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Urology

OVERVIEW

The Department of Urology at The Santosh Hospital Bangalore is dedicated to providing state-of-the-art medical and surgical care in all aspects of adult and pediatric urology. The Department provides expert care for male and female patients of all ages who suffer from problems of the urinary tract. Urologists also attend to diseases and conditions of the male reproductive organs. The department offer complete advanced diagnostics and therapeutic urology under one roof.

FACILITIES AND PROCEDURES
ENDOUROLOGY

The department is well equipped to treat a wide variety of urological diseases involving the adrenal gland, kidney, ureter, urinary bladder and prostrate. In order to minimize patient morbidity and improve recovery, the procedures are performed with the help of latest endourology techniques. The procedures performed include:

  • Transurethral Resection of the Prostate (TURP)
  • Transurethral Resection of the bladder Tumor
  • Precutaneous Nephrolithotomy
  • Ureterorenoscopy (URS)
  • Cystolithotripsy
KIDNEY STONE

The Department has the expertise and technology to effectively diagnose and treat all types of kidney stones. The Department offers technologically advanced procedures to treat kidney stones, including minimally invasive techniques performed using small incisions or natural openings.

The Department urologists and urologic surgeons work closely with colleagues in nephrology and radiology to ensure patients undergoing treatment for kidney stones receive the most comprehensive care possible.

The specialists evaluate each patient to determine the most effective kidney stone treatment, based on the type, size, location and cause of a kidney stone. They also recommend measures to prevent future stone formation.

The urologists rely on several minimally invasive procedures to remove kidney stones that are too large to pass naturally.

Surgery

Surgical treatment may be necessary for kidney stones too large to pass naturally or that may cause bleeding, kidney damage or ongoing urinary tract infections.

Minimally invasive surgical treatments Extracorporeal shock wave lithotripsy

Extracorporeal shock wave lithotripsy uses shock waves to break kidney stones into tiny pieces that are then passed in the urine. Physicians often use this procedure to remove stones about 1 centimeter in size or smaller. During SWL, patients lie on a cushion. Patients receive sedatives, local or general anesthesia to alleviate pain. The shock waves pass through the body until they hit the kidney stones, causing the stones to break apart. The procedure usually takes 45 to 60 minutes. The sand-like particles that remain afterward are easily passed in the urine.

Side effects can include blood in the urine for a short time after the procedure and minor bruising on the back or abdomen. Some patients may experience discomfort as the stone fragments pass through the urinary tract. Some stones are resistant to shock wave treatment, and patients may require additional treatment if the stone does not shatter completely. Most patients resume normal activity in a few days. It may take several months for all stone fragments to pass.

Percutaneous nephrolithotomy (PNL)

Percutaneous nephrolithotomy (PNL) is an option when shock wave lithotripsy is not effective or if the kidney stone is too large for extracorporeal shock wave lithotripsy to effectively treat. Mayo Clinic is a leading institution in PNL research and practice.

Patients undergoing PNL receive general anesthesia. Urologic surgeons perform PNL through a small incision in the back and into the kidney, using an instrument called a nephroscope to break up and extract the stones. Urologists attempt to remove all the stone fragments through the nephroscope during the procedure, leaving none to pass through the urinary tract. Patients usually stay in the hospital for one to two days following PNL, with additional recovery time lasting one to two weeks.

Ureteroscopic stone removal

Urologists perform ureteroscopic stone removal to remove stones lodged in the ureter or in the kidney. Patients undergo this outpatient procedure while sedated with general or local anesthesia. The surgeon passes a small ureteroscope into the urethra, through the bladder into the ureter to break up and snare the stone. In some cases, stones are shattered using a laser. Fragments may be passed by the patient or they may be extracted. The surgeon may place a small tube (stent) in the ureter to relieve swelling and promote healing.

Parathyroid surgery

Some calcium stones are caused by overactive parathyroid glands - four small endocrine glands located behind the thyroid gland that are responsible for the amount of calcium in the blood and bones. A small benign growth in one of the parathyroid glands can cause the glands to become overactive, raising the body's calcium level, which can lead to kidney stone formation. Removing the growth from the gland stops the formation of kidney stones. General surgeons, rather than urologists, perform parathyroid surgery.

