Around 10,000 people are diagnosed with bladder cancer each year. It often happens because harmful things like cigarette smoke can damage the bladder lining.   

The most common symptom is blood in the urine. If you have this see your GP immediately.  

The first step to treatment is finding out what stage your cancer is at. This is usually done with an operation called TURBT to remove the growth from the bladder to see how deep in the bladder wall it is (Day case TURBT (Transurethral Resection of the Bladder Tumour).  You may also have a scan of the rest of the body. 

Treatment for bladder cancer depends on how deep it is in the bladder wall. If it is just inside the bladder it is called intravesical.  

If it involves the lining and muscles of the bladder this is called invasive. This is a serious diagnosis and often you will need both chemotherapy and surgery to treat it. 

Find out more about treatments for bladder cancer: 

• Treatment for bladder cancer | Macmillan Cancer Support
• Action Bladder Cancer UK
• Fight Bladder Cancer 

Treatment for bladder can include surgery. Bristol Urological Institute has the most experienced surgeons in the country who provide robotic surgery for bladder cancer. Robotic assisted surgery allows smaller incisions (cuts), less blood loss, and less anaesthesia needed. This means patients recover far more quickly.

Our consultants Mr Koupparis and Mr Rowe were the first in the country to remove a patient’s bladder due to cancer and reconstruct a new bladder out of bowel using the Da Vinci robotic surgical platform. 

Kidney cancer is also known as renal cancer and is most common in people over 60.  

Find out more about kidney cancer, symptoms, treatment, and recovery:

• Home - Kidney Cancer UK
• Kidney cancer | Macmillan Cancer Support 

Cancer of the penis is quite rare. If you have any symptoms you will need further tests like a biopsy, lymph node aspiration, and scans like a CT scan.  

Once we have the results of your tests, we will work out the right treatment with you. This may be a combination of treatments that could include: 

• Surgery to remove the cancer, and possibly to reconstruct the penis.
• Radiotherapy.
• Chemotherapy.  

Find out more about penile cancer, symptoms, treatment, and recovery: 

• Penile cancer | Macmillan Cancer Support.
• Orchid Fighting Male Cancer 

Prostate cancer is the most common cancer in men in the UK. Slow-growing prostate cancer is more common and does not always cause symptoms or shorten life. It is often found on a routine blood screening. More aggressive prostate cancer can cause problems urinating (peeing) and can spread to other parts of the body like bones. 

At Bristol Urological Institute we have some of the most experienced prostate cancer specialists in the country. We work with our oncology colleagues and a team of specialist nurses. 

Find out more about treatments you may have for prostate cancer:

• Brachytherapy
• External radiotherapy
• Active surveillance
• High intensity focused ultrasound (HIFU)
• Robotic Assisted Laparoscopic Prostatectomy   

Find out more about prostate cancer, treatments, and support on the websites below:

• Prostate Cancer UK | Prostate Cancer UK
• Prostate cancer | Macmillan Cancer Support
• Prostate cancer - NHS

Testicular cancer is most common in males aged 15-40. The risk of testicular cancer over your lifetime is roughly 1 in 250 (0.4%).

It has one of the highest cure rates of all cancers. More than 90% will be cured.  

Testicular cancer is often suspected if you find a lump. Not all lumps on the testicles are tumours, and not all tumours are malignant (cancerous).  If you find a lump, get it checked by your GP. Find out more about testicle swellings and lumps: Testicle lumps and swellings - NHS.

If your GP suspects your lump is a cancer, they will refer you for scans and blood tests. You may then meet a surgeon at Bristol Urological Institute to discuss removal of the testicle – this is called an orchidectomy.

Some important things to discuss with your surgeon

• Your blood test results (tumour markers) before your operation
• Prosthesis insertion.
• Pre-operative sperm banking.

Most people will have surgery within the next 2 weeks, and you will usually go home on the same day (day case). You will be given all the information you need including when and where to go, and when to stop eating and drinking.

