Specializd Operations with Laser, Endoscopy and Laparoscopy Treatment for Cancer Surgery,
Bladder, Prostate and Kidney Stone Treatment, Laparoscopic, Prostate and Urine Related Problems





PCNL--Percutaneous nephrolithotomy (PCNL) is a surgical procedure to remove stones from the kidney by a small puncture wound (up to about 1 cm) through the skin. It is most suitable to remove stones of more than 2 cm in size and which are present near the pelvic region. It is usually done under general anesthesia or spinal anesthesia.

URSL: - This is the endoscopic treatment of ureter stones using a mini-scope. Under general anaesthesia, the ureteroscope is passed via the urethra into the bladder and up the ureter. A laser fibre or lithoclast probe is used to break the stone into smaller pieces. These tiny stone pieces will pass out on their own. Sometimes a wire basket is used to fish out the stone pieces. This surgery takes 30 mins on average and can be done as a day case. Occasionally, a double-J (DJ) stent may need to be inserted if there be any injury to the ureter wall or if there is already gross hydronephrosis (swelling) of the kidney due to the impacted stone. The success rate for stones lodged in the lower ureter is near 100%. For stones lodged at the mid to upper ureter, there is a chance they may float up into the kidney beyond the reach of the scope. If this happens, then a DJ stent is inserted and the stone managed by ESWL.

The advantages of this method over ESWL is that even hard stones can be broken and the ureter opening is simultaneously dilated by the scope to facilitate stone passage.

TURP - During transurethral resection of the prostate (TURP), an instrument is inserted up the urethra to remove the section of the prostate that is blocking urine flow. TURP usually requires a stay in the hospital. It is done using a general or spinal anesthetic. What To Expect After Surgery The hospital stay after TURP is commonly 1 to 2 days. Following surgery, a catheter camera.gif is used to remove urine and blood or blood clots in the bladder that may result from the procedure. When the urine is free of significant bleeding or blood clots, the catheter can be removed and you can go home. Strenuous activity, constipation, and sexual activity should be avoided for about 4 to 6 weeks. Symptoms such as frequent urination will continue for a while because of irritation and inflammation caused by the surgery. But they should ease during the first 6 weeks.

TURBT - Transurethral Resection of Bladder Tumor (TURBT)

What is a TURBT ?
A TURBT is a procedure in which bladder tumors can be removed from the bladder wall. This is a procedure performed completely with a scope that is inserted through the urethra into the bladder. It is generally performed in the hospital setting as an outpatient with the patient anesthetized. During the procedure, a scope with a special cutting instrument is inserted through the natural channel into the bladder and then the tumor is removed. The resulting area of resection can then also be cauterized by specialized instruments.

What is the purpose of a TURBT ?
A TURBT allows your urologist to both diagnose and potentially treat various bladder disorders. The most common indication for a TURBT is bladder cancer. 75% of bladder cancers that are discovered are superficial in nature. In other words, most bladder cancers grow only on the surface of the bladder wall and not deep into the bladder wall. This allows a surgeon to remove the bladder tumor down to the level of the bladder wall without damaging the deeper layers of the bladder.

The information that is gained from this procedure will inform your surgeon as to the type of tumor or abnormality that is in the bladder, as well as how extensive it is. This can then guide your physician in determining whether or not additional treatment will be required for your condition.

What are the common symptoms following my TURBT ?
As with most procedures that require endoscopy of the urinary tract, there is often burning and some mild discomfort when urinating for several days. It is also common to have a change in the force of the urinary stream for several days and perhaps even 1-2 weeks.

Bleeding is also very common after this procedure. In the immediate hours after the procedure, there is often blood left over from the procedure that inevitably will color the urine bright red. Also, small clots may be produced and evacuated in this time period. Usually this bleeding will clear in 1-2 days.

It is also very common for a patient to experience a small episode of repeat bleeding 1-2 weeks following his/her procedure. Typically, this is a small healing scab that is released from the urinary tract 1-2 weeks after the healing process has begun. This may be associated with a small amount of bleeding that should be self-limited.