Paul Anderson
@PCB_Anderson
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Genito-Urethral Reconstructive Surgeon, Dudley & Honorary Consultant Reconstructive Urologist, Royal Centre for Defence Medicine, Birmingham
West Midlands, England
Joined October 2013
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My (much) better half, improving the lives of 1000s of women through proper education around managing the menopause / peri menopause 👏🏻👏🏻
In this unique episode, Dr Newson talks to her husband, a consultant urologist, about the lack of menopause training among medical professionals. If you’ve ever wondered about what kind of man is married to Dr Newson, this is the episode for you!
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Lifetime 1st. My wife & I both lecturing at the same conference! Me: urethral trauma.
@drlouisenewson
: Genitourinary syndrome of the Menopause (GSM). Never seen her lecture before. She’s really good! (better than me😕).
@BAUSurology
thank you for inviting us!
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Just doing the ward round when who should pop up on the telly next to my patient’s bed - my wife
@mymenopausedr
!!
@DudleyGroupNHS
@lorraine
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155
Fantastic Urolink trip operating
#Awassa
#Ethiopia
Getch’s
#urethroplasty
skills have grown👏🏻👏🏻 24ops in 5/7. Usual African mix inc Difficult redoBPAs (Note 2 self-they ALL need SPC)& Simultaneous BPA+penile urethral occlusion-Tricky!
@SocietyGURS
@ISORU1
@IVUmed
@DudleyGroupNHS
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Fantastic but tiring week operating as part of the faculty for the 14th Jacob Lester Eshleman workshop at
#KCMC
#Tanzania
. 70 delegates. The usual difficult BPAs (rerouting / inf pubectomy) complicated by no ortho alignment. Pelvic ‘ring’ seems a misnomer!
@BAUSurology
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63
It’s wonderful to back in
#Lahore
teaching / operating (mainly pelvic fractures)
@pklinrc
with
@nadeembinusrat
The friendliness and hospitality of Pakistanis is 2nd to none! Looking forward to my return trip
#PKLI
#urethroplasty
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4
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Wonderful to resume
#urolink
#Urethroplasty
workshops again! It is my privilege to help the v talented
@MabediCharles
in
#Malawi
. Gotta say I’m not loving the way the narrow African male pelvis complicates BPAs but we’re coping!
@SuzieVenn
@IVUmed
@drjoshi_pankaj
@SocietyGURS
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A hard but pleasurable week operating & teaching in
#Lilongwe
with
@MabediCharles
19 cases (4 BPA+bulbs) the future Mx of
#urethroplasty
in
#Malawi
is in safe 🤲🏾Anyone else done a BPA anastomosis in an almost side 2 side manner?
@SJHudak
@SuzieVenn
@IVUmed
@SocietyGURS
@ISORU1
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Greatly enjoying the hospitality of Prof Manzoor Hussain and his team at SIUT, Karachi along with Steve Payne &
@MajShabbir
Apparently the urethral rerouting I did this morning on a child with PFUI was the first one ever performed at this hospital 🥇
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Back in
#Lilongwe
for a week of urethroplasty with
@MabediCharles
problem is Charles is v good so I’m only doing the v difficult ones this time round! Redo BPAs. Preputial tube for bulbar necrosis. Tiring but fun! Tanzania in November 👍🏻
@BAUSurology
@ISORU1
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A long week for scrub staff in
#Lilongwe
. They are the unsung heroes of
#urethroplasty
workshops-often staying v late. His face says it all!
@MabediCharles
+me with
matching
@integra_life
headlights! They’re great. Looking forward to more challenging cases next year 🇲🇼
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@AlanPlotzker
@DGlaucomflecken
@mcknight_writes
You could say similar things about prestigious international conferences where the speakers not only talk for free but have no financial support to attend / register so giving a 15min talk at can set you back £1,000s.
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Another great week in
#Awassa
,
#Ethiopia
teaching
#urethroplasty
with
#Urolink
. Fantastic to see Dr Getaneh’s skills grow. The future is improving for stricture patients in Southern Ethiopia!
@SuzieVenn
@IVUmed
@ISORU1
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Using up my accumulated leave from Covid at
@DudleyGroupNHS
teaching posterior
#urethroplasty
in
#Lilongwe
.
@MabediCharles
has mastered anterior urethroplasty after only 1 previous visit! 7 BPAs amongst our week of operating. Hard work. 1 Pt had waited 6yr for surgery!
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For those of us that spend too much time dealing with BXO / lichen sclerosis, you may find this interesting
@drjoshi_pankaj
@SocietyGURS
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Drying lone stars and hooks on the
#aga
. My usual practice before heading off to
#urethroplasty
workshops. Anyone else disinfect & scrub used single use equipment prior to charity trips abroad?