It is usually done under general anaesthetic (you will be asleep). When you wake up you will have a dressing on the wound on your groin. The stitches in the incision (cut) are usually dissolvable so don’t need to be removed.

Find out more about testicular cancer, symptoms, treatment, and recovery:

• Testicular cancer | Macmillan Cancer Support
• Testicular Cancer Charity | It's in the Bag 

We have a few groups of knitters who work hard behind the scenes to contribute items for our patients.  

Sharon says “I chose to knit the cannula sleeves as they are easy but fun to knit, you follow guidelines but can vary the patterns and colours and add different “twiddles”, so it doesn’t get boring. My father and my mother-in-law both lived with Dementia, and it feels good to help others with similar experiences.” 

The Rodway Rubies WI knitting and crochet group are also generous contributors making blankets, twiddle muffs, teddies and other items in abundance, going through bags of wool. They enjoy being able to give something to the hospital community. 

In 2024-25 our knitters and crafters produced 635 items for our patients including 142 lap blankets, 85 teddies, 260 twiddle muffs and 81 cannula sleeves.  

John is Chair of the NBT Patient and Carer Partnership Group. He was also a volunteer during the pandemic, throughout all the lockdowns, delivering medication from the Pharmacy to the wards around the hospital. As a Patient and Carer Partner, John gets involved in a variety of activities from being on interview or award panels to giving feedback on policies, strategies or patient-facing information. 

Joyce and Steve with Maudie 

Joyce and Steve love to volunteer with their dog Maudie and our patients and staff love when our furry friends come visiting. Pets As Therapy Volunteers are dedicated pet owners who visit our patients and staff with their pets. Joyce and Steve love the joy it brings to patients and them in return too.  

Fiona with Millie

Fiona and Millie also volunteer with us in conjunction with Pets As Therapy. The value of pet ‘therapy’ and animal visits is widely accepted as a powerful aid to stimulation and communication. Studies have shown the presence of companion animals can improve the wellbeing of patients and lower the rate of anxiety, simply by making the hospital environment happier, more enjoyable and less forbidding.    

Here are Sandra, Daphne and Rosemary – Shop Manager and volunteers at Southmead League of Friends. The League of Friends has been supporting Southmead Hospital for 47 years by funding requests for the benefit of patients and staff, with most of its money coming through the coffee shop just around the corner from this photo. They don't just provide reasonably priced refreshments, but a friendly face and listening ear to staff and the public. To date the League has funded over £1.8million of requests for the hospital and look set to reach £2million this year!    

Ron is a befriender and helps keep our allotment in great shape! Ron volunteers on the Stroke Ward and visits patients. He shares his experience of having a stroke, which can provide hope and reassurance. He also provides a friendly face and a relaxed conversation, usually telling people about the pumpkin he planted that went missing! Here you can see Ron in the shed by the allotment which is just behind the new Surgical Centre and open to anyone to have a little wander around and sit in the sunshine. 

Jenny is also a befriender on the Stroke ward. Jenny was a patient following a stroke in 2022 where she was visited by fellow befriender Ron (also photographed) who inspired her to volunteer. Although Ron only discovered this during this photoshoot when they both had a lovely catch-up in between modelling for photos! Jenny is a friendly face to patients, she’ll point to the bed and tell her story. Patients discuss their own experiences and see her as a role model to recovery. A highlight was when Jenny saw the physiotherapist who taught her to walk again once she was back as a volunteer, and he was delighted to see her walking so well. 

Moss is a Move Maker and can be seen driving the Buggy here in the Atrium. As a photographer himself Moss has many talents including contributing to the journeys of 40,000+ patients who have been driven by the buggy this past year alone. Our Move Makers help direct people from the entrance but also drive, wheel or sight guide patients to where they need to go. They really make sure our patients and carers are supported on their journey in the hospital.

