Mr Andrew SymesMBBS BSc MRCS MD(Res) FRCS(Urol)

Mr Andy Symes CV

Andy Symes MBBS, BSc, MD (Res), FRCS (Urol)

Professional Background

Mr Andy Symes I was appointed as a Consultant Urological Surgeon to Brighton and Sussex University Hospitals NHS Trust in 2011, to support the provision of an acute general urology service, but more specifically to set up a comprehensive stone service.

My education was at Eton College, and I qualified from Guys and St Thomas's medical schools in 1999 as a doctor, with an MBBS and a BSc in clinical anatomy. I rotated through University College Hospitals London and the Royal Marsden Hospital, before spending two years at UCL researching novel gene expression in human prostates for which I was awarded an MD.

My specialist urological training was on the highly regarded South-West Thames rotation in London, where I gained extensive experience in all aspects of general adult urology. In particular I spent 2 years at a high volume stone centre at St Georges Hospital London, where I specialised in the surgical treatment of urinary tract stones. I was successful in the FRCS (Urol) examination in 2009 and was awarded the Keith Yates Gold Medal for outstanding performance in Great Britain and Ireland. I was awarded the Certificate of Completion of Training in 2011 and entered onto the Specialist Register of the General Medical Council.

I split my NHS week between the Royal Sussex Country and Princess Royal Hospitals in Brighton and Hayward's Heath respectively.

My private practice is based in the Brighton Nuffield Hospital, the Hayward's Heath Nuffield Hospital, and the Spire Montefiore Hospital in Hove.

My clinical practice encompasses the investigation, diagnosis and treatment of a number of benign and cancerous urological disorders including; blood in the urine, urine infections, kidney stones, enlarged prostate (BPH), overactive bladder syndrome, raised PSA blood test, prostate cancer, bladder cancer, kidney cancer and testis cancer. I am particularly interested in minimally invasive surgery for enlarged prostates.

I am a recognized specialist in the field of urinary tract stones. I offer the full compliment of treatments including lithotripsy, laser stone surgery (ureteroscopy) and keyhole techniques for large stones (PCNL or percutaneous nephrolithotomy). In 2012 I was able to get funding for a fixed site, top of the range, Storz lithotripter, which has now been in-situ for over a year. I run this service and am able to provide emergency next day treatment. This is the only service of its kind in Sussex.

I remain interested in research and am currently involved with setting up a trial to investigate the use of low energy shockwaves to treat men with chronic prostatitis / chronic pelvic pain syndrome. The research that I started at UCL into gene expression in prostate tissue remains ongoing and has been published in peer reviewed journals. I have been involved with national NIHR funded stone trials. I regularly review journal articles for the British Journal of Urology, British Medical Journal and the public library of science (PLOS ONE). I have published extensively in urology, both in peer reviewed articles and book chapters, and in addition have presented my work internationally.

I enjoy teaching and training and currently have a dedicated stone registrar whom I am training up towards consultant level. I am involved with the selection and interview process of future urology consultants at a national level. I also regularly teach medical students from Brighton and Sussex Medical School and examine at their final exit exams. I organize and deliver regional teaching days for urology higher surgical trainees in the Kent, Surrey and Sussex deanery.

Audit of one's practice is a compulsory part of a doctors working life. I contribute to a national audit process run through the British Association of Urological Surgeons. This data will be used in the near future for publication of individual surgeons outcomes, a process which I fully support and look forward to. In addition my work is regularly reviewed through a monthly clinical governance process.

1997 B.Sc. (Hons) – Bachelor of Science (Honors)
1999 MB.BS – Bachelor of Medicine, Bachelor of Surgery
2003 M.R.C.S – Membership of the Royal College of Surgeons
2004 St Peter's Trust Grant (Institute of Urology - London)
2006 Traveling Surgical Society Prize (Chertsey)
2009 F.R.C.S (Urol) – Fellowship of the Royal College of Surgeons (Urology), Keith Yates Gold Medal Winner
2011 M.D (Res) – Doctor of Medicine (Research)
2014 Clinical excellence award NHS

British Association of Urological Surgeons (BAUS)
BAUS Section of Endourology
Fellow of the Royal College of Surgeons of England

Abboudi H, Bolgeri M, Nair R, Chetwood A, Symes A, Thomas P. 'A reservoir within a reservoir' - An unusual complication associated with a defunctioned inflatable penile prosthesis reservoir. Int J Surg Case Rep. 2014;5(10):758-60.