@IVUmed
@SocietyGURS
these single use items are anything but single use out there
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#Urolink
‘s 4th urethroplasty workshop in
#Lusaka
ends with a traumatic prostatorectal fistula needing BUMG and gracilis flap. If the table won’t go up, then sometimes you have to operate kneeling to get those apical prostatic stitches in!
#TeachOneReachMany
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Back in
#Lusaka
for 1week of posterior
#urethroplasty
with my good friend Nenad Spasojevič.
@lee_c_zhao
@UroRecon
the future is definitely robotic. My back is killing me now! Think I’ve missed the boat w/ learning robotics 😕. I’ll do fistulae in an awkward, open, out of date way
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#Urolift
now part of our armamentarium at
@DudleyGroupNHS
great treatment for preserving sexual function! I’ll be offering it to my
#urethroplasty
patients who develop prostatic obstruction
@asad_abedin
@UbeeSS
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I really ought to get some decent photos taken. The rest of the faculty look like movie stars on the USANZ website. This is my actual passport photo. I’m not as miserable irl as I look in that pic btw. Anyway, I’m looking forward to a fantastic meeting
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Big article in May’s edition of GQ on my work with the injured servicemen
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@md_eun
@TempleUrology
But BPH therapy is about improving LUTS and not about making a massive channel. Who cares if only a small channel is made if the patient feels better and is happy. Alpha blockers increase Qmax by 2 and still produce happy patients. It’s not Ca surgery. It’s QoL surgery
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If anyone wants to talk to me about the urethroplasty fellowship I offer (next available April 2020), I’ll be at this BSoT meeting...
Interested in a
#fellowship
? Don't know where to start? Want a relaxed forum through which to network, learn more and even speak to current fellows about their experience? Then join BSoT at our Monday afternoon fellowship event at
#BAUS2019
in Glasgow.
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Enjoying 🇮🇳 ++, learning so much from
@drjoshi_pankaj
&
@sanjaybkulkarni
and now reunited with
@DrSanjayPande10
. Thirteen years ago we spent 2/52 together visiting another legend of urethroplasty - Guido Barbagli, who inspired me to do GURS. A belated Thank you Prof Barbagli!
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@Rheumatology_Dr
@goldstone_tony
@Telegraph
@trentconsultant
@hall_nhs
@DrOKaneAgain
@paullewismoney
@BMA_Consultants
I’m staring at my job plan, trying to shave off another 0.5PA to get me under the limit. Sad. Already jettisoned medical service head, assigned educational supervisor, one OP clinic per fortnight but more needs to go. I was quite happy on my old timetable before this taper fiasco
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He might be knocking on a bit but there is practically nothing that Prof Mundy doesn’t know or hasn’t done when it comes to PFUI. Worth reading…
Enjoy learning . Read our second issue . Prof. Mundy speaks on Pelvic fracture urethral injury
@uclh
@SIU_urology
@BJUIjournal
@AmerUrological
@USANZUrology
@SocietyGURS
@IMORU
@sanjaybkulkarni
@drjoshi_pankaj
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It was a great pleasure to be on the faculty for the urethroplasty troubleshooting webinar Thank you
@drjoshi_pankaj
@sanjaybkulkarni
@drreynaldogomez
@ultoe1
#urology
#urethroplasty
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@drbenwhite
There are two sides to every story and whilst this is an aggressive email has it arisen following an RCA into a serious incident where a pt came to harm because they left the dept without a discharge letter? Why did this individual feel the need to write this email? Just saying…
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@MigraineTrust
@mymenopausedr
my daughter posted this on IG. A powerful and eloquent description of life with migraine. I thought it deserved wider dissemination (I’ve only posted a still, not the video - not tech savvy enough!)
#MigraineAwarenessWeek2021
#BetterMigraineCare
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Always a pleasure to operate with my good friend
@DavidHdez_Uro
and Guillermo Conde. Gotta do this redo urethroplasty then get on a plane, fun weekend plans scuppered, due to
#Tenerife
losing its air corridor status. Not sure about my dodgy scrubs...
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Came to check my slides and found my face on a video loop 😳 I find it so gentlemanly that in Indian conferences no one asks unpleasant questions and no one is reprimanded for (massively) over running their allocated time! Not like
#EAU
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@michael22joseph
This is also so relevant to
@BAUSurology
I’m on call this week and half the admissions are v elderly v Co-morbid with catheters and haematuria from anticoagulants. For recurrent admissions I work out Chadvasc score and usually stop the anticoagulant.
