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Current trends in Urology

Common Problems

  • Stones
  • BPH
  • Stricture urethra

Renal stones

  • ESWL
  • Renal & upper ureteric stones less than 2 cm
  • Non-operative non anesthesia modality
  • Success rates around 85 % stone clearance
  • No substantial side effects
  • No admission required
  • Age no bar

BPH

  • Transurethral resection of the prostate (TURP)
  • TURP –a most common procedure
  • Due to good cautery, Camera etc up to 200 gm prostates can be resected
  • The problem of bleeding & TURP syndrome
  • LASER can take care of these problems

Advantages of Thulium LASER

  • Minimal blood loss- only 15 to 20 % of TURP
  • No TURP syndrome as Normal saline used as an irritant
  • A catheter can be removed within 24 hours
  • Discharge within 24 to 36 hours
  • Even patients on Ecosprin & clopidogrel- safe
  • Post-op recovery better
  • Even large glands up to 200 gms can be resected

 

Stricture Urethra

  • Visual internal Urethrotomy
  • LASER Urethrotomy
  • Barbagly’s Urethroplasty using buccal mucosal grafts
  • The full-length urethra can be repaired through a perineal incision
  • Success rates around 90 % long term

 

What is PCNL?

What is PCNL?

PCNL is a Percutaneous Nephrolithotomy. If you have a large, multiple or complex stones. The surgery does one to three hours and typically needs a hospital stay of one to two nights. You should be ready to continue regular activities in one to two weeks.

Is PCNL dangerous?

PCNL is a reliable and efficient procedure for removing large, difficult, and many renal calculi. Still, a serious and life-threatening difficulty that can happen during or after PCNL is bleeding, which can happen during needle passage, tract dilatation, or nephrostomy.

Advantages:

  • Minimal Access Surgery
  • Stones of almost any size cleared
  • Hardness not a criteria
  • Minimal complication
  • Regional Anesthesia
  • A short hospital stay of 2 – 3 days
  • Minimal post-op pain
  • Ancilliary producers like Endopyelotomy can be done
  • Even staghorn stones can be cleared by single or double punctures
  • Success rate –   Total stone clearance    90%
  • Sandwich Therapy – PCNL + ESWL