Prof James Malone-Lee
My research work has focused on the pharmacology, biomechanics and physiology of urinary incontinence. In recent years my discoveries in relation to chronic bladder inflammation in the aetiology of overactive bladder have resulted wider collaborations with microbiologists, physiologists, immunologists and pharmacologists. I am a keen supporter of basic science as the foundation of modern medicine but nevertheless I remain an avowed clinical researcher.
I can summarise my discoveries as follows:
Urodynamic investigations appear to provide little information useful to the clinical management of patients with lower urinary tract symptoms
Quantitative microbiology applied to the routine MSU, based on the Kass criteria of 1957 to 1960 is extremely insensitive, missing many genuine infections.
The dipstick tests for leucocyte esterase and nitrite are substantially worse than the culture methods. Such tests should not now be used to exclude urine infection.
Microscopy of a fresh unspun, unstained specimen of urine, to count the urinary leucocytes is the best test for urine infection that we have but it will miss about 40% of infections.
Many persons with lower urinary tract symptoms are living with chronic infections that go untreated because of contemporary guidelines.
The symptoms that patients describe are extremely important, accurate and the best guide to the pathology afoot. They should never be ignored and pain is not necessarily essential.
Many urine infections are caused by mixed colonies and mixed growths are associated with important independent markers of urinary tract inflammation and infection.
Many urine infections involve intracellular bacterial colonisation of the urothelium by mixed pathogens that are fastidious and extremely difficult to treat by conventional methods.
Clinical Evaluation of Incontinence Products
Indigenous microbiota of humans
Personal Tutor Group
I have six clinical undergraduates for whom I act as their personal tutor. I meet with them weekly at the main campus for a teaching seminar.
I run this JCPC on Fridays at lunchtime for the available first year clinical students on the Whittington Campus.
Weekly Clinical Examination
I teach a group of students every Tuesday afternoon. We concentrate on the clinical examination. The main purpose is to get them to become confident with the clinical examination but also to understand the pathophysiology of the physical signs.
BSc Laboratory Projects
These students are with us for six weeks in order to accomplish the laboratory project that forms part of their BSc. We take on about six each year.
Summer Attachment Scholarships
We usually have about six students attached to us over the summer holidays. I provide bursaries for two medical students from my private patient income. We attract a number of Nuffield students and frequently BSc project students ask to come back to spend the summer with us. It is a successful programme and I provide two £1,000 bursaries each year for the highest performing BSc project students which they receive in return for a long vacation attachment with us.
The Joseph Bell School of Observation, Medical Detection and Diagnostic Precision
This is a two week special study module that focuses on the 19th and early 20th century bedside clinical skills teaching an approach to clinical medicine that is very parsimonious about investigations. We take ten students four times a year.
Dr Lena Ciric; Prof Alan Cottenden; Prof Mike Wilson; Prof Ivan Parkin
Prof Heather Gage; Prof Mandy Fader
- Gill K, Horsley H, Kupelian AS, Sathiananthamoorthy S, Swamy S, Collins L, Rohn JL, Malone-Lee J (2013). ARE WE JUSTIFIED IN THE DISMISSING MICROSCOPIC PYURIA OF 1-9 WBC ML-1 AS NORMAL IN SYMPTOMATIC PATIENTS?.
- Sathiananthamoorthy S, Gill K, Swamy S, Kupelian A, Collins L, Malone-Lee J (2013). A MICROBIOLOGICAL ASSESSMENT OF THE ROUTINE MIDSTREAM URINE CULTURE TO IDENTIFY URINARY TRACT INFECTION IN PATIENTS WITH LOWER URINARY TRACT SYMPTOMS.
- Kupelian A, Collins L, Sathiananthamoorthy S, Swamy S, Gill K, Horsley H, Malone-Lee J (2013). THE IMPLICATIONS OF OCCULT URINARY TRACT INFECTION IN MS.
