Dr Jalesh Panicker works as a consultant neurologist in uro-neurology at The National Hospital for Neurology and Neurosurgery, and is a reader in uro-neurology and clinical neurology at the University College London (UCL) Queen Square Institute of Neurology.
He is clinical lead for uro-neurology, and together with a team that includes a urologist, uro-gynaecologist, gastroenterologist, nursing, health psychologist and clinical scientists performing urodynamics and pelvic neurophysiology tests. The Department of Uro-Neurology offers a holistic, multi-disciplinary approach to the evaluation and treatment of bladder, bowel and sexual dysfunction in patients with established and suspected neurological disorders.
Dr Panicker qualified in 1996 and subsequently trained in both general medicine and neurology. He became involved in the management of patients with neurogenic bladder dysfunction early in his career when setting up a neurorehabilitation service. He maintains an academic and clinical interest in uro-neurology and pelvic neurology and his primary interest is in understanding the neural control of the lower urinary tract, and the neurological basis for bladder and sexual dysfunction following inflammatory, degenerative and traumatic disorders of the nervous system and their management.
In his dedicated uro-neurology clinics, he sees patients across a wide range of neurological disorders that include multiple sclerosis and related inflammatory disorders, dementias, Parkinson’s disease and Parkinson's plus syndromes, spinal cord tumour and traumatic disorders such as cauda equina syndrome. A growing number of patients with unexplained bladder, sexual and bowel dysfunction are being referred for evaluating a possible neurological cause, and he leads a dedicated pelvic neurology service that includes pelvic neurophysiology testing evaluating the afferent and efferent sacral somatic innervation, urodynamics testing and close links with neuroradiology. The department runs a dedicated service for young women presenting with unexplained urinary retention, many of whom ultimately are found to have a primary disorder of sphincter relaxation (Fowler’s syndrome).
Dr Panicker is involved in the training of health care professionals from the United Kingdom and overseas across different specialities. He is involved in the running of MSc courses and PhD supervision at UCL, and his clinical research is supported by external grants. He has edited two books, and published more than 150 peer-reviewed articles and 35 book chapters.
Dr Panicker has an academic interest in uro-neurology and pelvic neurology and his clinical research into understanding the neural control of the lower urinary tract and the neurological basis for bladder and sexual dysfunction following inflammatory, degenerative and traumatic disorders of the nervous system and their management is supported by external grants.
Current areas of research:
• Melatonin for the treatment of Nocturia in adults with Parkinson’s disease
• A magnetic resonance imaging study evaluating the central control of lower urinary tract functions in patients with neurogenic and idiopathic overactive bladder
• STARTUP (Stimulation of the Tibial Nerve – A randomised trial for urinary problems associated with Parkinson’s)
• Pelvic neurophysiology and urodynamics findings in patients with MOG positive Transverse Myelitis
• Sexual dysfunction in women with neurological disorders
• Sensitivity of intracellular sodium accumulation to tissue damage in spinal cord injury: a multi-parameter study
• Exploring the relationship between sexual trauma and lower urinary tract symptoms
• Exploring psychological co-morbidities in women with Urinary retention
• Exploring the clinical relevance of sacral Tarlov cysts- pelvic neurophysiology and urodynamics study
• Exploring voiding dysfunction in Parkinson’s Disease
Top 15 out of > 150 peer reviewed publications and > 35 book chapters.
Li V, Panicker JN, Haslam C, Chataway J. Use of a symptom-based questionnaire to screen for the presence of significant voiding dysfunction in patients with multiple sclerosis and lower urinary tract symptoms: a pilot study. J Neurol 2020. doi: 10.1007/s00415-020-10068-2.
Panicker JN, Sakakibara R. Lower Urinary Tract and Bowel Dysfunction in Neurologic Disease.Continuum 2020;26(1):178-199. doi: 10.1212/CON.0000000000000824.
Panicker JN, Marcelissen T, von Gontard A, Vrijens D, Abrams P, Wyndaele M. Bladder-bowel interactions: Do we understand pelvic organ cross-sensitization? International Consultation on Incontinence Research Society (ICI-RS) 2018. Neurourol Urodyn 2019;38: Suppl 5:S25-S34. doi: 10.1002/nau.24111.
