Department of Urology

 

Minimally Invasive Surgery in Urology
Urinary stones have afflicted mankind since ancient times. Bladder and kidney stones have been detected in Egyptian mummies in 4800 BC. Now, this ancient affliction too, benefits from the latest advances in surgery.

About 40% of the outpatients seeking medical advice at any clinic present symptoms relating to the urinary system.

What brings the patient to the Urologist?
Frequent urination especially during nights, inability to pass urine freely, bloodstained urination, burning urination, severe colicky pain at the flank or lower abdomen, pain and swelling of the testes are all symptoms which prompt the patients to consult the urologist.

What are the tests required to diagnose urologic problems?
A detailed medical history, clinical examination, urine and blood tests for sugar and urea, Xray and ultrasound scan of the kidneys, may all be required.

What are the common urologic conditions?
Kidney stones, ureteric and bladder stones, urinary tract infection, enlarged prostate with urinary obstruction, cancer of the kidney, bladder. Also, prostate, stricture urethra and hydronephrosis and phimosis are common diseases.

What is the role of minimally invasive surgery?
Open Surgery was the mainstay of treatment until the year 1990, after which a breakthrough occurred with the advent of Endo Urology and extra corporeal shockwave lithotripsy. Most Urologic conditions could be treated effectively and noninvasively, with shorter operating hours, shorter hospital stay and early return to work.

Cystoscopy
This involves direct inspection of the lower urinary passage, urinary bladder and enlarged prostate gland using fiber optic telescopes. It is an outpatient procedure not requiring anaesthesia. It is useful for diagnosing the cause of bleeding from the urinary tract.

Ureteroscopy
A very useful tool to diagnose and treat urinary stones, strictures and tumours of the ureter and pelvis. Usually done under regional anaesthesia, it is very useful in relieving blocks in the kidneys due to stones, tumours or strictures.

Trans urethral Resection of Prostate (TURP)
This permits removal of enlarged prostate in multiple chips without any skin incision, using under water electrocautery and cutting electrodes. The procedure is performed generally under local anaesthesia without the need for massive blood transfusions. It requires only 3-4 days of hospitalization, and eliminates the need for lifelong medication and frequent catheterizations.


Internal Urethrotomy (OIU)
Endoscopic incision of urethral strictures under regional anaesthesia to relieve blocks along the lower urinary passage.

Vesicolithotripsy
Endoscopic crushing and fragmentation of stones in the bladder and removal through cystoscope sheaths.

Trans urethral Resection of Bladder Cancers (TURBT )
Endoscopic resection of growths involving the bladder, without open surgery, under regional anaesthesia.

Percutaneous Nephrolithotomy (PCNL)
Enables fragmentation and removal of large stones in the kidney, multiple stones and Staghorn stones. The procedure is performed under general anaesthesia, with the patient lying prone on the OT table. Using Xray control, a track is created to the kidney from the overlying skin. Special endo urologic instruments are used to widen the track and fragment the stones using energy sources like air under pressure (pneumatic), ultrasonic sources etc.

What is the MIOT experience?
The Urologists at MIOT are well experienced in both Open Surgery and Endo urology. We have performed over a 100 minimally invasive procedures in the past two years, on patients from Oman, Maldives, Seychelles, Srilanka, Canada, Singapore, and from all parts of India.