Tom McNicholas has written widely on many aspects of urinary disease. He is particularly in demand for teaching on benign prostatic disease and urinary symptoms. He has major interests in the management of prostate cancer, the treatment of urinary stone disease and in making common urological investigations (especially prostatic biopsy) both painless and safer.
He has written over 150 major scientific papers which can be reviewed in the bibliography. Most recently he has been lead author of the chapter on Benign Prostatic Disease in the latest addition of Campbell’s Urology. This 4 volume textbook is the “bible” for urology and is used by urological experts worldwide. He is one of only a small handful of British urologists to have been recognised in this way.




Sexual Dysfunction No Longer Inevitable When Treating Enlarged Prostate



British Journal of Urology International paper underlines need for men with BPH to discuss “male orgasmic dysfunction” with their doctor prior to any treatment; UroLift® system shows ability to treat prostate symptoms while preserving sexual function
PLEASANTON, CA, US -- NeoTract, Inc., today welcomes the publication of a paper in the British Journal of Urology International which calls for men suffering from enlarged prostate to discuss with their doctors the likely impact of treatment options on their sexual function. Most procedures and many medications can cause sexual dysfunction. Clinical studies show that treatment with the UroLift® system has not been associated with any new onset of sustained ejaculatory or erectile dysfunction.
BPH, benign prostatic hyperplasia, enlarges the prostate, which can lead to lower urinary tract symptoms (LUTS) that can cause serious quality of life issues such as interrupted sleep, urgent and frequent need to urinate, depression and isolation. The paper, by Sturch, Woo, McNicholas and Muir suggests the days of men having to accept the inevitability of dry orgasms following BPH treatment should be over as new surgical techniques and treatments become available. The paper also welcomes the emergence of the UroLift® prostatic urethral lift system which effectively treats BPH while preserving sexual function.
The authors state, “An even more radical development may be the UroLift device, now available in many countries and with randomized controlled trial evidence for its efficacy in LUTS/BPH patients. The device reshapes the anterior prostatic urethra creating a channel by tensioned monofilament sutures placed under cystoscopic guidance. Sutures are anchored with a metallic tab on the prostate capsule and then tensioned on the luminal aspect to compress the prostate. This has been shown to achieve a rapid and sustained improvement in flow rate and symptom score in follow up studies (up to 12 months). So far not a single patient has developed dry orgasm following its use. This system seems to offer an excellent minimally invasive method to treat LUTS, while preserving sexual function.”
Co-author, Consultant Urologist at King’s College London, Gordon Muir, says: "It’s exciting as a surgeon to be able to offer men new options when managing their prostate symptoms. For many years we just assumed that successful treatment would mean a permanent dry orgasm and didn’t consider how the man might feel about that. Now we can offer and adapt treatments to suit the individual!
"While not every man is suitable for every treatment or operation, we can at least have a proper discussion about what is important to a man, and his partner. This has dramatically changed the way I counsel patients for surgery, and for the better, putting the patient at the centre of decisions about his care.”
Dr Roger Henderson, practising GP and media commentator on medical issues, wholeheartedly agrees with the BJUI paper: "As a GP I see half a dozen patients with an enlarged prostate every week and these men are worried about the traditional treatments on offer; taking medication for life or an invasive operation which may cause impotence or incontinence. Men desperately need more advice and help about maintaining their prostate and preserving their sexual health and wellbeing throughout their lives. Sexual wellbeing is an important factor in maintaining older men's happiness and their ability to live an active, fulfilled life."
The BJUI paper is being made public as the two-year results from a randomised controlled study of 206 subjects are published in Urology Practice, a journal of the American Urological Society. Symptoms, quality of life and urinary flow improved rapidly and remained durable to two years, with only 7.5% of the men who had the UroLift system needing additional BPH procedures. Treated men returned to normal activity within 8 days and showed significant improvement in symptoms by two weeks. While urinary symptoms were effectively treated, not a single patient lost ejaculatory or erectile function as a result of the treatment. By comparison, 65% of men undergoing the standard surgery (transurethral resection of the prostate, TURP) lose the ability to ejaculate.
The data are published as adoption of the Prostatic Urethral Lift across the UK is gathering momentum. Frimley Park Hospital in Surrey announced this month (October 2014) that it is the first hospital in England to offer treatment on the NHS. Frimley Park Hospital is a leading NHS foundation trust hospital serving more than 400,000 people across north-east Hampshire, west Surrey and east Berkshire.
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Mr Neil Barber, Consultant Urologist at Frimley Park Hospital, says: "I am very excited that Frimley Park is pioneering this treatment within the NHS. Take up across the UK is slower than the treatment deserves. Unfortunately, as with all
new and revolutionary treatments, it takes a while for the system to catch up.”
“I would urge patients to ask their urologists about this treatment and I would encourage my urologist colleagues to follow Frimley Park's example and start offering treatment as soon as possible because this is an exciting, game changing procedure.”