Becky is a Patient Partner who joined after her experience with our Maternity department. Becky likes that volunteering is a small opportunity to give back to the community. It is also a chance to use her voice and support other patients. She also supports by giving feedback on patient-facing information and carrying out walks around the ward to evaluate the environment to ensure good patient experience in all areas. Becky says, “part of the reason I wanted to volunteer was coming from a minority group my experience with the maternity department was very good and I also wanted to get that side across. I believe when I joined, at the time, there was a lack of diversity from people wanting to volunteer and it was something I wanted to represent in a positive way.” We are grateful to have Becky as a partner. 

Jackie is a Ward Support Volunteer for the Percy Phillips Ward in Maternity. She joined us whilst in the UK for a year as she wanted to give back to the community and try something new. Jackie commented on volunteering at NBT: “The experience has been amazing. The staff have been very welcoming. They are all so hardworking. I enjoy the little things I can do to help them. I would say, the highlight of my shift is interacting with the patients when I visit them with the tea trolley.”

Here are some of our Volunteer Musicians. We currently have 82 active volunteer musicians. They have gifted us 687 hours of music in 2024-2025. They also won the recent ‘We Support NBT’ Award at the NBT Staff Awards. The youngest musician started volunteering at seven years old and can be seen in the group photo with his two siblings. Some of these volunteers have supported us for over 20 years! Our musicians bring so much joy to patients, visitors and staff, with many commenting through our feedback methods or directly to them at the end of a song.

Annie volunteers as Ward Support at Gate 24. She also volunteers with several other groups in Bristol some of which include Caring in Bristol and running a litter picking group in Bishopston. We really do have such amazing volunteers at NBT! Our Ward Support volunteers are there for a friendly chat to patients, a listening ear, raising any concerns, making sure drinks are topped up and various other things. They are always supervised and supported by our staff. 

Emily is one of our peer mentor volunteers. She loves giving her time to people and being a listening ear to those that haven't felt heard. Our peer mentors support others living with a similar condition. We have 11 different groups who use their lived experience to signpost patients to help their recovery or manage their symptoms.  Peer Mentoring offers an opportunity to have a one-to-one chat and share personal experiences and stories either face to face or over the telephone. It is intended to complement the care and education patients and carers receive from the healthcare team and we are so grateful to our volunteers for supporting as peer mentors.   

Sue is a Purple Butterfly volunteer, supporting patients and their families who are experiencing end of life care. This role works closely with our Palliative Care staff team. At this difficult time, they can offer one-to-one support, compassionate listening, comfort and companionship. Each visit is unique; sometimes silent company or just a gentle presence is all that is needed. The volunteers can offer respite so that the patient’s visitor is able to take a short break away from the bedside, in the knowledge their loved one is not alone. Part of the volunteer’s role can include reading, playing music, simply chatting or sitting in silence.

Tim and Anita are two of nearly 100 Move Makers who help patients and visitors navigate our hospitals. They stand out with their wonderful bright pink tops and matching trainers. Tim and his wife Anita decided to become Move Makers in honour of Tim’s sister Kay who was not only an amazing sister but also one of the original Move Makers. Anita loves meeting inspirational patients and says, “it is an amazing experience, every shift is different”.

Katie joined NBT as a Living Well Volunteer after being supported by NBT herself. Through this role she supports other young women with Breast Cancer. As a Patient Partner she gets involved in a variety of activities. More recently this has been our Patient Conversations which is our way of getting live feedback while someone is either an inpatient or outpatient waiting for their appointment. Katie will have an informal chat with our patients and carers to see how their experience is going and then be able to feed that back to the department. If there is anything that can be improved in real time, we aim to do this or take on the feedback for the future.

Martin volunteers with our Discharge Lounge at Gate 24. He volunteers for enjoyment and is valued by the team. Martin supports and provides a ‘listening ear’ to both patients and their families who are being discharged after stays or appointments in hospital and who maybe are experiencing a wide range of emotions at this time. Being a volunteer at NBT is always interesting, worthwhile and Martin says he highly recommends it!

