What is PCNL?

November 1, 2022 UncategorizedDr. Ketan VartakComments Off

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

Current trends in Urology

October 3, 2022 Current trends in UrologyDr. Ketan VartakComments Off

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