Stacks Image 332
Stacks Image 20

Professor Tom McNicholas

qualified in Medicine from St Bartholomew's Hospital London in 1977. He underwent general surgical training on the South Coast on the Wessex surgical training rotation and then returned to London for Registrar training at University College Hospital. He became a Research Fellow, then Registrar and then Senior Registrar in the St Peter's Group of Hospitals, a group of specialist urinary and kidney disease hospitals in London. His research then and since has been wide ranging but with a particular emphasis on developing new ideas and applying new technology to the improved management of common conditions. He became an expert on laser treatments for benign and malignant urinary and especially prostatic disease and was one of the pioneers of the early days of keyhole laser stone surgery. Because of his interest in endoscopic photography Tom took the first pictures of many of these new techniques as they were developed by John Wickham's group at the St Peter's Hospitals and at the Institute of Urology. He also became an expert in urological ultrasound and developed several ultrasound techniques for treatment of prostatic disease. Tom was lucky enough to be in at the birth of the modern methods of treatment for urinary stones including percutaneous renal surgery, ureteroscopic laser surgery and extra corporeal shock wave lithotripsy (ESWL). Since moving to Hertfordshire to start up the first Department of Urology at the Lister Hospital in Stevenage in 1991 there has been an enormous expansion in his department which now consists of 7 full time consultants with 2 part time consultants. His aim has always been to offer the best of modern treatment allied to the best standards of traditional medical care with an emphasis on communication of complex issues to patients so they understand their choices.
Stacks Image 924

Other contributions to the NHS

Reviewer for NHS Health Technology Assessment programme (2003-6 and 2006-15)
Specialist Advisor to the NICE Interventional Procedures Programme (2003-15)
Visiting Professor, University of Hertfordshire Faculty of Health and Human Sciences 2005 onwards.


National and international trial supervision by Prof McNicholas:

2013-17 Member of data and safety committee of NIHR "MASTER" trial: national multicenter study: comparing 2 forms of treatment for male urinary incontinence (artificial sphincters and male slings). 2014-17 Chairman of Trial Steering Cmtee (TSC) of NIHR national multicentre study: "UNBLOCS" Comparison of TURP and Thulium laser Resection for male LUTS/BPH.
Stacks Image 713

For a list of publications by Prof. Tom McNicholas please see the publications page

Tom has been an innovator
He:
1 -was the first person to use laser energy in the prostate (interstitial laser therapy) McNicholas T, Steger A, Charig C, Bown S. Interstitial Yag laser coagulation of the prostate. Lasers Med Sci 1988;3: 446.

2 - was the first urological surgeon in Europe to use an endoscopic or telescopic laser device for the treatment of benign prostatic enlargement (BPH) in1992 (the TULIP device).

3 - set up the research study that showed the first clinical evidence of a new pathway affecting the control of both the urinary system and the control of erections. By this new pathway "Viagra-like" drugs (known as Phosphodiesterase inhibitors or PDEIs) were shown to improve erectile function, but also to improve urinary function (Sairam K, Kulinskaya E, McNicholas T. Sildenafil influences lower urinary tract symptoms. BJU Int. 2002;90(9):836-9). This has led to a whole new range of treatment options for men. As a result of the research that followed this work the PDEI drug Cialis (also known as tadalafil) has been licensed world wide for the relief of urinary symptoms as well as for erectile difficulties.

4 - as part of his investigation of PDE inhibitor drugs he was also the first to describe the beneficial effects of these PDEI drugs on chronic, painful and often disabling nerve injuries known as neuropathies. (Sairam & McNicholas. Sildenafil in diabetic peripheral neuropathy. Br J Diabetes & Vasc Dis 2002).

5 – was part of the original
Urolift project team in 2005 and has advised on the development of this exciting treatment ever since then. Urolift is a novel, minimally invasive alternative to standard surgery (TURP) for the treatment of urinary symptoms due to an enlarged prostate. The UroLift implants hold the prostatic urethra open without the need for incisions, surgical resection or thermal injury to the prostate. He published a guide to the method (McNicholas et al European Urology 2013) and has taught it to many surgeons. A rigorous study of Urolift led to FDA approval in the USA in 2013 and was published in the prestigious Journal of Urology in 2014. NICE approved Urolift as safe and effective for use in the UK NHS in January 2014 and further detailed NICE review in September 2015 recommended Urolift’s wider use as safe and effective but also a cost saving treatment for mens’ urinary symptoms.


The NICE approval in 2014 is outlined here:
http://www.nice.org.uk/guidance/ipg475/informationforpublic

The latest advice (2015) is outlined here:
http://www.nice.org.uk/guidance/mtg26