Bolgeri M, Nair R, Symes A. A useful aid in navigating the tortuous ureter. Ann R Coll Surg Engl. 2014 Mar;96(2):169

Jallad S, Goubet S, Symes A et al. Prognostic value of inflammation or granuloma after intravesival BCG in non-muscle-invasive bladder cancer. BJU Int. 2014 May;113(5b)

Symes AJ, Eilertsen M, Millar M et al. Quantitative Analysis of BTF3, HINT1, NDRG1 and ODC1 Protein Over-Expression in Human Prostate Cancer Tissue. PLoS One. 2013 Dec 27;8(12):e84295.

Misra S, Gupta A, Symes A, Duncan J. Haemophagocytic syndrome after intravesical bacille Calmette-Guérin instillation. Scand J Urol. 2013 Sep 27.

Lukacs S, Tschobotko B, Szabo N, Symes A. Systemic BCG-Osis as a Rare Side Effect of Intravesical BCG Treatment for Superficial Bladder Cancer. Case Rep Urol. 2013;2013:821526

Nair R, Drinnan NR, Symes A. Re: A single dose of a non-steroidal anti-inflammatory drug (NSAID) prevents severe pain after ureteric stent removal: a prospective, randomized, double-blind, placebo-controlled trial. BJUI Int. 2013 May;111(5):E265-6

Symes A, Rane A. Urological applications of single-site laparoscopic surgery. JMAS. 2011;7:90-95.

Wang Q, Symes AJ, Kane CA et al. A novel role for Wnt/Ca2+ signaling in actin cytoskeleton remodeling and cell motility in prostate cancer. PLoS One. 2010;5:e10456.

Ingram MD, Symes AJ, Naerger HG, Hatrick AG. Testicular artery embolization for the treatment of life-threatening hemorrhage post orchidectomy. Cardiovasc Intervent Radiol. 2009;32:381-384.

Dickinson L, Symes A, Anson K. A rare cause of obstructive uropathy. BMJ Minerva. 2008;337:a2266

Symes A, Shaw G, Corry D, Choong S. Pelvi-calyceal height, a predictor of success when treating lower pole stones with extracorporeal shockwave lithotripsy. Urol Res. 2005;33:297-300.

Sahai A, Symes AJ, Challacombe BJ, Glass JM, Popert RJ, Dasgupta P. Laparoscopic ureteroneocystostomy for benign lower ureteric stricture: case study and literature review. Int J Clin Pract Suppl. 2005;115-117.

Symes A, Foley C. 'Living and loving after prostate surgery' by Grace Dorey. Book Review. BJUI Int. 2005;96:688.

Sandhu SS, Symes A, A'Hern R et al. Surgical excision of isolated renal-bed recurrence after radical nephrectomy for renal cell carcinoma. BJU Int. 2005;95:522-525.

Symes A, Kalsi V, Rickards D, Allen C, Choong S, Philp T. Dystrophic ureteral calcification associated with Churg-Strauss vasculitis. Urology. 2004;64:1231.e9-1231.11.

Mirnezami R, Sahai A, Symes A, Jeddy T. Day-case and short-stay surgery: the future for thyroidectomy? Int J Clin Pract. 2007;61:1216-1222.

Sahai A, Symes A, Jeddy T. Short-stay thyroid surgery. Br J Surg. 2005;92:58-59.

Symes A, Ellis H. Variations in the surface anatomy of the spinal accessory nerve in the posterior triangle. Surg Radiol Anat. 2005;27:404-408. Symes A, Kalsi V, Rickards D, Allen C, Choong S, Philp T.

Haji A, Sahai A, Symes A, Vyas JK. Percutaneous versus open tendo achillis repair. Foot Ankle Int. 2004;25:215-218.