Liz volunteers with our Macmillan Wellbeing Centre. From meet and greet to providing refreshments, craft workshops and Christmas stalls, she is an all-round star. She started volunteering at Frenchay Hospital when she retired, teamed up with her friend, the late Pat Webb, and they both came to Southmead at the same time. Liz creates beautiful paper flowers, some of which have been used as a bouquet for a hospital wedding. She also provides monthly craft sessions for cancer patients.

Julia is an honorary chaplain and Maria is a chaplaincy volunteer. They are both based at the Sanctuary at Gate 30 but they visit all across the Hospital providing a listening ear to anyone who needs them, whether the person is religious or not.  Julia shared, “I am constantly learning from all I come into contact with whilst working within the Chaplaincy team.” All chaplaincy volunteers are trained to support spiritual, pastoral, and religious care for people in the hospital.

Anela is a Patient and Carer Partner. She got involved with NBT through the Bristol Sight Loss Council and has done a huge amount across the Trust to improve access for those with a visual impairment. Her work involves delivering sight loss awareness training to staff, advocating for and testing accessibility for our Digital Patient Engagement projects, reviewing and supporting new projects looking at the physical space and more. She also sits on the Patient and Carer Partnership group which involves feeding into meetings, projects, policies and various work to ensure NBT represents all the Patients and Carers it serves.

Richard is one of three volunteers who work with our Major Trauma Team. The volunteers make phone calls to patients two weeks after they’ve been discharged from hospital. On the calls the patients are asked a standard set of questions to assess how they are managing and get feedback from their time in Southmead Hospital. Any concerns or questions raised by the patients in the calls are fed back to trauma practitioners who call the patient back to resolve any issues. Feedback from the calls is compiled into quarterly reports and passed back to the clinical specialties to contribute to continual improvement of the service.

Megan volunteers as a Ward Support on Ward 27A Cardiology. For Megan, volunteering has given her the opportunity to work within a medical environment, which she wants to pursue as a career in the future. “Volunteering is a great opportunity to learn new things and experience an area you may wish to move into in the future”, she said. Megan is off to University in September and we wish her all the best. Who knows, we may see her back as a Staff Member at NBT in the future!

Dai is a Patient Feedback Volunteer. Our Feedback Volunteers help with any current surveys we have and with Patient Conversations. Dai speaks to a variety of patient and carers across the hospital, to understand how their experience has been. This helps the different departments and wider Trust consider what is going well and what they can improve. Dai says the highlight for him is meeting people whether that is the nurses, doctors, patients and other volunteers.

Sue is one of the lovely Move Makers who you’ll see when coming into the Emergency Department (ED). We have Move Makers across ED, the entrance to the Brunel Building and at Cossham Hospital. You’ll spot the Move Makers in pink or green tops, and they are always ready to help. Sue volunteered throughout the pandemic, “which was challenging but very rewarding”. She deals with anxious relatives and friends as part of her role and she knows how frightening the ED department can be, so is great at supporting our visitors and giving them a bit of calming reassurance, directions or a cup of tea.

• Varicose veins are veins under the skin of the legs which have become tortuous, widened, and bulging (varicose). Varicose veins are very common and do not cause medical problems in most people.
• Blood flows down the legs through the arteries and back up the legs through the veins. The main systems of deep veins, carry most of the blood back to the heart. The veins under the skin (superficial veins), are less important and can form varicose veins.
• All veins contain valves which should only allow the blood to flow one way. If the veins become widened and varicose, these valves no longer work properly. Blood can then flow backwards down the veins and lead to increased pressure when standing, walking, or sitting. Lying down or ‘putting your foot up’ relieves this head of pressure and usually makes the legs feel better.
• The symptoms and treatment depend on how badly the valves in the veins are working, although the trouble people get from their varicose veins is variable. Varicose veins often appear first in pregnancy, when hormones relax the walls of the veins and when the womb presses on the veins coming up from the legs.
• People who are overweight are more likely to get varicose veins and to find the symptoms troublesome. Bad varicose veins can run in families, but this is not always the case. Usually there is no special cause for varicose veins.
• Varicose veins should not be confused with more superficial spider and thread veins which lie within the skin not deep into it.