- Khasriya R, Sathiananthamoorthy S, Ismail S, Kelsey M, Wilson M, Rohn JL, Malone-Lee J (2013). Spectrum of bacterial colonization associated with urothelial cells from patients with chronic lower urinary tract symptoms.. J Clin Microbiol, 51(7), 2054 - 2062. doi:10.1128/JCM.03314-12
- Kupelian AS, Horsley H, Khasriya R, Amussah RT, Badiani R, Courtney AM, Chandhyoke NS, Riaz U, Savlani K, Moledina M, Montes S, O'Connor D, Visavadia R, Kelsey M, Rohn JL, Malone-Lee J (2013). Discrediting microscopic pyuria and leucocyte esterase as diagnostic surrogates for infection in patients with lower urinary tract symptoms: results from a clinical and laboratory evaluation.. BJU Int, 112(2), 231 - 238. doi:10.1111/j.1464-410X.2012.11694.x
- Gill K, Brenton T, Kupelian A, Horsley H, Sathiananthamoorthy S, Collins L, Malone-Lee J (2012). URINARY LACTOFERRIN AS A PROMISING, NEW, IMPROVED SURROGATE MARKER FOR URINARY TRACT INFECTION..
- Brenton TG, Gill K, Malone-Lee JG (2012). Assessment of urinary lactoferrin as a surrogate marker for urinary tract infection in patients with lower urniary tract symptoms.
- Sathiananthamoorthy S, Swamy S, Kupelian A, Horsley H, Gill K, Collins L, Malone-Lee J (2012). "MIXED GROWTH OF DOUBTFUL SIGNIFICANCE" IS EXTREMELY SIGNIFICANT IN PATIENTS WITH LOWER URINARY TRACT SYMPTOMS..
- Contreras-Sanz A, Scott-Ward TS, Gill HS, Jacoby JC, Birch RE, Malone-Lee J, Taylor KM, Peppiatt-Wildman CM, Wildman SS (2012). Simultaneous quantification of 12 different nucleotides and nucleosides released from renal epithelium and in human urine samples using ion-pair reversed-phase HPLC.. Purinergic Signal, 8(4), 741 - 751. doi:10.1007/s11302-012-9321-8
- Gill K, Khasriya R, Kupelian A, Brackenridge L, Horsley H, Sathiananthamoorthy S, Malone-Lee J (2011). TREATING OAB WITH ANTIBIOTICS.
- Malone-Lee J (2011). RESPONSE James Malone-Lee responds to the media flurry over safety of anticholinergic drugs in elderly people. BMJ-BRITISH MEDICAL JOURNAL, 343, - . doi:10.1136/bmj.d4740
- Horsley H, Weissler A, Kupelian A, Gill K, Sathiananthamoorthy S, Brackenridge L, Malone-Lee J (2011). PLANKTONIC URINARY EPITHELIAL CELL COUNTS AS DISEASE INDICATORS IN OAB.
- Malone-Lee J (2011). James Malone-Lee responds to the media flurry over safety of anticholinergic drugs in elderly people.. BMJ, 343, d4740 - .
- Kupelian A, Horsley H, Guo Y, Gill K, Sathiananthamoorthy S, Brackenridge L, Weissler A, Malone-Lee J (2011). A NOVEL FLUORESCENCE TECHNIQUE TO ILLUMINATE BACTERIAL ADHESION TO UROTHELIAL CELLS IN OAB: A RADIANT DEMONSTRATION OF PATHOLOGY IN ACTION.
- Gill K, Jeyakumar A, Brenton T, Malone-Lee J (2010). A URINE TEST FOR OAB.
- Khasriya R, Khan S, Lunawat R, Bishara S, Bignall J, Malone-Lee M, Ishii H, O'Connor D, Kelsey M, Malone-Lee J (2010). The inadequacy of urinary dipstick and microscopy as surrogate markers of urinary tract infection in urological outpatients with lower urinary tract symptoms without acute frequency and dysuria.. J Urol, 183(5), 1843 - 1847. doi:10.1016/j.juro.2010.01.008
- Gill K, Jeyakumar A, Brenton T, Malone-Lee J (2010). A URINE TEST FOR OAB. INTERNATIONAL UROGYNECOLOGY JOURNAL, 21, S255 - S256.
- Khasriya RK, Lunawat R, Bishara S, Khan S, Falzon M, Maraj B, Spence-Jones C, Malone-Lee J (2009). HISTOLOGICAL EVIDENCE FOR UROTHELIAL INFLAMMATION AT THE HEART OF THE OVERACTIVE BLADDER. INT UROGYNECOL J, 20, S130 - S131.