Symes A, Anson K. Energy Sources in Urology. The Scientific Basis of Urology, Third Edition (Mundy AR, Fitzpatrick J, Nead DE, George NJR) 2010

Symes A, Das Gupta R, Rane A. Tuberculosis, AIDS, and other uncommon urinary tract infections. (Awaiting publication)

Nair R, Abboudi H, Chetwood A, Bolgeri M, Coker C, Symes A, Larner T, Thomas PJ. Forgotten organs of ancient Egypt: A modern day atlas of retroperitoneal anatomy. Manchester, June 2013

Hughes P, Nair R, Gupta AK, Symes A. Dr. John Macintyre (1857-1928): An unknown "spark" in the field of Uro-radiology. Glasgow 2012

Symes A, Best S, Cadeddu J, Rane, A. LESS (Laparo-Endoscopic Single Site Surgery): initial experience in upper tract extirpation and reconstruction. Manchester 2010

Symes A, Magrill D, Le Roux, Rhane A, Patel U, Corbishley C, Anderson C. Radiofrequency assisted partial nephrectomy without hilar clamping: a novel technique using the HABIB 4X. Glasgow 2009

Townsend E, Symes A, Barber N, Naerger H. Chronic Testicular pain – is surgical management effective? Manchester 2008

Sockett LJ, Borwell J, Symes A, Parker T, Montgomery BSI, Barber NJ. Electro-motive drug administration (EMDA) of intravesical mitomycin-C in patients with high-risk non-invasive bladder cancer and failure of BCG immunotherapy. BAUS Manchester 2008

Sangster P, Symes A, White T, Burton C, Walker R, Morley R, Thompson A, Le Roux P, Sandhu S. A multi-institutional analysis of patient outcomes following intravesical Bacillus Calmette-Guerin treatment for non-muscle invasive bladder cancer. San Francisco 2010

Magrill D, Symes A Borley N, O'Donnell A, Rane A, Anderson C. "Cost of nephrectomies in a tertiary referral centre – inadequacies in the centrally allocated funding from the NHS". Shanghai 2008

Symes A, Magrill D, Ord J, Errico M, Rane A, Anderson C. "Radiofrequency Assisted Laparoscopic Partial Nephrectomy without Hilar Clamping; a Novel Technique using the HABIB 4X ™". Shanghai 2008

Sahai A, Symes A, DasGupta P. Laparoscopic ureteroneocystostomy. Mumbai 2004

Symes AJ, Sandhu SS, Goldstraw M, Woodhouse CRJ. The management of haemorrhagic cystitis with sodium pentosan polysulphate. Hawaii 2004

Symes AJ, Sandhu S, Eisen T, Gore ME, Christmas TJ. Surgical excision of loco-regional recurrence after radical nephrectomy. Hawaii 2004

Symes A, Shaw G, Corry D, Choong S. Pelvi-calyceal height, a predictor of success when treating lower pole renal stones with extra-corporeal shock wave lithotripsy. Hawaii 2004

Shaw G, Symes A, Corry D, Choong S. Music, a useful, cheap and side-effect free adjunct to analgesia in extra-corporeal shock wave lithotripsy. Hawaii 2004

Shaw G, Symes A, Choong S. Topical local anaesthetic cream, a useful adjunct to analgesia in ESWL Hawaii 2004

Symes A, Sandhu S, Dearnley D, Horwich A, Christmas TJ. The Outcome of Patients treated with Salvage Radiotherapy. Hawaii 2004

Shaw G, Symes A, Corry D, Choong S. Music, a useful, cheap and side-effect free adjunct to analgesia in extra-corporeal shock wave lithotripsy. Hong Kong 2004

Symes A, Kalsi V, Choong S, Allen C. MDCT (multidetector computed tomography) – the essential navigator. Hong Kong 2004

Shaw G, Symes A, Corry D, Choong S. Pelvi-calyceal height, a predictor of success when treating lower pole renal stones with extra-corporeal shock wave lithotripsy. Hong Kong 2004

Jallad S, Hughes P, Gupta A, Goubet S, Symes A, Thomas P. Can presence of granuloma act as a marker of response to intravesical BCG in non-muscle invasive bladder cancer? South Thames Urology Regional Meeting Frimley Park 2011

M Bolgeri, R Nair, H Abboudi, A Chetwood, D Brennan, C Coker, A Symes. Implementation and initial results of a new fixed-site lithotripsy center. South Thames Urology Regional Meeting Brighton 2013

