1. Mark Lynch Clinical Lead Urology, Croydon University Hospital Consultant, St George’s Hospital

2. Croydon Urology – the future
July 2013
July 2014
M Lynch
Consultant Interview
Job plan for further Consultant
July 2015
SGH integration
July 2015+
Urology centre?

3. Lower Urinary Tract Symptoms
BPH (50%)
Prostate cancer (16%)
Other pathology

4. BPH

6. BPH Epidemiology: Autopsy Epidemiology: Clinical 23% men aged 41-50

8. BPH Epidemiology: Less common Higher income groups
Western / industrialized countries
Less common
Alcohol and cirrhosis
Far East (Japan, China, Korea)

9. AUA / IPSS Symptom Score

10. BPH Assessment Variability Symptom score Quality of life Drug therapy
Surgery
Examination – neurology
PSA ??

11. BPH Complications Renal failure Bladder calculi Infection Incontinence
Retention
Haematuria

12. BPH
Management
Watch and wait
Pharmacology
Surgery
TURP - TURiS

13. Medical Therapy Conservative measures Bladder diary Alpha blockers
5 alpha reductase inhibitors
Combination therapy

14. Bladder Diary

15. Bladder Diary

18. BPH
DRE
Routine bloods
MSU

19. AUA / IPSS Symptom Score

20. Bladder Diary

21. LUTS
Advice
Medication
Review

22. CUH – Here to help! LUTS clinic IPSS Flow-rate Information documents
Decision making clinic for surgery
Medical management strategy for primary care