- Lunawat R, Khasriya R, Falzon M, Balachandran L, Malone-Lee J (2009). SPUN URINARY SEDIMENTS AND GIEMSA STAIN REVEAL A CHRONIC INFLAMMATORY INFILTRATE IN PATIENTS WITH SYMPTOMS OF OAB. NEUROUROLOGY AND URODYNAMICS, 28(7), 776 - 777.
- Khan S, Khasriya R, Badiani R, Bishara S, Malone-Lee J (2009). ENHANCING THE DETECTION OF PYURIA IN FRESH URINE FROM PATIENTS WITH OVERACTIVE BLADDER BY USE OF THE STERNHEIMER-MALBIN STAIN.
- Contreras-Sanz A, Janska S, Alexander SLH, Lunawat R, Bishara S, Khasriya R, Taylor KMG, Malone-Lee J, Wildman S (2009). Increased urothelial ATP release from a subset of OAB patients..
- Bishara S, King BF, Malone-Lee J (2009). Isolated detrusor muscles cells lengthen in outflow obstruction.
- Khasriya R, Khan S, Ismail S, Ready D, Pratten J, Wilson M, Kelsey M, Malone-Lee J (2009). BACTERIAL URINARY TRACT INFECTION IN PATIENTS WITH OAB SYMPTOMS AND NEGATIVE MIDSTREAM CULTURES EXPOSED THROUGH CULTURE OF THE URINARY SPUN SEDIMENT.
- Khasriya RK, Ismail S, Khan S, Lunawat R, Bishara S, Ready D, Pratten J, Kelsey M, Wilson M, Malone-Lee J (2009). MISSED URINARY TRACT INFECTION IN OVERACTIVE BLADDER EXPOSED THROUGH CULTURE OF URINARY SPUN SEDIMENT. INT UROGYNECOL J, 20, S114 - S115.
- Madani R, Karastergiou K, Ogston NC, Bhome R, Haloob N, Tan GD, Karpe F, Malone-Lee J, Jahangiri M, Hashemi M, Mohamed-Ali V Mohamed-Ali V (2009). RANTES release by human adipose tissue in vivo and evidence for depot specific differences.. American Journal of Physiology - Endocrinology and Metabolism, 296(6), E1262 - E1268. doi:10.1152/ajpendo.90511.2008
- Malone-Lee JG, Al-Buheissi S (2009). Does urodynamic verification of overactive bladder determine treatment success? Results from a randomized placebo-controlled study.. BJU Int, 103(7), 931 - 937. doi:10.1111/j.1464-410X.2009.08361.x
- Contreras-Sanz A, Janska S, Alexander SLH, Lunawat R, Bishara S, Khasriya R, Taylor KMG, Malone-Lee J, Wildman SSP (2009). Increased urothelial ATP release from a subset of OAB patients. FASEB JOURNAL, 23, - .
- Sui G, Fry CH, Malone-Lee J, Wu C (2009). Aberrant Ca2+ oscillations in smooth muscle cells from overactive human bladders.. Cell Calcium, 45(5), 456 - 464. doi:10.1016/j.ceca.2009.03.001
- Idriz S, Gao H, Malone-Lee M, Lunawat R, Khan S, Khasriya R, Malone-Lee J, Bishara S (2009). BLADDER CANCER IS NOT ASSOCIATED WITH IRRITATIVE LOWER URINARY TRACT SYMPTOMS.
- Bishara S, Gao H, Khasriya R, Lunawat R, Malone-Lee M, Malone-Lee J, King BF (2009). PATIENTS WITH OAB HAVE LONGER MORE CONTRACTED BLADDER MUSCLE CELLS THAN CONTROLS. INT UROGYNECOL J, 20, S150 - S151.
- Idriz S, Bishara S, Kirkham A, Rickards D, Julian P, Shah R, Malone-Lee J (2009). The comparative pressure-flow plot properties of radiological bladder neck and prostatic obstruction. BJU INT, 104(11), 1670 - 1675. doi:10.1111/j.1464-410X.2009.08679.x
- Khan S, Chandhyoke N, Bishara S, Mahmood W, Khasriya RK, Lunawat R, Malone-Lee J (2009). THE PRESERVATION OF PYURIA IN URINE SAMPLES WITH BORIC ACID. INT UROGYNECOL J, 20, S132 - S133.
