Marc Laniado MD FRCS(Urol) FEBU
CONSULTANT IN UROLOGY

  
   
       
 
Hospitals
Training
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Special Interests
NHS Patients
Private Patients

Special Interests

I use the most up to date methods to assess symptoms and to determine the appropriate cause for the symptoms, whether treatment is necessary and the most appropriate treatment including non or minimally invasive interventions where possible.

Prostate enlargement (BPH) and urinary symptoms

To assess urinary symptoms, I try to distinguish symptoms due to benign prostatic enlargement, a bladder abnormality or other cause. Then I ask patients to complete two questionnaires: the International Prostate Symptom Score (IPSS) and BPH Impact Index (BPII) to grade the severity of the disorder. I use simple (ultrasound, urinary flow rates) and special investigations when necessary. An analysis of all the information using algorithms and clinical judgement is made. Treatment options are based on the severity of the problem, the likely progression of the relevant problem over time and the responsiveness of the problem to potential treatments. Therapies include observation, laser (GreenLight) prostatectomy and traditional prostate resection.

Laparoscopic Urological Surgery

Today, I teach other UK urologists laparoscopic procedures on training course in the UK and France. I trained in laparoscopy at the Cleveland Clinic in USA and subsequently in England to develop the following techniques:

  • laparoscopic nephrectomy (transperitoneal and retroperitoneal) for renal cancer
  • laparoscopic pyeloplasty for pelviureteric junction obstruction (also known as PUJ or UPJ) obstruction
  • laparoscopic pelvic lymph node dissection (for prostate cancer)
  • laparoscopic radical prostatectomy (for prostate cancer)

I perform between one and three laparoscopic procedures per week on average.

Prostate Cancer

I have performed research in prostate cancer for many years. Initially this was at Imperial College for which I received an MD thesis. I have performed subsequent research elsewhere as well as contributed book chapters.

Significant numbers of men are found to have a high PSA indicating a risk of prostate cancer, which can sometimes be serious. I use the most up to date diagnostic algorithms and tests to determine the risk of any and high-risk prostate cancer. Relevant problems are discussed in a multidisciplinary meeting with oncologists, radiologists and other colleagues.

My regular work includes

  • Diagnosis (prostate specific antigen [PSA] testing. PCA3plus, and transrectal ultrasound [TRUS] guided biopsy of the prostate with local anaesthetic to make the test as tolerable as possible
  • Prognosis estimation using computer algorithms, neural networks, alternative testing techniques
  • Treatment (laparoscopic lymph node dissection, radical prostatectomy, HIFU [high intensity focused ultrasound], hormone)

Stones

Stones are very common and my practice includes kidney stone assessment and, when necessary, treatment using lasers and flexible ureteroscopes. I try to assess patients for the risk of recurrence and encourage dietary modification where appropriate. I regularly perform laser procedures for stones.

Urinary Incontinence

Many women I see find their lives disturbed by urinary leakage. After a history, examination, symptom scoring and special tests, it is usually possible to find a cause and subsequent treatment

  • clinical evaluation
  • videourodynamics
  • tension free vaginal tape (Monarc midurethral transobturator tape)
  • life style modifications
  • medication

General Urology

  • blood in the urine (haematuria/hematuria)
  • Urine infection ('cystitis', UTI)