Gupta A, Nair R, Richenberg J, Symes A. The Scouting for stones: Optimising follow-up imaging for conservatively managed upper urinary tract calculi Senior Urological Registrars Group Annual Scientific Conference. Brighton 2012

Hughes P, Nair R, Jallad S, Symes A, Simpson E, Larner T. Evaluating the Role of Contrast Enhanced Ultrasound in the Assessment of Complex Renal Lesions Hughes P, Nair R, Jallad S, Symes A, Simpson E, Larner T Association for Surgeons In Training (ASIT) Cardiff 2012

Gupta A, Nair R, Richenberg J, Symes A. Scouting for stones: Optimising follow-up imaging for conservatively managed upper urinary tract calculi Urology Section: Clinical Radiological meeting and State of the Art Lecture The Royal Society of Medicine, London 2012

Symes A, Eilertsen M, Brouilette KT, Feneley MR, Nariculam J, Patel HRH, Masters JRW, Ahmed A. Identification of novel epithelial markers of prostate cancer. Pearce Gould Visiting Professor Lectures. UCL London 2010

Symes A, Magril D, Bondad J, Le Roux P. Laparoscopic retroperitoneal adrenalectomy. South Thames Urology Regional Meeting Basingstoke 2009

Kailayanathan T, Symes A, Patel A, Lewis K, Gordon S. Emergency IVU for investigation of suspected ureteric colic – can it still be justified? South Thames Urology Regional Meeting Basingstoke 2009

Sangster P, Symes A, White T, Burton C, Walker R, Morley R, Thompson A, Le Roux P, Sandhu S. A multi-institutional analysis of patient outcomes following intravesical Bacillus Calmette-Guerin treatment for non-muscle invasive bladder cancer. South Thames Urology Regional Meeting Kingston 2009

Symes A, Dickinson L, Munneke G, Patel U, Anson K. Urological pathology associated with endovascular aortic aneurysm repair (EVAR) – a growing endourological problem? Joint meeting BAUS Section of Endourology, RSM Section of Urology Norwich 2009

Symes A, Feneley M, Masters J, Ahmed A. Gene expression profile of normal human prostate epithelium. BAUS Section of Academic Urology, Royal College of Surgeons London 2008

Symes A, Dickinson L, Patel U, Monekeye G, Anson K. An audit of urological pathology and complications associated with EVAR. South Thames Urology Regional Meeting, Redhill 2008.

Sockett LJ, Borwell J, Symes A, Parker T, Montgomery BSI, Barber NJ. Electro-motive drug administration (EMDA) of intravesical mitomycin-C in patients with high-risk non-invasive bladder cancer and failure of BCG immunotherapy. South Thames Urology Regional Meeting, Chichester 2007

Symes AJ, Sandhu S, Eisen T, Gore ME, Christmas TJ. Surgical excision of loco-regional recurrence after radical nephrectomy. Royal Society of Medicine, Urology section, Short papers meeting 2004

Symes A, Sahai A, Jeddy T. Day case Thyroid surgery. Travelling Surgical Society. Ashford & St Peter's Hospitals 2006

Symes A, Sahai A, Jeddy T. Day case Thyroid surgery. International Association of Ambulatory Surgeons. Seville 2005

Symes A, Sahai A, Jeddy T. Day case Thyroid surgery. British Association of Endocrine Surgeons. Lund, Sweden 2004

Sahai A, Symes AJ, Jeddy T. Short stay Thyroid Surgery – A safe alternative for the UK. European Society of Endocrine Surgeons. Pisa 2004

Sahai A, Symes A, Jeddy T. Short stay thyroid surgery – a safe regimen for the UK. St. Thomas' surgical society 'Cheselden meeting'. St Thomas's 2003

Jeddy T, Sahai, A, Symes A. Ambulatory thyroid surgery. 5th International Congress of Ambulatory Surgery. Boston USA 2003

Haji A, Symes A, Sahai A, Vyas J. Percutaneous versus open tendo Achillis repair. Orthopaedic regional meeting . Basildon 2002

Symes A, Ellis HE. Surface Anatomy of the Spinal Accessory Nerve - British Association of Clinical Anatomists. Nottingham 1997.