Panicker JN, Selai C, Herve F, Rademakers K, Dmochowski R, Tarcan T, von Gontard A, Vrijens D.Psychological comorbidities and functional neurological disorders in women with idiopathic urinary retention: International Consultation on Incontinence Research Society (ICI-RS) 2019. Neurourol Urodyn 2020 Jul;39 Suppl 3:S60-S69. doi: 10.1002/nau.24233.
Panicker JN, Schubert M. What Is the Role for Pelvic Neurophysiology Testing in Neurourology Practice? Eur Urol Focus. 2020;6(5):811-813. doi: 10.1016/j.euf.2019.11.001.
Polat Dunya C, Tulek Z, Uchiyama T, Haslam C, Panicker JN. Systematic review of the prevalence, symptomatology and management options of sexual dysfunction in women with multiple sclerosis.Neurourol Urodyn 2020;39(1):83-95. doi: 10.1002/nau.24232.
Panicker JN, Simeoni S, Miki Y, Batla A, Iodice V, Holton JL, Sakakibara R, Warner TT. Early presentation of urinary retention in multiple system atrophy: can the disease begin in the sacral spinal cord? J Neurol 2020 Mar;267(3):659-664. doi: 10.1007/s00415-019-09597-2.
Stankovic I, Quinn N, Vignatelli L, Antonini A, Berg D, Coon E, Cortelli P, Fanciulli A, Ferreira JJ, Freeman R, Halliday G, Höglinger GU, Iodice V, Kaufmann H, Klockgether T, Kostic V, Krismer F, Lang A, Levin J, Low P, Mathias C, Meissner WG, Kaufmann LN, Palma JA, Panicker JN, Pellecchia MT, Sakakibara R, Schmahmann J, Scholz SW, Singer W, Stamelou M, Tolosa E, Tsuji S, Seppi K, Poewe W, Wenning GK; Movement Disorder Society Multiple System Atrophy Study Group. A critique of the second consensus criteria for multiple system atrophy. Mov Disord. 2019 Jul;34(7):975-984. doi: 10.1002/mds.27701.
Yiannakas MC, Liechti MD, Budtarad N, Cullinane P, Yang X, Toosy AT, Panicker JN, Gandini Wheeler-Kingshott CAM. Gray vs. White Matter Segmentation of the Conus Medullaris: Reliability and Variability in Healthy Volunteers. J Neuroimaging. 2019 May;29(3):410-417. doi: 10.1111/jon.12591.
Salatzki J, Liechti MD, Spanudakis E, Gonzales G, Baldwin J, Haslam C, Pakzad M, Panicker JN. Factors influencing return for maintenance treatment with percutaneous tibial nerve stimulation for the management of the overactive bladder. BJU Int. 2019 May;123(5A):E20-E28. doi: 10.1111/bju.14651.
Seth JH, Gonzales G, Haslam C, Pakzad M, Vashisht A, Sahai A, Knowles C, Tucker A, Panicker J. Feasibility of using a novel non-invasive ambulatory tibial nerve stimulation device for the home-based treatment of overactive bladder symptoms. Transl Androl Urol. 2018 Dec;7(6):912-919. doi: 10.21037/tau.2018.09.12.
Panicker JN, Anding R, Arlandis S, Blok B, Dorrepaal C, Harding C, Marcelissen T, Rademakers K, Abrams P, Apostolidis A. Do we understand voiding dysfunction in women? Current understanding and future perspectives: ICI-RS 2017. Neurourol Urodyn. 2018 Jun;37(S4):S75-S85. doi: 10.1002/nau.23709.
Phé V, Pakzad M, Haslam C, Gonzales G, Curtis C, Porter B, Chataway J, Panicker JN. Open label feasibility study evaluating D-mannose combined with home-based monitoring of suspected urinary tract infections in patients with multiple sclerosis. Neurourol Urodyn. 2016 Nov 4. doi: 10.1002/nau.23173.
Batla A, Phé V, De Min L, Panicker JN. Nocturia in Parkinson's Disease: Why Does It Occur and How to Manage? Movement Disorders Clinical Practice 2016: (online ahead of print).
Panicker JN, Fowler CJ, Kessler TM. Lower urinary tract dysfunction in the neurological patient: clinical assessment and management. Lancet Neurol. 2015;14(7):720-32. doi: 10.1016/S1474-4422(15)00070-8.