- Bishara S, Gao H, Malone-Lee M, Clark S, Lunawat R, Khan S, Khasriya R, King B, Malone-Lee J (2009). INCREASED ATP MEDIATED CONTRACTION OF ISOLATED DETRUSOR CELLS OF PATIENTS WITH OUTFLOW OBSTRUCTION.
- Lunawat R, Khasriya R, Bishara S, Maraj B, Falzon M, Malone-Lee J (2009). HISTOLOGICAL EVIDENCE OF UBIQUITOUS OCCURRENCE OF CHRONIC CYSTITIS IN UROTHELIAL BIOPSIES FROM PATIENTS WITH SYMPTOMS OF OVERACTIVE BLADDER AND NORMAL URINANALYSIS. NEUROUROLOGY AND URODYNAMICS, 28(7), 754 - 755.
- Khan S, Khasriya RK, Badiani R, Lunawat R, Bishara S, Malone-Lee J (2009). THE STERNHEIMER-MALBIN STAIN AS A MEANS OF ENHANCING, MICROSCOPY OF FRESH URINE SAMPLES IN OAB PATIENTS. INT UROGYNECOL J, 20, S185 - S186.
- Khan S, Khasriya R, Bishara S, Mahmood W, Chandhyoke N, Mohenden M, Malone-Lee J (2009). PRESERVATION OF URINARY WHITE CELLS TO ENABLE ADOPTION OF MICROSCOPY OF UNSPUN URINE FOR PYURIA INTO ORDINARY CLINICAL ASSESSMENT PROTOCOLS OF LOWER URINARY TRACT SYMPTOMS.
- (2008). Absorbent products for urianry/faecal incontinence: a comparative evaluation of key product designs. Health Techonology Assessment, 12(29), 1 - 208.
- Khasriya R, Bignall J, Khan S, Malone-Lee J (2008). Routine MSU culture in patients with symptoms of OAB may be missing many genuine infections. INT UROGYNECOL J, 19, S48 - S49.
- Fader M, Cottenden A, Getliffe K, Gage H, Clarke-O'Neill S, Jamieson K, Green N, Williams P, Brooks R, Malone-Lee J (2008). Absorbent products for urinary/faecal incontinence: a comparative evaluation of key product designs - Introduction. HEALTH TECHNOL ASSES, 12(29), 1 - +.
- Fader M, Cottenden A, Getliffe K, Gage H, Clarke-O'Neill S, Jamieson K, Green N, Williams P, Brooks R, Malone-Lee J (2008). Absorbent products for urinary/faecal incontinence: a comparative evaluation of key product designs.. Health Technol Assess, 12(29), iii - 185.
- Malone-Lee J (2008). A defence of rigorous method in clinical science.. Neurourol Urodyn, 27(6), 462 - 465. doi:10.1002/nau.20550
- Al-Buheissi S, Khasriya R, Maraj BH, Malone-Lee J (2008). A simple validated scale to measure urgency.. J Urol, 179(3), 1000 - 1005. doi:10.1016/j.juro.2007.10.075
- Khasriya R, Bhome R, Khan S, Ali V, Malone-Lee J (2008). Urinary Interleukin-6 and pyuria in patients with symptoms of OAB. INTERNATIONAL UROGYNECOLOGY JOURNAL, 19, S42 - S43.
- Bishara S, Shah J, Malone-Lee J, King B, Fry C (2008). M2 receptor activation modulates human and guinea pig detrusor contractions via cAMP inhibition.
- Khasriya R, Khan S, Bignall J, Lunawat R, Malone-Lee J (2008). Routine MSU culture in patients with symptoms of OAB may be missing many genuine infections.
- Fader M, Glickman S, Haggar V, Barton R, Brooks R, Malone-Lee J (2007). Intravesical atropine compared to oral oxybutynin for neurogenic detrusor overactivity: a double-blind, randomized crossover trial.. The Journal of Urology, 177(1), 208 - 213. doi:10.1016/j.juro.2006.08.099
- Idriz S, Kirkham A, Rickards D, Malone-Lee JG (2007). The failure of cystometric pressure/flow plots in characterising bladder outflow obstruction.