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This is why I favour the ventral approach! Good results, minimal dissection and the ability to choose one of three different techniques intra-operatively
@ISORU1
@sanjaybkulkarni
@lee_c_zhao
@IVUmed
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@vass_vassiliou
@TharushaGunawa4
@CardioShades
Let’s get German white coats that are above the elbow. Bring back the white coat. I suppose I am talking about the 1990s when my fellow SHOs, some of them 🇩🇪 had strange white coats that finished above the elbow & we thought them a bit odd but they’d fit with bare below the elbow
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Thank you so much
@USANZUrology
I had the best time in Adelaide. Great conference, great people, new friends made! I'll definitely be back. Check out my interview with GU Cast I start at 10mins 40. The other speakers are equally interesting though..
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@sanjaybkulkarni
What an absolute gentleman. How many other doyens would give credit at the end of their video presentation to the person who 1st presented the technique they are showing? I’ve certainly never seen that before. I will endeavour to follow Sanjay’s example of respect for colleagues!
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@pklinrc
I feel v honoured you made this! I look forward to returning to your institute and operating/ teaching again
#Lahore
@nadeembinusrat
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@xandvt
Totally brilliant. Not just educationally but the emotional side too. Just binned loads of UPFs I didn’t realise were UPFs (esp ‘healthy’ snack bars) My youngest is a huge fan of you two. When are you back on the telly? Good luck with your UPF-free life
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The airline losing your baggage when you’re travelling in Europe for fun is annoying but when they lose it and you’re in Africa for a charity surgical work shop, it’s a whole new level of inconvenience 😕
@SuzieVenn
@IVUmed
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@VaibhavModgil
Does this mean you no longer want that penile lengthening procedure I had you scheduled in for?
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@MazahirZulfiqar
@SocietyGURS
The thickness of the c.spongiosum and how well it bleeds. Don’t forget two “thin” grafts of 1cm each will add 20Fr to the diseased lumen and still give you a good result.
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@VaibhavModgil
I was putting these in during my fellowship at UCH. One of my very very rare publications!
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@mobelal3
@BAUSurology
Amazing talk Mo. Totally humbled by what you’ve been through and what you continue to achieve. Needs to be watched on catch up for all those who missed it.
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@dr_mattmorgan
@goldstone_tony
Working less is not all bad. Well, obviously it is for patients, but I’ve just been to
#beargrylls
theme park when normally I would have had meetings in my capacity as medical service head, then MDT then a clinic. All this lost work. Ridiculous.
#scrapthetaper
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@VaibhavModgil
How much do you charge for this? Winter's coming and I'm not keen on a cold contracted dartos
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@AnthonyE247
It was a pleasure having you in
#Dudley
! Good luck with your fellowship with my old friend
@MajShabbir
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@westmidsurol
@w_mahmalji
@WyeValleyNHS
@BSoT_UK
@BAUSendourology
@Sri_URO
@UroHFernando
Well deserved! You’ve been an innovator since the day you took up at that post 👏🏻
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@elainejredmond
@wesley_verla
@LumenNicolaas
@TamsinGreenwel1
@DanielaAndrich
I use the disposable LoneStar too, sorry. I’d love a simple table mounted perineal retractor to avoid the ‘funnelling’ you can get with LoneStar. If you could just push the retractor into the obese man’s perineum you wouldn’t operate at such depth for the proximal cases
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@donwglee
@AmyTurek
@IlyasRa04459072
@BSCEMEA_Urology
David remains a # and not an @?! Don, I think you need to create and curate a (parody) Prof Ralph account. I’ll follow
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@moustafaelsawy
@sanjaybkulkarni
@PatrickSelph
@RodrigoKrebs
Bulbar stricture - you can choose : NTABU or ventral or dorsal or dorsal + ventral. Mid penile, you could Asopa or dorsal (via perineal incision). I cannot see the f navic stricture clearly unless it’s that near obliterative area? Maybe Asopa, if really tight maybe 1st stage
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Strongly recommend this fellowship run by my talented stone / laser surgeon colleagues!
Just advertised for endourology fellow’s post. US guided supine PCNL access, US guided nephrostomy insertion, en bloc Holep, weekly ultrasound scanning list with a senior sonographer to learn US skills. Interested candidates can direct message me.
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@theveindoc
There is no problem as long as all data is stored in a GDPR compliant way. We all do it. Well, personally, I don’t have any bits of paper. It’s all in a secure cloud these days.
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@urethrologist
Nice paper Keith but in my practice it wouldn’t be a fair comparison. I only do transecting anastomotic augmented urethroplasties on the worst obliterative strictures. Bad spongiofibrosis. Obliteration >2cm. Otherwise I avoid the technique. Hope all’s well. P
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@drjoshi_pankaj
@SocietyGURS
@brurology_group
@usanz
@ISORU1
What graft material have you used to cover the defect in the tunica, Pankaj?
