Kidney Stone and Failure Treatment in Delhi, India | Urology
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Urology

Overview

Department of Urology

Metro Hospital understands that urological disorders can have a huge impact on one's confidence & comfort during normal & social life and therefore offers comprehensive urology services( both Medical & surgical intervention) to diagnose & treat various urological disorders under one roof & has a reputation for its expertise in the treatment of most complex urology cases.

The deptt has full-fledged urology & andrology services and strives to deliver the best healthcare to our patients who seek advanced urological treatment in India.

The deppt is supported by lab & diagnostic services such as radiology, pathology, microbiology & is equipped with modern facilities & latest equipments to treat all urological disorders such as overactive bladder, UTI, bladder cancer, prostate health, PVP, stone diseases etc.

There are various endoscopic facilities available and TURP is routinely performed.

Services

Department of Urology

Laparoscopic Urology

Metro heart institute with Multi specialty is the only institute in Faridabad offering laparoscopic management of urologic problems such as PUJ obstruction, Kidney diseases, Kidney and Bladder Cancer, Kidney Stone.

Laparoscopic pyeloplasty

Laparoscopic Pyeloplasty provides patients with a safe and effective way to perform reconstructive surgery of a narrowing or scarring where the ureter (the tube that drains urine from the kidney to the bladder) attaches to the kidney through a minimally invasive procedure.

This operation is used to correct a blockage or narrowing of the ureter where it leaves the kidney. This abnormality is called a ureteropelvic junction (UPJ) obstruction which results in poor and sluggish drainage of urine from the kidney. UPJ obstruction can potentially cause abdominal and flank pain, stones, infection, high blood pressure and deterioration of kidney function.

When compared to the conventional open surgical technique, laparoscopic pyeloplasty has resulted in significantly less post-operative pain, a shorter hospital stay, earlier return to work and daily activities, a more favorable cosmetic result and outcomes identical to that of the open procedure.

lap. Simple & Radical Nephrectomy

Laparoscopic Nephrectomy provides patients with a safe and effective way to remove a diseased or cancerous kidney. Laparosopic nephrectomy is a minimally invasive technique, which provides patients with less discomfort and equivalent results when compared to the larger incision required with traditional open surgery. When compared to conventional open surgery, laparoscopic nephrectomy has resulted in significantly less post-operative pain less Intraoperative blood loss a shorter hospital stay, earlier return to work and daily activities, a more favorable cosmetic result and outcomes identical to that of open surgery.

Lap. Radical Cystectomy for Bladder Cancer

The main early symptom of bladder cancer is blood in the urine. In most cases, the cancer is just in the lining of the bladder. These can usually be treated relatively easily with endoscopic treatment which is often curative. If the cancer has spread through the bladder wall then endoscopic treatment is less likely to be curative but can often slow the progress of the cancer till definitive treatment with Lap./Open radical cystectomy with urinary diversion is done for same.

Prostate Cancer

With the advent of PSA malignancy of prostate gland is being diagnosed at an early stage. If diagnosed at a later stage it may lead to bone fractures, kidney failure, difficulty in urination.Treatment options for early cancers are Lap./Open Radical Prostatectomy.For patients presenting late the treatment options are are medical/surgical castration.

BPH

After the age of 50 the prostate gland enlarges squeezing the urethra and slowing the flow of urine from the bladder.

The following symptoms can start:

  • Slower urine flow
  • Reduction in strength of flow (not being able to hit the back of the pan)
  • Urinating more frequently, especially at night (sometimes a symptom)
  • Difficulty starting and stopping the flow

If left untreated the prostrate can completely block the urethra and the outflow of urine. This is called acute retention and the bladder becomes stretched and painful. Even before complete blockage occurs there may be complications like infection damage to the kidneys, damage to bladder, bladder stone.

Ureteroscopy

Ureteroscopy entails the passage of a small telescope, called a the ureteroscope, through the urethra and bladder and up the ureter to the point where the stone is located. The stone will need to be fragmented, which is usually accomplished with a laser/lithoclast. Once the stone is broken into tiny pieces, these pieces are removed from the patient. In most cases, a ureteral stent is left in place temporarily following ureteroscopy, to ensure that the kidney drains urine well.

Patients may require an overnight hospital stay and are back to work the next day.

PERCUTANEOUS NEPHROLITHOTOMY (P.C.N.L.)

Technological revolution has made open surgery for the removal of kidney stones relatively uncommon. Modern equipment and procedures, such as percutaneous surgery, use x-ray imaging, guide wires and tubes to remove kidney stones. P.C.N.L. is performed to remove stones that are causing a blockage or to treat ongoing symptoms such as pain and recurrent infection. Recovery time after surgery is much shorter as no large open incisions need to be made.