LAPAROSCOPIC UROLOGY

Making use of the latest laparoscopic technology, instead of making large incisions, small 10 mm puncture wounds are made through which special telescopes and instruments are passed into the abdomen. The surgeon is able to use instruments through small keyholes to perform surgery. At The Santosh Hospital Bangalore this technique is used to perform the following procedures:

  • Retroperitoneoscopic Ureterolithotomy
  • Retroperitoneoscopic Pyelolithotomy
  • Retroperitoneoscopic Radical Nephrectomy
  • Lap Radical Nephrectomy
  • Lap Nephroureterectomy
  • Lap Radical Prostatectomy
  • Lap Radical Cystectomy
  • Lap Adrenalectomy
PAEDIATRIC UROLOGY

The Santosh Hospital Bangalore has surgeons with specialist experience in dealing with surgical problems of kidneys, bladder and genitalia in children. Careful investigations are undertaken to decide when a surgical intervention is required in children and when it can be avoided. The procedures offered are:

  • Hypospadius Surgery
  • Endoscopic Cure for Reflux and Incontinence
  • Treatment for Pediatric Obstruction
RECONSTRUCTIVE UROLOGY

Reconstructive urology consists of the treatment of conditions of the lower urinary tract, including urinary incontinence, urethral stricture disease and severs bladder dysfunction. Urology surgeons have expertise and extensive experience performing complex reconstructive surgery on the kidney, ureter, bladder, urethra and male genitals. The procedures offered are:

  • Urethoplasty
  • Augumentation Cystoplasty
  • Neo Bladder (Continent Diversion)
  • Construction of new urinary bladder
NEUROLOGY

Neurology involves treatment of neurological diseases and conditions that affect lower urinary tract (bladder and urinary sphincters) function leading to inability to urinate, urinary incontinence, recurrent urinary tract infections, urinary stones, and even kidney failure. Procedures offered at The Santosh Hospital include:

  • Urodynamics (Uroflowmetry, CMG, EMG, UPP)
FEMALE UROLOGY

The Department of Urology at The Santosh Hospital Bangalore offers a comprehensive evaluation and treatment plan for urinary tract disorders prevalent mostly in females. These include urinary incontinence and pelvic floor prolapse, voiding dysfunction, recurrent urinary tract infection, urethral syndrome and interstitial cystitis. Expert evaluation of these conditions involved complete history and physical examination. Urodynamics (bladder function test) and imaging studies are undertaken to evaluate the urinary tracts. Additional bladder studies such as cystoscopy may also be instigated.

  • TVT and TOT for female urinary stress incontinence (Transvaginal sling).
  • Anterior Vaginal Wall Repair ( Prolapse)
  • Prolift - Repair for prolapse
ANDROLOGY & MALE INFERTILITY

The endocrinology and infertility experts at Department of Urology, The Santosh Hospital Bangalore, focus on andrology and male infertility testing and treatments. Experienced andrologists diagnose and treat possible causes of male infertility, minimize patient distress and provide patients with reasonable options.

COMMON UROLOGICAL PROBLEMS

Stones and Prostatic diseases are the common disorders encountered by an urologist. The tropical weather in addition to other environmental factors makes this region as one of the stone belts of the world. Prostatic diseases on the other hand are ubiquitous and it is the disease of the aging male.

STONE DISEASE:

Stones form in the kidney or in the urinary bladder. Stones that form in the kidney can stay there and cause pain, infection, loss of renal function or it may travel down into ureter and cause pain. Stones can be treated by Endoscopic, percutaneous and completely non invasive means. The type of treatment would depend on the size, composition and location of your stone. The stones that form in the bladder are infection stones and are usually secondary to obstruction in urine emptying.

Prevention: Dietary modifications and increase in water intake may reduce the incidence of stones. At least 10 glasses of water a day should be consumed. 2 glasses with every meal and 2 in between meals. Dietary modifications include restriction of animal protein and avoidance of certain foods.

PROSTATIC DISEASES:

Prostate can be a site of infection, benign growth or Malignancy. The exact nature of the disease would depend on the symptoms and the outcome of investigations. The most common entity in prostate is Benign Prostatic Hyperplasia. There are varieties of drugs to treat this condition medically. Failure of medical treatment and certain other associated features like refractory retention, renal failure, bladder stone, blood in urine and urinary tract infection would warrant surgical intervention. The Physician would advice the appropriate treatment for you.