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@lee_c_zhao
@NYUUrology
@AmrElbakryUro
I’m thinking of revisiting BLMG. The mouth morbidity for full length urethroplasty gets forgotten. I used to harvest a 6 x 8cm graft via a Pfannensteil to make a 30Fr 16cm tube but the issue was the junctions.
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Not totally convinced by this unless patients went to a hotel / facility nearby. Not sure they can adequately learn perineal post op care regime straight after surgery then get into a relative’s car for a long journey. 75-77% success. Were patients happier?
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@drozanbozkurt
@so_uro
@UropediaUCD
@SocietyGURS
@SUSTurkey
@EAUYAUrology
@EAU_YAURecon
@Uroweb
Why not use Methylene Blue? It makes things easier. Definitely try it on a few cases before you dismiss it
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@moustafaelsawy
@AVZhivov
@sanjaybkulkarni
@PatrickSelph
@RodrigoKrebs
DVIU. If that were my untouched stricture I’d take the day case procedure with a 50% chance of success. Too invasive to go straight for urethroplasty IMHO
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@schusterbruce
@RBCH_NHS
@MattHancock
@goldstone_tony
@nhs_pensions
@BMA_Consultants
No point getting CEA. Get too many and you need to drop sessions you love (e.g. operating) to lower your PAs. This whole taper business is a bloody nightmare
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@chriscraigCCC
Is this in order to become competent SFAs (surgical first assistants if you’re reading this and non medical) or to become independent or even supervised operators, because there’s a big difference
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@sanjaybkulkarni
@moustafaelsawy
@PatrickSelph
@RodrigoKrebs
Is there a need to augment the whole length when long sections look good enough on the RUG?
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0
4
@emmavardy2
@Rheumatology_Dr
@goldstone_tony
@Telegraph
@trentconsultant
@hall_nhs
@DrOKaneAgain
@paullewismoney
@BMA_Consultants
I’m really glad that I’ve been too lazy to apply for CEA this past decade or I’d be dropping even more sessions...
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@lee_c_zhao
@NYUUrology
@DrJustinChee
@SocietyGURS
I just place a ventral (+/- dorsal) BUMG to augment the stenosed skin tube or proximally strictured urethra. Do you favour this flap over a buccal graft augmentation for redo perineal urethrostomies, Lee?
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@AndrewJD
You’re a bit late to the party. My middle daughter’s up to 17 I think. Took my two elder daughters for nasal piercings and A GREY VENFLON STRAIGHT THROUGH THE SEPTUM. No local anaesthetic. I was in tears (they’re defiled etc), as well as them
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@Leedsurology
and they're a sod to fix. All the trauma leading to essentially loss of the urethra and fibrosis ++. Transecting augmented anastomotic is what he'll end up with because the obliteration will >2cm, mark my words
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@Pippa_Sangster
@MajShabbir
@BAUSurology
That was a good session. Well organised Pippa. I particularly enjoyed Julian trying to switch his phone off towards the end of his v informative talk
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How interesting that female urologists seem quite happy to pursue an entirely male patient subspecialty (male GURS) but the reverse cannot be said for male urologists (only 2.4% choosing female pelvic medicine & reconstruction) 🤔
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@BJSurgery
@rbarbosa91
@AmyLightnerMD
@bplwijn
@des_winter
@ksoreide
@MalinASund
@evanscolorectal
@nfmkok
@robhinchliffe1
@young_bjs
Great article but no mention of the Barron handle. I couldn’t do my reconstructive without it. Nothing else gives the same level of control over where exactly you place / angle your incision IMO
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@CorydonMD
Which branch of surgery? Don’t forget the work-life balance. Urology offers a reasonable work-life balance IMHO cf other specialties (UK perspective. Can’t comment on US where you seem to start the working day at 0500…. Why do you even do that?)
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@theveindoc
@mrjohnleach
And not all specialties can just pick up extra private work the way surgeons can...
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@RodrigoKrebs
@moustafaelsawy
@sanjaybkulkarni
@PatrickSelph
@AVZhivov
Tbh that’s why I favour dilation / dilatation over DVIU
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Testosterone - not just for men!
@thesundaytimes
I prescribe testosterone in my
#menopause
clinic; it also helps with mood, energy and concentration
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@FCAFigueiredo
Interesting technique. I used to do (almost) full length full circumferential (single stage tube) bladder mucosa urethroplasties but harvested open, usually an 8x6cm piece which became a 16cm 30Fr tube but it was a lot of work and morbidity. Worked well for pan urethral BXO
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@jed_mercurio
Fantastic series! I was a final year med student. Love that episode with the Sengstacken tube. I’ll start rewatching the whole series imminently. I learnt a lot for my finals from Cardiac Arrest!
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