Professional background

Professor David Ralph is professor of urology at UCLH and UCL, London since 1996. His training included general surgery at St Thomas’s and St Mary’s Hospitals London, and urology at Leeds and the St Peter’s Hospitals London. He is a fellow of both the London and Edinburgh surgical colleges and has also obtained a BSc in biochemistry and an MS in London.

Since appointed in 1996, he has built up the andrology department at UCLH from a single man unit into a department of six consultants, six clinical fellows, MD and PhD students and junior staff. It is now the largest, most prestigious andrology department in the world with over 50 international observerships per year and the highest number of tertiary referrals in the UK.

His practice is entirely confined to andrology with the main interests being penile reconstruction, Peyronie’s disease, erectile dysfunction with penile prosthesis insertion and male infertility. He currently inserts over 200 penile implants per year. He runs a large multidisciplinary erectile dysfunction service with a European training fellowship for penile prosthesis implantation and is director of the Erectile Dysfunction Clinical Trials Unit.

He has held many prestigious positions, the most notable including the chairman of the BAUS section of andrology, president of the British Society of Sexual Medicine and president of the European Society for Sexual Medicine (ESSM). He is currently chairman of The European Society of Genitourethral Reconstructive Surgeons, president of the Sexual Advice Association charity and a specialist advisor to NICE.

He founded the national penile cancer centre at UCLH, the international training centre for penile prostheses insertion and the major phallic reconstruction unit. It is also the biggest priapism centre in the UK.

He has over 250 peer-reviewed publication, 60 chapters and books, 500 international presentations and 500 invited lectures. He has been awarded the Brantley Scott medal in 2016 for recognition of his international contribution to prosthetic urology and the British Society For Sexual Medicine career award in 2017.


Research interests

  • Peyronie's disease
  • Penile Prosthesis
  • Erectile dysfunction
  • Priapism
  • Male infertility
  • Genital microsurgery
  • Phalloplasty
  • Adolescent genital pathology 


Most recent publications

Floppy Glans-Classification, Diagnosis and Treatment.
Skrodzka M, Heffernan Ho D, Ralph D.Sex Med Rev. 2020 Apr;8(2):303-313

The surgical management of ischaemic priapism.
Johnson MJ, Kristinsson S, Ralph O, Chiriaco G, Ralph D.Int J Impot Res. 2020 Jan;32(1):81-88.

Review of penile reconstructive techniques.
Kristinsson S, Johnson M, Ralph D.Int J Impot Res. 2020 Mar 9.

Which patients with ischaemic priapism require further investigation for malignancy?
James Johnson M, Hallerstrom M, Alnajjar HM, Frederick Johnson T, Skrodzka M, Chiriaco G, Muneer A, Ralph DJ.Int J Impot Res. 2020 Mar;32(2):195-200.

Prosthetic Placement After Phalloplasty.
Blecher GA, Christopher N, Ralph DJ.
Urol Clin North Am. 2019 Nov;46(4):591-603.

Microdissection TESE (mTESE) following adult orchidopexy for undescended intra-abdominal and inguinal testicles - surgical techniques and outcomes from a single-centre cohort.
Sangster P, Alnajjar HM, Ahmed K, Christodoulidou M, Williamson E, Kelly JD, Dawas K, Ralph D, Muneer A.
Andrology. 2019 Jul 10.

Penile Reconstruction and the Role of Surgery in Gender Dysphoria.
Lee WG, Christopher N, Ralph DJ.
Eur Urol Focus. 2019 5(3):337-339

Subjective and objective results in surgical correction of adult acquired buried penis: A single-centre observational study.
Cocci A, Cito G, Falcone M, Capece M, Di Maida F, Morelli G, Christopher N, Ralph D, Garaffa G.
Arch Ital Urol Androl. 2019 Mar 29;91(1):25-29.

Repair of the penile suspensory ligament for congenital and acquired pathology.
Ralph O, Shroff N, Anfosso M, Blecher G, Ralph D.
BJU Int. 2019 Mar 22.. [Epub ahead of print]

Immediate Placement of a Penile Prosthesis as First-line Treatment for the Management of Ischaemic Priapism.
Muneer A, Ralph DJ.
Eur Urol Focus. 2019 (4):529-530.

Penile length is preserved after implant surgery.
Habous M, Giona S, Tealab A, Aziz M, Sherif H, Abdelwahab O, Binsaleh S, Ralph D, Bettocchi C, Mulhall JP, Muir G.
BJU Int. 2019 May;123(5):885-890.

Antifibrotic Synergy Between Phosphodiesterase Type 5 Inhibitors and Selective Oestrogen Receptor Modulators in Peyronie's Disease Models.
Ilg MM, Mateus M, Stebbeds WJ, Milenkovic U, Christopher N, Muneer A, Albersen M, Ralph DJ, Cellek S.
Eur Urol. 2019 Feb;75(2):329-340

Johnson M, Raheem A, De Luca F, Hallerstrom M, Zainal Y, Poselay S, Mohammadi B, Moubasher A, Johnson TF, Muneer A, Sangster P, Ralph DJ.
An analysis of the frequency of Y-chromosome microdeletions and the determination of a threshold sperm concentration for genetic testing in infertile men.
BJU Int. 2019 Feb;123(2):367-372.

