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ΣΥΝΈΝΤΈΥΞΗ
Tεύχος 30 | Iούλιος-Αύγουστος 2024
T.S.: Have you developed any original surgical techniques? Could you name your favorite one and the story behind its invention?
Prof. Anthony Mundy: No, I have not invented anything. I have learned a lot from watching other people and I have said: "Oh, that's a good way of doing this. I haven't seen that before".
T.S.: In your opinion should more patients with urethral strictures opt for urethroplasty? What is the role of new devices, such as drug-coated balloons, in the management of urethral and ureteral strictures?
Prof. Anthony Mundy: Do you mean now or in the long term? If we are talking about now, then it is a very useful new technique, which makes such a huge difference. The following question is: "What about in the long run?". The answer is that I don’t think it will make any difference at all. The Optilume balloon may mean that the patients won't need to have their strictures dilated for a year rather than six months. But the stricture will come back because it's scar tissue. When you finish blowing up your balloon, what you have left behind is scar tissue. This is the thing we have been through over and over and over again, because there are patients who don't need more than one treatment, anyway. I also have a number of patients who I dilate once a year. Also, I have patients, who will dilate themselves if necessary, and again they do it on an occasional basis. So, we get used to seeing people, who have been treated because of "recurrent strictures". But, because of the way the modern surgical practice works and because of the interaction with general practitioners out in the community, what you are actually talking about are the patients who have frequently recurrent strictures, rather than those people who have occasionally recurrent strictures. The changeover of doctor to patient in the community is such, that if anybody goes more than three to six months without any intervention, they will probably end up seeing an altogether different doctor. To that doctor is a new patient, not a recurrent stricture. So, this is all a joke. People want to write articles for journals about this "fabulous" balloon. By the way, how many thousands of euros does it cost? How much does one metal bougie, like the one I used to use when I was a trainee, on those men standing up, and a cleaning wipe
cost? Where is the progress? Again, I am exaggerating a point to prove a point. But in fact, you have to look at something in its total context, not just as a very clever piece of kit. You have to look at the total picture before you can really get much of a grip on what is going on.
F.N.: Reconstructive urologists often face frightening complications and disease recurrence. How do you cope with these cases?
Prof. Anthony Mundy: If I asked you to give me an example, I think you would probably have a bit of difficulty answering that. The answer is that there are people who have difficult complications and there are some of them you can help and some of them you can't help. Although I have gone back into somebody, who had a laparotomy and they were bleeding from an aortic incision due to a stab wound, I am not the best person to do that, but I was the only surgeon around at the time. Other people could be better at doing it and they would be much more relaxed about it because they are used to do that sort of thing, but they weren’t there at the time. The reality is that when you are as old as I am, you have seen what there is to see. I don't think you can show me anything that would make me think: "Oh my God!".
The other thing is that I have a philosophy in life, at which my colleagues very often laugh when they first hear it, but then they come around to it. My little item of philosophy is: " Life is a bitch, and then you die." Where we are now, in Athens or in London, life is bloody marvelous. We are looked after well. We are looked after by a government. We do what we want, where we want, when we want, and how we want. But if you go off into some of the Philippine Islands or the other remote areas of the world, for example the Gaza Strip, you can see that in these places, life is a bitch and then you die. So, to be honest, every day I am very happy for everything that still involves breathing and a palpable pulse.
F.N.: We read in your CV that you are an Honorary Professor of Medicine at the University of Crete. How often do you visit Greece? Could you name your favorite place?
Prof. Anthony Mundy: I don't go nearly as often as I used to, largely because of COVID. As I told you before, Kelly worked out that I spent five weeks in
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