Rick Popert is the Senior Urological Surgeon at Guy’s & St Thomas’ Hospital appointed in 1996. He has always embraced surgical innovation and considers himself fortunate to have worked at Guy’s Hospital where he helped to build one of the foremost urological centres in Europe. He retired from full time NHS practice in 2019, to concentrate on his work as a Fellow on the NHS Innovation Accelerator. He continues to work part time for the NHS as a specialist in prostatic disease at Guy’s Hospital. He is the Chairman of the Urology Cancer MDT for London Bridge Hospital.

Benign Prostate Enlargement (BPE):
Holmium Laser Prostatectomy (HoLEP), since 2002
Prostate Artery Embolisation (PAE), since 2014
REZUM Steam Therapy, since 2019
Robotic Aquablation, since 2022

Rick has specialised in the treatment of Prostatic disease for over 25 years. He established the first Holmium Laser Prostate (HoLEP) Surgery Centre in London. He has done over 1500 HoLEP procedures. The service is recognised nationally and receives tertiary referrals from all over London and around the country, specialising in the treatment of very large prostates.

In 2014, he was the first Urologist in London to offer Prostate Arterial Embolisation (PAE), a minimally invasive alternative to HoLEP for large glands, avoiding the risks of surgery. In 2029 he introduced day case REZUM steam therapy, a less invasive alternative to standard TURP or HoLEP surgery.

Robotic Aquablation 2022 – At Guy’s Hospital Rick established the first aquablation program within the NHS in London. The key area which he has addressed is the management of patients with prostate volumes of 80 – 150cc. These patients would normally be offered a traditional Holmium Laser prostatectomy, however many patients are concerned about the risks of ejaculatory dysfunction and urinary incontinence. Robotic Aquablation appears to be a very suitable solution for these patients and is also available at London Bridge Hospital HCA@Guys.

Prostate Cancer Diagnostics
General Anaesthetic Transperineal (TP) Prostate Biopsies, since 2007
General Anaesthetic TP MRI – US Fusion Biopsies, since 2012
Local Anaesthetic PrecisionPointTM TP Biopsies including MRI Fusion, since 2018

Rick is passionate about improving prostate cancer diagnosis. He was introduced to the PrecisionPointTM technology by the inventor Matt Allaway and immediately recognised the benefits, avoiding the infective complications of Transrectal Biopsies and the morbidity associated with General Anaesthetic multi-puncture Transperineal Biopsies. In 2019, he was appointed a Fellow on the NHS Innovation Accelerator with the ambition to scale this nationally and has completely transformed practice across the UK. TP biopsies now account for 90% of all prostate biopsies, before the pandemic it was about 30%. During the Pandemic, he worked with HCA @ The Shard to establish the first private outpatient local anaesthetic TP biopsy programme in London, replicating the service at Guy’s Hospital.

Prostate Cancer Treatments
Dynamic Prostate Brachytherapy, since 2003 (over 1500 cases)
Robotic Assisted Radical Prostatectomy, since 2006 (over 1200 cases)
Fiducial Markers and Insertion of Perirectal SpaceOAR, since 2018 (over 300 cases)

Dynamic Prostate Brachytherapy:
In 2003, Rick introduced Dynamic Prostate Brachytherapy, and with the oncology team have the UK’s largest experience of this day case technique having treated over 1000 patients. Prostate brachytherapy is suitable for patients with low to intermediate risk prostate cancer and we are also exploring the use of the dynamic technique as a Focal treatment for very localised prostate cancer.

Robotic Prostate Surgery:
Rick was one of the first surgeons in London to convert to Robotic Prostate Surgery in 2006 having done training visits to both Detroit and the Cleveland Clinic. He has extensive experience in Robotic Prostatectomy having performed over 1200 cases. Within HCA @ Guy’s he is able to offer the most technically advanced robotic surgery including the “Neurosafe” evaluation of surgical margins.

Insertion of Fiducial Markers & Perirectal SpaceOAR:
Working with Dr Morris, Consultant Oncologist, all available radiotherapy treatments can be offered from External Beam Radiotherapy, Brachytherapy and the Cyberknife. It is recommended that patients have insertion of Fiducial Markers and a Perirectal SpaceOAR before starting their radiotherapy treatment. This procedure can be offered conveniently under local anaesthetic in the Shard Outpatient Centre.
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