Habous M, Tal R, Tealab A, Aziz M, Sherif H, Mahmoud S, Abdelwahab O, Nassar M, Kamil U, Abdelrahman Z, Binsaleh S, Giona S, Ralph D, Bettocchi C, Mulhall JP.
Predictors of Satisfaction in Men After Penile Implant Surgery.
J Sex Med. 2018 Aug;15(8):1180-1186.

Mateus M, Ilg MM, Stebbeds WJ, Christopher N, Muneer A, Ralph DJ, Cellek S.
Understanding the Role of Adenosine Receptors in the Myofibroblast Transformation in Peyronie's Disease.
J Sex Med. 2018 Jul;15(7):947-957

Chung E, Wang R, Ralph D, Levine L, Brock G.
A Worldwide Survey on Peyronie's Disease Surgical Practice Patterns Among Surgeons.
J Sex Med. 2018 Apr;15(4):568-575.

Habous M, Tealab A, Farag M, Soliman T, Williamson B, Mahmoud S, Elserafy A, Mekawi Z, Remeah A, Nassar M, Laban O, Abdelwahab O, Binsaleh S, Giona S, Ralph D, Mulhall J.
Malleable Penile Implant Is an Effective Therapeutic Option in Men With Peyronie's Disease and Erectile Dysfunction
Sex Med. 2018 Mar;6(1):24-29.

Castiglione F, Ralph DJ, Muneer A
Surgical Techniques for Managing Post-prostatectomy Erectile Dysfunction
Cur sex health rep 2017: 18(11):9

Kousournas G, Muneer A, Ralph D, Zacharakis E
Contemporary best practice in the evaluation and management of stuttering priapism
Ther Adv Urol 2017:9(9-10):227-238

Von Stempel C, Zacharakis E, Allen C, Ramachandran N, Walkden M, Minhas S, Muneer A, Ralph D, Freeman A, Kirkham A
Mean velocity and peak systolic velocity can help determine ischaemic and non-ischaemic priapism
Clin Rad 2017:72(7):8

Kalejaiye O, Raheem AA, Moubasher A, Capece M, McNeillis S, Muneer A, Christopher AN, Garaffa G, Ralph DJ.
Sleep disorders in patients with erectile dysfunction. BJU Int. 2017 Jul 15(Epub ahead of print)

Falcone M, Garaffa G, Raheem A, Christopher NA, Ralph DJ
The outcome of penile prosthesis insertion in 247 patients completing female to male gender reassignment surgery.
BJUInt. 2018 Jan;121(1):139-144

Garcia Gomez B, Ralph DJ, Albersen M, Moncarda I, Romero JO
Grafts for Peyronie’s Disease: a comprehensive review
Andrology. 2018 Jan;6(1):117-126

Falcone M, Garaffa G, Castligone F, Ralph DJ
Current management of penile fracture: an up to date systematic review.
Sex Med Rev 2018 Apr;6(2):253-260

Johnson M, Parnham A, Ralph DJ
Priapism: A rare initial presentation for chronic lymphocytic leukaemia.
J Clin Urol: 2017: 1-2:

Wilson SK, Mora-Estaves C, Egydio P, Ralph D, Habous M, Love C, Shamsodini A, Valenzuela R, Yafi FA.
Glans Necrosis Following Penile Prosthesis Implantation: Prevention and Treatment Suggestions. Urology. 2017:107:144-148

Abdel Raheem A, Capece M, Kalejaiye O, Abdel-Raheem T, Falcone M, Johnson M, Ralph OG, Garaffa G, Christopher AN, Ralph DJ.
Safety and effectiveness of collagenase clostridium histolyticum in the treatment of Peyronie's disease using a new modified shortened protocol.
BJU Int. 2017 120(5):717-723

Aleid M, Muneer A, Renshaw S, George J, Jenkinson AD, Adamo M, Elkalaawy M, Batterham RL, Ralph DJ, Hashemi M, Cellek S.
Early Effect of Bariatric Surgery on Urogenital Function in Morbidly Obese Men.
J Sex Med. 2017 Feb;14(2):205-214.

De Luca F, Garaffa G, Falcone M, Raheem A, Zacharakis E, Shabbir M, Aljubran A, Muneer A, Holden F, Akers C, Christopher N, Ralph DJ.
Functional outcomes following immediate repair of penile fracture: a tertiary referral centre experience with 76 consecutive patients.
Scand J Urol. 2017 Apr;51(2):170-175

Garaffa G, Ralph DJ.
Free Flap Phalloplasty For Female To Male Gender Dysphoria.
J Sex Med. 2016 Dec;13(12):1942-1947

Falcone M, Garaffa G, Raheem A, Christopher NA, Ralph DJ
Total phallic reconstruction using the radial artery based forearm free flap after traumatic penile amputation. J Sex Med. 2016; 13(7):1119-24.

