General urology
While prostate disorders are common among elderly men, the advent of new drugs has made therapy less surgical. However, refinement in surgical techniques like using a bipolar loop or saline TURP results in superior surgical outcome thus benefiting many patients.
Stricture Urethra
Self-catheterization after endoscopic internal urethrotomy has stabilized even a protracted stricture. Recently, buccal, bladder mucosal graft uretheroplasty offers a cure for stricture problems. The use of urolume stent as a permanent alternative to dilatation is an exciting concept.
Urolithiasis
Urolithiasis management consists of non operative removal of bladder, ureteric or renal calculi in over 98% patients. Ureteral calculi are managed by ureteroscopy using C-arm facility to ensure near 90% success.
The department is equipped with a wide range of ureteroscopes and accessories that ensure removal of calculi. The availability of laser and lithoclast enery enables stones to be disintegrated completely in situ
Shockwave lithotripsy is used to manage renal calculi that are less than 3 cm and located in the renal calyces-middle and upper or upper ureter. Ultrasound in localisation is a new addition and has revolutionized management of upper tract calculi.
Percutaneous nephrolithoplaxy (Keyhole Surgery) with the master lithoclast is used to disintegrate a large stone into smaller pieces and extract them visually. ( renal calculi > 2.5 cms , partial and complete stag horn calculi ). Patients are provided comprehensive advice on how to prevent stones after an elaborate metabolic - urine and blood work up, especially in patients with recurrent stone formation. Flexible ureteroscopy is used to diagnose undiagnosed unilateral renal bleed - the, "idiopathic haematuria syndrome" and for disintegration of lower calyceal calculi.
Female urology and Urodynamics
ncontinence is a common urological problem. Urodynamic tests are performed to differentiate various types of incontinence - stress / urge / over flow and other causes. Stress continence can be corrected by a revolutionary technique called tension free transvaginal tape, an outpatient procedure. All other forms of incontinence in women can be corrected by neuro modulation or neuro stimulation with or without drugs or by the artifical urinary sphinter operation.
Urodynamics is an important adjunct to assess neurological disorders especially incontinence in both the paediatric and geriatric age groups. The department has a multichannel state of the art, Urodynamic system with C-arm integration for video urodynamics. It is especially useful in patients with Diabetes Mellitus and neurological disorders to evaluate whether obstruction or detrusor dysfunction is the cause of the poor voiding. Postoperative incontinence or bladder dysfunction can also be evaluated by video urodynamics.
Pediatric Urology
The department has a wide array of equipments including neonatal scopes to diagnose and manage pediatric urological emergencies including posterior urethral valve. The co-operation of pediatricians trained in neonatal care and anesthesiologists has made it possible to successfully tackle Hypospadias, Epispadias, Exstrophy of bladder, duplications, pelvic ureteric obstructions (PUJO), Vesicoureteric reflux (VUR) and many other congenital and acquired disorders. Vesicoureteric reflux can be corrected by an endoscopic deflux injection technique. Undescended testes can be corrected by laparoscopy.
The department offers pediatric reconstructive urology for congenital pediatric disorders. We have considerable experience in the correction of complex stricture urethra, mega urethra, duplicated urethra, neobladder and continent pouches. Laparoscopy in children for ablation of non functioning renal unit is a commonly performed surgery.
Uro Oncology & Reconstructive Urology
The introduction of laparoscopy has radically changed the management of phaeochrmocytoma and small renal masses. Minimally invasive surgery is employed in radical nephrectomies and nephroureterectomies with tumor size less than 8 cm. Operable carcinoma prostate is managed by radical prostatectomy. Radical cystectomy remains the best option for operable bladder cancer. Over one hundred cystectomies have been performed in the department of Urology over the past ten years.
The introduction of laparoscopy has radically changed the management of phaeochrmocytoma and small renal masses. Minimally invasive surgery is employed in radical nephrectomies and nephroureterectomies with tumor size less than 8 cm. Operable carcinoma prostate is managed by radical prostatectomy. Radical cystectomy remains the best option for operable bladder cancer. Over one hundred cystectomies have been performed in the department of Urology over the past ten years.