Dr Roger Henderson welcomes the news of the first NHS hospital to offer UroLift System treatments:
"The UroLift System is a game changing procedure which should be offered in every NHS hospital. As a GP I see half a dozen patients with an enlarged prostate every week and these men are worried about the traditional treatments on offer; taking medication for life or an invasive operation which may cause impotence or incontinence.

"In my view, great new innovation like this takes far too long to get to patients, sometimes it is awareness, sometimes it is about funding and coding. Whatever the reason, it makes no sense for the UroLift System not to be offered by every hospital in the UK, on the NHS. Care that is safe, clinically effective and provides a positive experience for patients should be funded.”
In January 2014 the National Institute for Health and Clinical Excellence (NICE) recommended the Prostatic Urethral Lift procedure, which utilizes the UroLift implants, for adoption within the NHS under normal arrangements.
About BPH and the UroLift System Treatment
BPH is a common condition afflicting more than 500 million ageing men worldwide. Chronic lower urinary tract symptoms (LUTS) associated with BPH can cause loss of productivity and sleep, depression and decreased quality of life. Medication is often the first line therapy but relief can be inadequate and temporary. Side-effects can include sexual dysfunction, dizziness and headaches, prompting many patients to quit using the drugs. For these patients, the classic alternative is surgery that cuts or heats prostate tissue to open the blocked urethra. Although effective, patients have to 'earn' their symptom relief after a difficult period of irritative voiding symptoms and catheterization. Even the 'gold standard' surgery, TURP (Transurethral Resection of the Prostate), can leave patients with permanent side- effects such as urinary incontinence, erectile dysfunction and very commonly retrograde ejaculation (dry orgasm).
The UroLift System is designed to open the urethra directly without applying incisions, surgical resection or thermal injury to the prostate. Obstructive prostate lobes are transurethrally pushed aside and small permanent UroLift implants hold the lobes in the retracted position, thus opening the urethra while leaving the prostate intact. Adverse reactions associated with UroLift System treatment were comparable to other minimally invasive surgical therapies as well as standard cystoscopy. The most common adverse events reported during the study included pain or burning with urination, blood in the urine, pelvic pain, urgent need to urinate, and the inability to control urine because of an urgent need to urinate. Most symptoms were mild to moderate in severity and resolved within two to four weeks after the procedure. Learn more at www.UroLift.co.uk.
The UroLift System is currently available for patients in Europe, USA, Australia and Canada.
About NeoTract
NeoTract, Inc. is dedicated to developing innovative, minimally invasive and clinically effective devices that address unmet needs in the field of urology. Our initial focus is on improving the standard of care for patients with BPH using the UroLift System, a minimally invasive permanent device designed to treat lower urinary tract symptoms (LUTS).
Media Contact: Amanda Hayhurst, Gloucester Road Communications Amanda@amandahayhurst.com; mobile: +44 0772 0205581.

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