Chung E and Ralph D, Kagioglu A, Garaffa G, Shamsodini A, Bivalacqua T, Glina S, Hakim L, Sadeghi-Nejad H, Broderick G.
Evidence based management guidelines on Peyronie’s Disease. J Sex Med. 2016;13(6):905-23.

A Muneer and DJ Ralph. Guideline of Guidelines- Priapism
BJUInt 2016; Nov 14 Epub ahead of print

 Modgil V, Rai S, Ralph DJ, Muneer A. An update on the diagnosis and management of ejaculatory duct obstruction.Nat Rev Urol. 2016;13(1):13-20

Zacharakis E, Ralph DJ, Walkden M, Muneer A.
Distal corpus cavernosum fibrosis and erectile dysfunction secondary to non-ischaemic priapism. Arch Ital Urol Androl. 2015;87(3):258-9.

Garaffa G, Ralph DJ.
Is the modified sliding technique the way forward in Peyronie's surgery?
BJU Int. 2015;116(6):840-1.

Zacharakis E, De Luca F, RaheemA, Garaffa G,Christopher AN, Muneer A, Ralph DJ. Early insertion of a malleable penile prosthesis in ischaemic priapism allows later upsizing of the cylinders. Scand J Urol. 2015; Jun 2 1-4

Garaffa G, Kuehhas FE, De Luca F, Ralph DJ
Long term results of reconstructive surgery for Peyronie’s Disease
Sex Med Rev 2015; 3: 113-121

Levine LA, Cuzin B, Mark S, Gelbard MK, Jones NA, Liu G, Kaufman GJ, Tursi JP, Ralph DJ . Clinical Safety and Effectiveness of Collagenase Clostridium Histolyticum Injection in Patients with Peyronie's Disease: A Phase 3 Open-Label Study. J Sex Med. 2015;12(1):248-58.

Abdel Raheem A, Ralph D.
Penile vibratory stimulation: a novel approach for penile rehabilitation after nerve-sparing radical prostatectomy. BJU Int. 2014;114(1):2-3.

Cellek S, Ralph DJ. Histone deacetylase inhibition: a new target for Peyronie's disease? BJU Int. 2014;114(6):796.

Zacharakis E, Garaffa G, Raheem AA, Christopher AN, Muneer A, Ralph DJ.
Penile prosthesis insertion in patients with refractory ischaemic priapism: early vs delayed implantation. BJU Int. 2014;114(4):576-81.

Kalsi JS, Shah P, Thum Y, Muneer A, Ralph DJ, Minhas S.
Salvage micro-dissection testicular sperm extraction; Outcome in men with Non obstructive azoospermia with previous failed sperm retrievals.BJU Int. 2014; 116(3):460-5

Garaffa G, Spilotros M, Christopher NA, Ralph DJ.
Total phallic reconstruction using the radial artery based free flap phalloplasty in patients with the epispadias-exstrophy complex.
J Urol. 2014;192(3):814-20.

Zacharakis E, Raheem AA, Freeman A, Skolarikos A, Garaffa G, Christopher AN, Muneer A, Ralph DJ.
The Efficacy of the T-Shunt Procedure and Intracavernous Tunneling (Snake Maneuver) for the Management of Refractory Ischemic Priapism.
J Urol. 2014;191(1):164-8.

Garaffa G, Ralph DJ Penile prosthesis implantation in acute and chronic priapism. Sexual Med Rev 2013; 1: 76-82

Abdel Raheem A, Rushwan N, Garaffa G, Zacharakis E, Doshi A, Heath C, Serhal P, Harper JC, Christopher NA, Ralph D.
Factors influencing intracytoplasmic sperm injection (ICSI) outcome in men with azoospermia. BJU Int. 2013;112(2):258-64.

Fode M, Ohl DA, Ralph D, Sønksen J.
Penile rehabilitation after radical prostatectomy: what the evidence really says.
BJU Int. 2013;112(7):998-1008

Philippou P, Shabbir M, Ralph DJ, Malone P, Nigam R, Freeman A, Muneer A, Minhas S. Genital lichen sclerosus/balanitis xerotica obliterans in men with penile carcinoma: a critical analysis. BJU Int. 2013;111(6):970-6

Garaffa G, Ralph DJ
Penile length and girth restoration in severe Peyronie's Disease using circular and longitudinal grafting. BJU Int. 2013 111(4 pt B).

Kayes O, Shabbir M, Ralph D, Minhas S.
Therapeutic strategies for patients with micropenis or penile dysmorphic disorder.
Nat Rev Urol. 2012 ;9(9):499-507

Garaffa G, Antonini G, Gentile V, Ralph DJ
Phalloplasty in the genetic male
Transl Androl Urol 2012;1(2)103-8.