- Ghei M, Maraj BH, Miller R, Nathan S, O'Sullivan C, Fowler CJ, Shah PJ, Malone-Lee J (2005). Effects of botulinum toxin B on refractory detrusor overactivity: a randomized,. The Journal of Urology, 174, 1873 - 1877.
- Pearson J, Winslet M, Malone-Lee J, Abberton E, Lovat L, Fourcin A, Hashemi M (2005). Objective measurement of voice irregularity associated with gastro-esophageal reflux disease.
- Ghei M, Nathan S, Maraj BH, Malone-Lee JG, Miller R (2005). A day case technique for administration of intradetrusor Botulinum toxin B under sedo-analgesia in neuropathic and non-neuropathic detrusor overactivity: Endoscopic Neurostabilisation (ENS).. Int Urol Nephrol, 37(3), 471 - 472. doi:10.1007/s11255-004-4736-y
- Fall M, Baranowski AP, Fowler CJ, Lepinard V, Malone-Lee JG, Messelink EJ, Oberpenning F, Osborne JL, Schumacher S European Association of UROLOGY (2004). EAU guidelines on chronic pelvic pain.. European Urology, 46(6), 681 - 689.
- Gluck T, Wagg A, Fry C, Malone-Lee J (2004). Effects of biochemical changes to filling media during urodynamic testing in women with lower urinary tract symptoms.. Scandinavian Journal of Urology and Nephrology - Supplementum, (215), 58 - 62.
- Wagg A, Malone-Lee J (2003). Pressure-flow variables in patients treated with tolterodine for detrusor overactivity. BJU International, 92(9), 969 - 971.
- Fader M, Clarke-O'Neill S, Cook D, Dean G, Brooks R, Cottenden A, Malone-Lee J (2003). Management of night-time urinary incontinence in residential settings for older people: an investigation into the effects of different pad changing regimes on skin health. Journal of Clinical Nursing, 12(3), 374 - 386.
- Malone-Lee J, Henshaw DJ, Cummings K (2003). Urodynamic verification of an overactive bladder is not a prerequisite for antimuscarinic treatment response. BJU International, 92(4), 415 - 417.
- Ferrari J, Malone-Lee J (2003). A radiographic study of the relationship between metatarsus adductus and hallux valgus. Journal of Foot and Ankle Surgery, 42(1), 9 - 14.
- Macaulay M, Clarke-O'Neill S, Fader M, Cottenden A, Malone-Lee J (2003). The user perspective on the use of washable absorbent bodyworn products for incontinence.
- Fader M, Clarke-O'Neill S, Cook D, Cottenden A, Malone-Lee J (2003). An investigation into night-time self-turning by nursing home residents. Journal of Clinical Nursing, 12(1), 147 - 148.
- Ferrari J, Malone-Lee J (2002). The shape of the metatarsal head and its relationship to hallux abductovalgus. Foot and Ankle International, 23(3), 236 - 242.
- Ferrari J, Malone-Lee J (2002). The shape of the metatarsal head as a cause of hallux abductovalgus. Foot and Ankle International, 23(3), 236 - 242.
- Ferrari J, Malone-Lee J (2002). Relationship between proximal articular set angle and hallux abducto valgus. Journal of the American Podiatric Medical Association, 92(6), 331 - 335.
- Malone-Lee JG, Walsh JB, Maugourd MF (2001). Tolterodine: a safe and effective treatment for older patients with overactive bladder. Journal of the American Geriatrics Society, 49(6), 700 - 705.
- Moore KN, Murray S, Malone-Lee J, Wagg A (2001). Rapid urinalysis assays for the diagnosis of urinary tract infection. British Journal of Nursing, 10(15), 995 - 1001.
- Abrams P, Malone-Lee J, Jacquetin B, Wyndaele JJ, Tammela T, Jonas U, Wein A (2001). Twelve-month treatment of overactive bladder: efficacy and tolerability of tolterodine. DRUGS AND AGING, 18(7), 551 - 560.