• Although varicose veins can get worse over the years, this often happens very slowly. Worrying that ‘they might get worse’ is not a good reason for treatment. Most varicose veins do not require medical attention.
• In a few people high pressure in the veins causes damage to the skin near the ankle, which can become brown in colour, sometimes with scarred white areas. Eczema (a red skin rash) can develop. If these changes are allowed to progress or the skin is injured, an ulcer may form. Skin changes are a good reason for going to see your GP and for referral to a specialist.
• Other problems which varicose veins occasionally cause are phlebitis and bleeding. Superficial venous thrombosis (sometimes called thrombophlebitis) means inflammation of the veins accompanied by thrombosis (clotting of blood) inside the veins which become hard and tender. 
  This is not the same as deep vein thrombosis (DVT) and is not usually dangerous. It does not mean that the varicose veins must be treated, though treatment is recommended for recurrent attacks.
• The risk of bleeding because of knocking varicose veins worries many people, but this is rare. It will stop with firm pressure on the area and the veins can then be treated to remove the risk of further bleeding.

• Many varicose veins do not have to be treated at all unless they are causing serious symptoms, such as recurrent phlebitis, bleeding, or ulcers.
• If simple measures have failed and the symptoms from your veins are significantly affecting your quality of life you should consider a surgical procedure. All procedures have their risks; deaths from blood clots passing to the lungs following vein surgery has been reported (see Deep Vein Thrombosis below).
• Aching, itching, and heaviness of the legs can often be relieved by support stockings or tights. Your GP can prescribe firmer and more effective ‘graduated compression stockings’ if ordinary ones are not helpful enough, these usually need only to be below the knee, rather than full length stockings.

• Varicose veins can be dealt with by injection treatment (sclerotherapy). An irritant substance is injected into the veins which causes local inflammation and seals off the vein.
• Larger varicose veins may be treating using radiofrequency ablation with or without foam sclerotherapy - this is a surgical intervention which uses radio waves. We rarely do open surgical stripping of the veins as newer techniques are as effective, less invasive, and have a shorter recovery time. The treatments we offer are “walk in walk out” procedures and you will not need to stay in hospital.

• Injections by foam sclerotherapy using ultrasound guidance is a newer technique that allows larger veins to be treated.
• Several needles may be required to complete one treatment. Some patients need more than one treatment session.
• The foam is made by mixing air with an irritant substance (we use a product called Fibrovein™). Your leg is then elevated and you are asked to move your foot up and down to keep the blood moving in the deep veins.
  The foam is injected and followed as it moves along inside the vein using the ultrasound. Pressure is applied for a few minutes over the vein and a firm compression stocking is fitted and worn for 2 weeks.
• Foam sclerotherapy is an alternative to a surgical procedure tying off the vein (‘high tie’) and removing the vein surgically (‘stripping’).
• Although foam works effectively, long term results are unknown. Recurrence of varicose veins should be considered and may require future treatment.

• Not all veins are suitable for foam sclerotherapy treatment. During assessment of the veins we use ultrasound to see if foam can be used to treat.
• Foam sclerotherapy works by destroying the lining of the vein. This causes the vein to shrivel up and your body absorbs the remaining tissue over time. You may notice some discomfort or discolouration of the skin.

• We aim to do any procedure within 18 weeks from the time you were referred by your GP. We do not like to keep people waiting for a long time but have to deal with patients based on medical priorities. Those with more serious symptoms such as skin changes or ulcers are prioritised.
• Delays are caused by heavy demands on staff and resources. There are particular problems dealing with varicose veins because large numbers of patients are referred. This means there is a limit on the number of operations which can be done, while also dealing with other conditions which are a serious threat to life or health.
• In Bristol and Weston-super-Mare GPs have clear guidelines from integrated care boards (ICBs) for assessment and referral for treatment. Funding for treatment is confirmed before referral.

