Professor Prokar Dasgupta – three significant and practice changing contributions
Dasgupta Theses 1. The effect of intravesical capsaicin on nerve densities in the urinary bladder in patients with detrusor hyperreflexia: MSc Urol -University of London and the Chisholm Medal, 1996 2. Towards an understanding of the role of intravesical capsaicin in detrusor hyperreflexia: MD thesis -University of London, 2000-1 Summary of Theses 1. Capsaicin is the pungent extract of red-hot chilli peppers. Chillies were grown as early as 5000 BC in Mexico and have been used medicinally, for thousands of years. Animal experiments have demonstrated that capsaicin blocks a C-fibre mediated micturition reflex in spinal cats. The aim of our MRC-funded study was to investigate its role in the treatment of detrusor hyperreflexia due to spinal cord disease. Intravesical instillations of 1-2 mmol/l of capsaicin, dissolved as a powder in 30% alcohol in saline, were effective in 70% of patients with refractory detrusor hyperreflexia. Capsaicin caused an increase in the maximum cystometric capacity and decrease in the amplitude of hyperreflexic detrusor contractions. Even after repeated instillations over 5 years there was no evidence of premalignant or malignant changes in biopsies from bladders thus treated. Suprapubic discomfort during instillations was reduced by the prior use of intravesical lignocaine (40ml of 2% for 20 mins) or by anaesthetising the bladder with iontophoresis of intravesical lignocaine (electromotive drug administration) before capsaicin. 2. Cryostat sections of flexible cystoscopic biopsies before and 6 weeks after capsaicin treatment were stained with the neuronal markers S 100 and PGP 9.5. By using computerised image analysis of lamina propria nerve densities it was found that intravesical capsaicin caused a reduction in densities of the presumptive sensory suburothelial nerves. Early data using electron microscopy seemed to show a reduction in the densities of clear and dense cored vesicles after capsaicin treatment. 3. Intravesical capsaicin is a significant advance in Uro-Neurology and has led to lead to the introduction of other neourotoxins to treat the overactive bladder, in particular Botulinum toxin. Supervised Theses PhD 1. XMRI in bracytherapy for prostate cancer – P Acher (examination 2009) 2. Image guided robotic prostatectomy for localised prostate cancer – S Thompson 3. Botulinum toxin in idiopathic detrusor overactivity – A Sahai (examination 2009) 4. SV2 and NOS expression and the effect of BTX-A – C Dowson MD 1. Cell free DNA in prostate cancer – J Boddy – degree awarded 2. Botulinum toxin in detrusor overactivity – M Kalsi 3. The urothelium in urinary tract infections – R Kucheria 4. Ergonomics of Robotic, Laparoscopic and Open surgery – O Elhage MS 1. Transatlantic telementoring and telerobotics – B Challacombe – degree awarded 2. Co-morbidity assessment in prostate cancer – R Singh (examination 2009) 3. Photodynamic cystoscopy in bladder cancer – E Ray (examination 2009) MSc 1. Effect of flexible uretero-renoscopy on renal function – M Bultitude – degree awarded 2. Botulinum toxin in neurogenic detrusor overactivity – R Popat - degree awarded 3. Botulinum toxin in overactive bladders – P Sangster - degree awarded along with the Chisholm Gold Medal 4. Virtual Reality Laparoscopic nephrectomy – T Nedas – degree awarded along with the Chisholm Gold Medal 5. Validation of a VR Laparoscopic Nephrectomy Simulator – James Brewin |