- Malone-Lee J, Shaffu B, Anand C, Powell C (2001). Tolterodine: superior tolerability than and comparable efficacy to oxybutynin in individuals 50 years old or older with overactive bladder: a randomized controlled trial. The Journal of Urology, 165(5), 1452 - 1456.
- Fader M, Pettersson L, Dean G, Brooks R, Cottenden AM, Malone-Lee J (2001). Sheaths for urinary incontinence: a randomized crossover trial. BJU International, 88(4), 367 - 372.
- Fader M, Moore KN, Cottenden AM, Pettersson L, Brooks R, Malone-Lee J (2001). Coated catheters for intermittent catheterization: smooth or sticky?. BJU International, 88(4), 373 - 377.
- Birns J, Lukkari E, Malone-Lee JG (2000). A randomized controlled trial comparing the efficacy of controlled-release oxybutynin tablets (10 mg once daily) with conventional oxybutynin tablets (5 mg twice daily) in patients whose symptoms were stabilized on 5 mg twice daily of oxybutynin.. BJU Int, 85(7), 793 - 798.
- Malone-Lee JG (2000). The efficacy, tolerability and safety profile of tolterodine in the treatment of overactive/unstable bladder. REV CONTEMP PHARMACO, 11(1), 29 - 42.
- Wagg AS, Malone-Lee JG, Fry CH (1998). An in vitro investigation into the active and passive components of viscoelastic relaxation in human bladder.
- Orrell RW, Jurkat-Rott K, Lehmann-Horn F, Lane RJ (1998). Familial cramp due to potassium-aggravated myotonia.. Journal of Neurology, Neurosurgery and Psychiatry, 65(4), 569 - 572.
- Deaney C, Glickman S, Gluck T, Malone-Lee JG (1998). Intravesical atropine suppression of detrusor hyperreflexia in multiple sclerosis.. J Neurol Neurosurg Psychiatry, 65(6), 957 - 958.
- Wagg AS, Malone-Lee JG, Fry CH (1998). An in vitro investigation into the active and passive components of visco-elastic relaxation in human bladder. J PHYSIOL-LONDON, 507P, 77P - 77P.
- Malone-Lee JG, Szonyi G (1998). The validity of efficacy measures of interventions for detrusor instability. J PHYSIOL-LONDON, 507P, 21P - 21P.
- Lieu PK, Sa'adu A, Orugun EO, Malone-Lee JG (1997). The influence of age on isometric and isotonic rat detrusor contractions.. J Gerontol A Biol Sci Med Sci, 52(2), M94 - M96.
- Fader M, Pettersson R, Brookes R, Dean G, Wells M, Cottenden A, Malone-Lee J (1997). A multicentre comparative evaluation of catheter valves. BRITISH J NURSING, 6(7), 359 - 367.
- Gray R, Wagg A, Malone-Lee JG (1997). Differences in detrusor contractile function in women with neuropathic and idiopathic detrusor instability.. Br J Urol, 80(2), 222 - 226.
- Wagg AS, Lieu PK, Ding YY, Malone-Lee JG (1996). A urodynamic analysis of age associated changes in urethral function in women with lower urinary tract symptoms.. J Urol, 156(6), 1984 - 1988.
- Collas DM, Malone-Lee JG (1996). Age-associated changes in detrusor sensory function in women with lower urinary tract symptoms.. Int Urogynecol J Pelvic Floor Dysfunct, 7(1), 24 - 29.
- Szonyi G, Collas DM, Ding YY, Malone-Lee JG (1995). Oxybutynin with bladder retraining for detrusor instability in elderly people: a randomized controlled trial.. Age Ageing, 24(4), 287 - 291.
- Ding YY, Malone-Lee JG (1993). Glyceryl trinitrate and external urethral sphincter spasm.. Br J Urol, 72(6), 986 - .
- Harari D, Malone-Lee JG (1991). Oxybutynin and incontinence during grand mal seizures.. Br J Urol, 68(6), 658 - .
- Fader M, Barnes KE, Malone-Lee JG, Cottenden A (1987). Choosing the right garment. Nursing Times, (Apr 15), 78 - 85.
- Fader M, Barnes K, Malone-Lee J, Cottenden A (1986). Hospital Equipment Information Report No 159: Incontinence garments.