Urology

HOD Message

There is an increasing incidence of stone disease in the northern part of India, around 15-20% This Trend is attributable to a large extent to our lifestyle and dietary habits. We at AMRITDHARA provide detailed check-ups for stone disease and deal with a complex procedure involving urolithiasis ranging from PCNL, RIRS( Retrograde Intrarenal Surgery ) , and Laparoscopic surgeries to open surgery

Services

The Department of urology at AMRITDHARA, my hospital, provides comprehensive state-of-the-art medical and surgical care in all aspects of urology. Our Urology Department provides Urological Care to both Men and Women of All Ages. We provide facilities for a wide range of basic and specialized urological investigations and treatments with world-class expertise in all aspects of urological care.
The area of expertise includes

Endourology

Endourology is a minimally invasive technique available to treat kidney stones. Stones may be extracted or fragmented using tiny instruments through natural body channels such as the urethra, bladder and ureter. In addition to treatment, our doctors help determine the cause of kidney stone development and help identify methods to prevent further stone formation. Thin, flexible instruments including lasers, graspers, miniature stone retrieval baskets, special scalpels, and cautery, can be advanced through working channels in the scopes in order to perform surgery without creating any incisions at all. The majority of endoscopic procedures can be done on an outpatient basis. Sometimes patients had to get admitted for 2-3 days.
Endo-Urological procedures include:

1. RIRS (Retrograde Intrarenal Surgery)

RIRS is an endoscopic surgery performed to remove renal stones by reaching the kidney from the ureter. RIRS procedure uses a viewing tube called fiber optic endoscope and a laser fiber – Holmium – to treat renal stones. Once the large stone is removed, small fragments of the stones are taken off through stone baskets.

2. Urethroscopy

It is used to treat strictures or blockages of the urethra. It is a diagnostic test to investigate the interior of the urethra and bladder, with the use of a thin instrument called ‘cystoscope’.

3. Cystoscopy

Cystoscopy is performed to find the cause of urinary tract problems such as
Urinary tract infections (UTIs), hematuria, urinary frequency, urinary urgency, urinary retention, urinary incontinence, pain or burning before, during, or after urination, trouble starting urination, completing urination, or both, abnormal cells, such as cancer cells, found in a urine sample
Used for diagnosis of Bladder tumor or stone (Flexible plastic tubes called stents can be passed up the ureter using cystoscopy and x-rays to relieve a blockage of the ureter.

4. Ureteroscopy

Ureteroscopy is performed to find the cause of urine blockage in a ureter or to evaluate other abnormalities inside the ureters or kidneys.
Used to treat stones and tumors of the ureter.

5. PCNL (Percutaneous nephrolithotomy)

PCNL is a technique used to remove specific stones in the kidney or upper ureter (the tube that drains urine from the kidney to the bladder) that are too large.

Pyeloplasty

Another procedure is Pyeloplasty which is done to remove UPJ (Ureteropelvic junction)obstruction. This surgical procedure removes the blockage and reconnects the ureter and the renal pelvis. It is the surgical reconstruction of the renal pelvis (a part of the kidney) to drain and decompress the kidney. The goal of the surgery is to relieve a uretero-pelvic junction (UPJ) obstruction.

Uro-oncology

This field is devoted to the diagnosis and treatment of tumors of urinary systems. Most importantly taking care of patients with
Prostate Cancer,
Kidney Cancer
Testicular Cancer
Penile Cancer
Bladder Cancer.

Reconstructive urology

Reconstructive urology is surgery to restore normal function by repairing, rerouting, or recreating areas of the upper and lower urinary tract and some reproductive organs. Patients might need reconstructive urology because of injuries, birth defects, medical conditions, or complications from surgery or other treatment.

Neuro-urology

Neuro-Urology deals with diseases and functional disorders of the lower urinary tract and of the sexual organs after damage or lesion of the associated neuronal innervation and control.

Andrology

Andrology is the medical field that specializes in men’s reproductive health. For treatment of male infertility, erectile dysfunction, and male sexual problems.

RIRS: A Novel Procedure to Treat Renal Stones

RIRS :

RETROGRADE INTRARENAL SURGERY

RIRS is an endoscopic noninvasive procedure done by a flexible fiberoptic endoscope. In RIRS the scope is placed through the urethral opening into the bladder and then through the ureter into the pelvi-calyceal system of the kidney. The scope can be directed to any calyx like upper, middle or lower calyx for diagnosis as well as a therapeutic procedure.

Procedure :

It is done under spinal or general anesthesia

With help of cystoscopy, Guidewire was passed into the ureter, followed by ureteral dilatation done with balloon dilater. Flexible Teflon access sheath passed into ipsilateral ureter on guide wire with help of C-Arm Machine.

Through which flexible ureteroscope is passed up to pelvi-calyceal system

Ans diagnostic as well as a therapeutic procedure.

Uses:

DIAGNOSTIC PROCEDURE:-

1)Malignancy2) Stone disease

3) Obstruction:- Caliceal stenosis, PUJ or VUJ narrowing

THERAPEUTIC PROCEDURE:-

1) Stone removal2) Malignant mass fulguration

3) Residual fragments removal

4) Stricture dilatation

ADVANTAGE :

Noninvasive procedure
Faster recovery
No blood loss
Less painful

RIRS is performed by a specialist, an uro-surgeon with special expertise in RIRS. The procedure is usually done under general or spinal anesthesia.

The advantages of RIRS over open surgery include a quicker solution to the problem, the elimination of prolonged pain after surgery, and much faster recovery. No Blood loss