvic ring disruption and that this disruption can be of several different types. We have assessed the specific nature of th...

We have been running a successful clinical peer-tutor selection process which has evolved to its current format by refining the process from feedback-data collected over the years. We developed a selection process, which is fair and equitable, ensuring that the best peer tutors are selected, while looking at challenges of gender and race bias inher...

At St George's, University of London we use peer-tutors to deliver our core clinical-skills curriculum to medical students. While some other universities use volunteer peer-tutors, we have a competitive application process, which is fair and equitable, and we pay our tutors for their time. The aim of our workshop is to help participants looking to...

What do students value in a peer tutor assessment and training session? The clinical skills peer-tutor programme at our institution was one of the first in the UK to recognise the importance of students as teachers, both in using them to deliver core teaching and in paying them for their time. The aim of this presentation is to demonstrate how ou...

The standard treatment of bulbar urethral strictures of appropriate length is excision and primary anastomosis (EPA), irrespective of the cause of the stricture. This involves transection of the corpus spongiosum (CS) and disruption of the blood flow within the CS as a consequence. The success rate of EPA in curing these strictures is very high, bu...

Fistulation is a relatively uncommon complication resulting from the treatment of pelvic malignancy but one which is associated with significant patient morbidity. Fistulae complicating treatment with radiation, when compared to those arising from surgical management alone, are usually more difficult to treat by virtue of tissue ischaemia and fibro...

The anatomy of the penile urethra presents additional challenges when compared to other urethral segments during open stricture surgery particularly because of its unsuitability for excision and primary anastomosis and its relatively deficient corpus spongiosum. Stricture aetiology, location, length and previous surgical intervention remain the pri...

Augmentation urethroplasty using oral mucosal graft has become the standard surgical treatment of long bulbar strictures. In very tight strictures the urethral plate is narrowed to the extent that an almost circumferential substitution with oral graft is necessary, with suboptimal results. If the obliterative segment within a longer stricture is sh...

Objectives To investigate the concept of urethral ‘atrophy’ which is often cited as a cause of recurrent incontinence after initially successful implantation of an artificial urinary sphincter (AUS); and to investigate the specific cause of the malfunction of the AUS in these patients and address their management.Patients and methodsBetween January...

Most urethral strictures are either idiopathic or iatrogenic secondary to urethral instrumentation or failed surgery for hypospadias. In this article, the authors provide a concise general overview of urethral stricture and its management.

Intermittent self-dilatation (ISD) may be recommended to reduce the risk of recurrent urethral stricture. Level one evidence to support the use of this intervention is lacking. Determine the clinical and cost-effectiveness of ISD for the management of urethral stricture disease in males. The strategy developed for the Cochrane Incontinence Review G...

Do replacement artificial urinary sphincters last as long as the first implanted? A Frost, S Bugeja, S Ivaz, DE Andrich, AR Mundy University College London Hospital Introduction: Patients with an artificial urinary sphincter (AUS) may go on to have one or more revisions/replacements over the course of their life. We carried out a retrospective s...

Introduction: This study presents a series of 66 cases of uro-rectal or uro-perineal fistulation managed by a transperineal repair with additional abdominal exposure as necessary. Patients and Methods: Between 2006–2013, 43 transperineal (17 with gracilis flap) and 23 abdomino-perineal fistula repairs were performed in 58 men. 13 were redo-procedu...

Does radiotherapy affect outcome following bulbar artificial urinary sphincter implantation for sphincter weakness incontinence resulting from prostate cancer treatment? S Bugeja, AV Frost, S Ivaz, F Campos, E Fes, DE Andrich, AR Mundy University College London Hospital Introduction: This study evaluates the impact of radiotherapy on the functio...

This article walks through some of the ideas behind patient-reported outcome measurement and quality-of-life research against the backdrop of urethral stricture disease and conditions of the lower urinary tract, more generally, why measurement matters at all, future areas for research and development and potential opportunities for misuse and manip...

Lymphoepithelioma-like carcinoma (LELC) of the urinary bladder is a rare variant, which can occur in a pure form or in conjunction with transitional cell carcinoma. Owing to the scarcity of reported cases, the optimum treatment is yet to be defined, although the benefits of chemotherapy are increasingly recognised. We present a case of a 64-year-ol...

Introduction: Patients who do not reach an undetectable PSA after radical surgery within 6 weeks are very likely to recur and often require adjuvant radiotherapy. Half-life of PSA clearance may improve prediction of recurrence and facilitate patient stratification for adjuvant radiotherapy. Patients and Methods: Since June 2007, 103 patients who un...

Introduction: Beyond oncological cure the success of radical prostatectomy is judged according to quality of life impact. Mostly ill-defined clinician-derived assessments of continence are available for the pre- operative counselling and decision-making process. We hypothesise that clinicians over-report continence rates and we compare continence r...

Author(s): S. Ivaz, W. Lam, T. Swallow, C. M. Corbishley, M. Perry, J. Pilcher, N. Watkin; Department of Urology, St. George's Hospital, London, United Kingdom; St. George's Hospital, London, United Kingdom; Department of Histopathology, St. George's Hospital, London, United Kingdom; Department of Radiology, St. George's Hospital, London, United K...

Background: Sentinel lymph node biopsy in squamous cell carcinoma (SCC) of the penis allows determination of nodal spread with much lower morbidity than a standard lymphadenectomy. Patients with positive sentinel nodes undergo a completion lymphadenectomy which often reveals no further metastatic disease. We assessed whether size of sentinel node m...

Background: Organ-sparing surgery in the treatment of penile cancer (SCC) requires a compromise between preservation of function and acceptable cosmetic appearance with the need for local cancer control. This study aims to determine the significance of a positive invasive surgical margin after penile-preserving surgery, and to identify appropriate...

Background: Dynamic sentinel node biopsy (DSNB) is the standard diagnostic procedure for clinically inguinal node-negative (cN0) patients with SCC penis in our center. However, we have previously reported that DSNB is associated with a 5%-10% false negative rate. In this study we aim to identify factors that might predict false-negative DSNB. Metho...

Endovascular repair of the thoracic aorta has been adopted as the first-line therapy for much pathology. Initial results from the early-generation endografts have highlighted the potential of this technique. Newer-generation endografts have now been introduced into clinical practice and careful assessment of their performance should be mandatory. T...