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Urology

Shija Hospitals and Research Institute, Langol is not only a pioneer but also a leading brand in the field of urinary stone management in Eastern India.

The urinary system - at a glance

The urinary system comprises of two kidneys, two ureters, one urinary bladder and one urethra. The kidneys remove the harmful toxic and unwanted chemicals from the blood and return the cleaned blood to the body. The waste materials and excess water forms urine and sends it to the urinary bladder through the ureters. The urinary bladder is a muscular bag that holds urine till it is expelled out of the body through the urethra.

What are urinary stones?

The kidneys remove a wide range of unwanted chemicals from the body. Normally they are dissolved in water and flows out. But under some situations, the chemicals are not completely dissolved in water. The un-dissolved chemicals become solid precipitate. These tiny crystals stick together and grow into a stone ranging in size from a grain of sand to a golf ball.

Facilities at SHRI for treating urinary stones?

In earlier days, kidney stone used to be treated with open surgeries, where the abdomen was cut open to remove the stone. Besides the long incision, it involved pain, increased chance of infection and longer hospital stay. But now, we offer the following minimally invasive procedures.

Lithotripsy (Lith = stone, tripsy = breakup)

Extracorporeal Shockwave Lithotripsy (ESWL) is the most frequently used non surgical treatment wherein shockwaves of high frequencies are generated outside the body to break the stones inside. The stones break up into pieces and are passed in the urine. Advantages of ESWL are, it is an out-patient procedure, no need to stay in the hospital, it is almost painless, there is no incision and recovery is very fast.

Percutaneous Nephrolithotomy (PCNL)

This treatment is used if the stone is large or its location does not allow effective use of ESWL. In this procedure, the surgeon makes a tiny incision in the back and creates a tunnel directly into the kidney. The stone is located with the help of nephroscope and removed either as whole or by breaking it into pieces. Advantages of PCNL are, single procedure completing stone clearance, suitable for large stones, stag horn or branched stones, stones in multiple locations. Hospitalization may be required for a few days and allows early return to normal life and work. Repeated hospital visits are not required and therefore it is economical.

Ureteroscopic Stone Removal (URS)

Apart from kidneys, stones can also form in the ureters as well. These can be removed without any surgery or incision. The surgeon passes a small instrument called ureteroscope through the urethra and bladder in the ureter. The stone is located and removed either as whole or by breaking it into pieces. Occasionally, a double - J (DJ) stent may be inserted after the procedure if there is any injury to the ureter wall or if there is gross swelling of the kidney caused by the stone. Discharge is usually on the same day. Advantages of this procedure are no incision, no bleeding, no hospital stay, minimal pain and faster recovery.

Cystoscopic Lithotripsy (CLT)

It is the removal of bladder stones using a cystoscope, which is an endoscope especially designed for urological use. To remove stones, an instrument that looks like a tiny basket or grasper is inserted through the cystoscope so that small stones can be extracted through the scope’s channel.

Trans - urethral Resection of Prostate (TURP)

'Benign Prostatic Hyperplasia' (BPH) which means extra growth of normal (non-cancerous) cells that often begins at the age of 40, causing your prostate to gradually increase in size as you get older. As the prostate surrounds the urethra, the enlargement can squeeze the urethra making it difficult for you to pass urine. A Trans-urethral Resection of the Prostate is a minimally invasive operation to remove the parts of the prostate gland that are pressing on the urethra in order to allow urine to flow more freely.

Trans - urethral Resection of Bladder Tumour (TURBT)

It is the endoscopic removal of tumours in the bladder. A resectoscope (a loop - cutting instrument) is passed through the urethra to cut the whole tumour down to its base. Biopsies are then taken from the base to see if it has invaded into the bladder muscle.

Armamentarium in the department of Urology

A comprehensive healthcare destination, Shija Hospitals provides all facilities of modern urological services. Accomplished specialists, highly competent technicians, dedicated nurses and warm personal care ensures that the best care is provided to everyone. Other support services include ICU, strong nephrology department and round the clock pathology, microbiology, biochemistry, radiology and imaging, pharmacy and ambulance facilities.

Modular Miniature Nephroscope System (MINI-PERK, KARL STORZ-GERMANY)

Stones of the renal pelvis can be treated either by ESWL or PCNL. As a low risk procedure with a longer treatment period, ESWL often leads to persistent residual stone fragments, whereas conventional PCNL achieves a higher stone-free rate and allows a shorter treatment period albeit with a somewhat higher surgical risk. The new modular nephroscope system is designed to fulfil all tasks of percutaneous surgery with one single instrument. The tool is a result of continuous research based on daily routine. Emphasis is given to improve patient comfort, access, stone clearance, to reduce procedure time and to avoid major complications like fluid overload, sepsis, renal lesions and haemorrhage. This state of the art system allows access to the renal collecting system making PCNL a safe, successful and comfortable procedure for both the patient and the surgeon.

KARL STORZ Calculase-II. Holmium Laser System

Shortly after their development, lasers were referred to as a solution eagerly looking for a problem. Indeed, lasers progressed rapidly as an omnipresent part of modern technology and procedural medicine. Recent advances in lasers and fiber optics make them ideally suited to travel through routes in the human body where no hand or scalpel has gone before. With its widespread use of small diameter endoscopic instruments, urology has been drastically and positively influenced by this technology. Perhaps more so than any other medical subspecialty. The Calculase low power Holmium YAG Laser system permits a cost effective and successful endoscopic fiber-guided laser lithotripsy for the treatment of bladder, ureter and kidney stones. Calculase may also be used for various soft-tissue applications in the urinary tract including strictures of the ureteropelvic junction, ureteral strictures and ablation of transitional cell carcinomas.

Landmarks of Shija Hospitals in the field of Urology

  • 1st to install Harmonic Scalpel for bloodless surgery in Indian Sub-Continent - 1997
  • Full fledged endourology (PCNL, TURP, ESWL, CLT, TURBT) for the first time in Manipur - 2003
  • First to perform laparoscopic nephrectomy in Manipur - 2006
  • First to install Stryker’s High Definition (HD) Camera with LED Light Source in Manipur - 2010
  • First to install KARL STORZ, Flexible ureteroscope, MINI PERK (miniature nephroscope) & Calculase-II, Holmium Laser system in Manipur - 2012

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