Stress Urinary Leakage

Leakage of urine while coughing, laughing, sneezing etc is termed as stress urinary leakage. This condition occurs due to weakness in lower abdominal muscles. Trans Vaginal Taping (TVT-O) is an effective state of the art minimally invasive procedure involving admission for a single day.

Male Infertility and Sexual Problems

Male factor infertility, impotence, premature ejaculation are still a taboo subject in our society. Many men due to inhibition and poor awareness are not able to relate their problems. A variety of treatment options ranging from medical management to minor surgical procedures and penile prosthesis are available under expert care. Turek is done to open up blocked Ejaculatory Ducts.

Overactive Bladder

This is a condition seen in neurologic patients, post spinal trauma or those recovering from spinal cord inflammations.Such patients benefit from BOTOX injections given directly into the bladder. This is a state of the art treatment available at MHIM, Faridabad with expert care. 

Pediatric Urology

Congenital (by birth) defects of urinary systems include PUJ Obstruction, VU Reflux, Neurogenic bladder etc. Such anomalies are managed under expert guidance with minimally invasive and contemporary techniques.

Achievements

Various patients who were unable to pass urine and were on catheter could pass urine well after the endoscope removal of their prostate. Elderly age and comoridities are not much of a factor at our center as even 90 years old patients have also been successfully operated upon at our hospital.

Successful laparoscopic pyelopasty and other reconstructive urologic work has also been done by minimally invasive technique. Laparoscopic radical cystectomy 

FIRST LAP RADICAL CYSTECOMY OF THE CITY.

Management of all urologic caner treatment is available in one roof.

Cases

BOTOX treatment for Overactive Urinary Bladder

Mr. Man Singh, 23 years gentlemen from Kosi was suffering from poor control over his urinary bladder after recovering from transverse myelitis a neurology condition Patient was passing urine every 10-15 min during the day and 30-40 min at night. His quality of life was very disturbed and he had no social circle. His marriage also was on hold of his urologic problem. He received treatment at several big centers for his problem with no benefit at all. For the first time in city of Faridabad BOTOX treatment was given for overactive bladder. After proper evaluation his bladder muscle was injected with Botox under vision using cystoscopic guidance. Post operatively patient is much relieved of his symptoms and he it passing urine every 2-3 hrs. and he does not have to get up at night to pass urine, he is now planning to get married soon.

Overactive bladder is a condition in which patient has constant desire to pass urine and has difficulty in holding on to urine. Patient has to pass urine every 15-30 min in day and night resulting in severe discomfort to patient and his family and curtailment of social activity. Several oral medications like bladder relaxants are prescribed for this condition. These medications have several side effects viz. dry mouth, constipation, blurred vision, urine retention. Those patients who do not improve with these medication are candidates for intravesical (into the bladder) BOTOX injection therapy.

BOTOX is now a days commonly used by cosmetologists for treatment of wrinkles & face lift. BOTOX has been approved by USFDA for treatment of overactive bladder in neurologic conditions and as an off label use in overactive bladder caused by non neurologic conditions viz. interstitial cystitis and other causes of overactive bladder. Botox injection given into the bladder muscle relaxes the bladder muscle & decreases the sensation of bladder fullness, therapy resulting in improved bladder capacity, better urine flow with decreased frequency and urgency of urination and better ability to hold urine.
The effect of Botox therapy lasts for 6-8 months and patient may require re-injection once or twice.

Green light treatment for enlarged prostate in patients on blood thinners

Mrs. Adnan Akbar, 68 year gentleman was previously operated for heart valve replacement and was also suffering from poor urine flow secondary to benign enlargement of prostate. He was on Acitrom (blood thinners prescribed to heart patients) which is an essential medicine for such patients to keep their blood thin & thus preventing clogging of valve. Through patient was suffering due to severe urinary symptoms but was refused surgery for enlarged prostate by many eminent urologist in view of high intra operative & postoperative chances of bleeding. At Metro Heart Institute with Multispeciality, Faridabad Dr. Anup Gulati performed a green light (KTP) laser surgery for enlargement of prostate. This patient is now free of his catheter & passing urine well.

KTP (green light) laser is a 120 watt state of the art laser which vapourises the enlarged prostate. This laser has superior coagulating properties and better control over bleeding during the surgery also it has having a better safety profile due to lesser tissue penetration. Blood loss during the procedure is minimal. These properties gives KTP laser a distinct edge over TURP and Holmium laser prostatectomy. The relief in urinary symptom and improvement in urine flow with KTP laser vapourisation are as good as with any other treatment for benign enlargement of prostate.