Most foam procedures are done as a day case. 

The hospital requires you to sign a consent form - as for any operation. 

You will not need to starve for foam injections but avoid a large meal immediately before the procedure. It is important to drink plenty on the day of the procedure as being dehydrated will cause the veins in your leg to shrink. 

You do not need to shave before foam injections. 

Painkillers are not routinely prescribed though you may wish to take paracetamol. 

• Immediately following the procedure you will be able to get up and dressed. You will walk to the recovery area and have a drink.
  Before leaving you will be given discharge information and aftercare instructions. Staff will check your leg for any bleeding, which is usually not much.
• You will be given an advice leaflet following your procedure. A discharge summary will be send to your GP to inform them of your hospital day case stay.
• You will be put in a compression stocking after the procedure with a bandage over the top. We usually ask you to wear both the stocking and bandage for 48 hours - so you will not be able to shower during this time. Following this you should be able to remove the compression stocking and bandage to shower. After you shower put the compression provided back on. You should do this for 2 weeks, only removing the compression to shower and sleep.
• If struggle to get the stocking on and off you can leave it on for a week or two, but you will not be able to shower.

Why wear support stockings? 

Wearing a compression stocking is recommended to reduce the risk of DVT. They can also provide support for comfort and reduce swelling.

When can drive? 

You should avoid driving a car for 24 hours after the procedure.

When can I return to work and play sports?

You can return to most sports as soon as you feel able. Avoid swimming and horse riding for at least a week and until all wounds are dry. 

When can I fly? 

• You should avoid long haul flights for six weeks after the procedure due to the risk of DVT.
• The risk from short haul flights is lower but should be avoided for four weeks after the procedure.

• Serious complications are uncommon. Occasionally the vein may not be completely seal after foam injections. In these cases a further attempt or a standard surgical operation may be offered.
• A small number of patients may experience brief side effects during foam treatment including lower back pain, chest tightness, confusion, migraine, coughing, faintness, panic attack, or visual disturbance. Visual disturbance has been reported by up to 6 percent of patients (6 in 100 patients). There are no reports of long term visual problems following foam treatment.
• Foam injections cause local inflammation which can cause mild discomfort, hard lumps where the veins were and brown staining of the skin. Rarely it is necessary to have trapped blood released a few days following the procedure.
• You are advised to avoid sun exposure for at least 6 weeks following treatment to reduce skin discoloration over the treated veins.
• Very occasionally the injections cause an allergic reaction.
• After any vein treatments tributaries of the vein (smaller veins) may remain.
• Aches, twinges, and areas of tenderness may all be felt in the legs for the first few weeks after the procedure. These will all settle down and should not stop you from becoming fully active as soon as you are able.
• Infection is an occasional problem. It usually settles with antibiotic treatment.
• Nerves under the skin can be damaged by the treatment. This is uncommon, but will give an area of numbness on the leg, which settles or gets smaller over weeks or months. If a nerve lying alongside one of the main veins under the skin is damaged, then a larger area of numbness can be caused. If this happens then numbness will happen over the inner part of the lower leg and foot.
• If a main vein behind the knee needs to be dealt with, then there is a risk to the nerve which gives feeling from the skin on the outer part of the lower leg and foot.
• Deep vein thrombosis causes swelling of the leg and can result in a blood clot passing to the lungs. It is a possible complication after varicose vein treatment, but is particularly unlikely if you start moving your legs and walking frequently soon after the operation.
• If you are taking the contraceptive pill/or are taking HRT, your risk of thrombosis is increased and the surgeon will discuss with you the pros and cons of stopping the pill or continuing it and taking special action to reduce your risk of thrombosis. If you start taking the contraceptive pill while waiting for your procedure, let the hospital know.

Some people develop new varicose veins during the years after a varicose vein procedure. Rarely, varicose veins simply re-grow in the areas which have been dealt with or else they develop in a different system of veins which were normal at the time of the original operation. If veins develop again, they can usually be dealt with by further treatment should they be troublesome.