Many patients with benign enlargement of prostate gland continue to suffer from urinary problems as there is a high risk of intra and post-operative bleeding in patients with heart disease. Patients with heart problems such as valve replacement, endocarditis, post stenting, post bypass are put on anticoagulant or blood thinner therapy. These drugs are vital for their heart ailment and cannot be stopped without subjecting the patient to a very high cardiac risk informed Dr. S.S. Bansal, Sr. Cardiologist & Managing Director. At Metro Heart Institute with Mutispeciality, Faridabad Dr. Anup Gulati senior consultant urology has carried out KTP green light laser vapourisation of enlarged prostate in many high cardiac risk patients. With this laser patient does not have to be off the anticoagulants, instead patient is switched over to low molecular weight heparin as an anticoagulant for 1-2 days. Anticoagulant agent is never fully withdrawn, thereby minimising complication & risk.

The urology services at Metro Heart Institute with Mutispeciality are available round the clock under guidance of team of senior urologists. The facilities provided by this department are management of enlarged prostates, management of kidney & ureteric stones, laparoscopic treatment of urologic cancers, management of urethral injury, pediatric urology and male infertility management.

Treatment of Poor Urinary Control by Neuromodulation Technique : A new concept

Sacral Neuromodulation is the most advanced and latest USFDA approved treatment for urinary bladder effected with nerve related problem. Recently this procedure has been successfully done by Dr. Anup Gulati, Sr. Consultant, Urologist at Metro Hospital, Faridabad. This treatment is available at only two places in North India.

13 years old boy Hamood had a Neurogenic bladder and was not able to pass urine, he was condemned to be on catheter since birth. He had no control on stool as well and was passing stool several times a day in diapers. Due to poor urinary bladder control his urea was also raised and was 88 mg%. Patient had no social life and was depressed.

Dr. Anup Gulati, urologist implanted a sacral neuromodulation device onto the nerves controlling the urinary bladder & rectum. After the surgery patient is passing 300-400 ml urine at a time with good control and his stool control is good and passes stool only once a day, he is now free of catheter and diaper, his family is very happy with response.

According to the treating urologist Dr. Anup Gulati this device is the most effective treatment for nerve related problems of urinary bladder control. This procedure has got USFDA approval 5 years back but is still to catch up in India due to high cost of the device.

According to the device company this is only the third time the device has been successfully used in North India, as the implantation of device requires great precision.

This device is of benefit to patients to have poor control on urination with increased frequency and uncontrollable urgency, often leading to leakage of urine in their clothes.
Also those patients like Hamood, who are not able to pass urine and have no control on stool due to nerve weakness, are benefited by this procedure. According to Dr. Anup Gulati, who has received specialized training for this procedure, this device is a life changer for these patients.

Laparoscopic Removal of Non-functioning kidney at Metro Hospital, Faridabad

Mr. Mukeen Khan, 19 yr gentleman, preseated in Urology OPD at Metro Hospital to Dr. Anup Gulati, Sr. Urologist with complaint of severe pain in Left side of abdomen on and off for last few months. His IVP revealed a non visualized left kidney , even after 24 hrs. of injection of dye. His further investigations revealed a non-functioning. 18 cm (normal size 10-11 cm) size left kidney with very thin parenchyma, secondary to obstruction at the junction of pelvis of kidney to the left ureter. Patient was taken up for Laparoscopic removal of the left non-functioning kidney.

The kidneys are situated at back in upper abdomen and the urine is carried to the bladder through the ureters. The junction of kidney and the ureter may be narrow from birth. Gradually , due to this small caliber the urine start accumulating in the kidney and the kidney tissue is replaced by water (urine). If not treated at right time with pyeloplasty the damage to the kidney may lead to complete loss of kidney function. Patient with pelvi-ureteric junction obstruction usually present between 15-35 yr. of age.

Laparoscopic removal of left non-functioning kidney was performed by Dr. Anup Gulati on Mr Mukeen Khan. This is a 11/2 hour procedure done with 3 key holes, involves minimal blood loss and morbidity. Unlike the open surgery which involves a big flank muscle cutting incision producing a big permanent scar With muscle weekness, laparoscopic procedure provides a better cosmetic result & no muscle weekness. Also the duration of hospital stay is only 3 day for laparoscopic nephrectomy and the patient is able to walk the next day, unlike the open surgery where hospitalization is 6-7 days with a bed rest for further 2 weeks.

The urology services at MHIM are available round the clock under the able guidance of Dr. Anup Gulati, senior urologist.

The facilities provided by this department are TURP, PCNL for renal stones, ureteroscopy for ureteric stones, treatment of stricture urethra & urinary leakage, laparoscopic urology viz nephrectomy, pyeloplasty, open & paediatric urology services.

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Care and services at Metro were extended to the best of the levels. I felt at Home.

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