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Living Donor Kidney Transplant

Management Team

Living Donor Kidney Transplant

Overview

This is a surgical procedure in which a kidney from a living donor and transplanted into a recipient who is experiencing kidney failure. As one kidney is adequate to sustain a healthy life, the donor can go on to live a healthy life even after the kidney donation.

Before undergoing a living donor kidney transplant, the transplant team evaluates your overall health, verifies the donor’s health, and ensures the kidney is a suitable match for you. Living donor kidney transplants provide some benefits as compared to decreased donor kidney transplants, such as:

  • Shorter waiting time: The database and waitlist for deceased donor kidneys is typically maintained nationally. The health of the patient who requires a kidney may decline while waiting for a suitable kidney to become available
  • Can help avoid dialysis: If the patient has not yet started dialysis, transplantation can help avoid it
  • Better survival rates: Patient survival rates are usually higher after kidney transplantation
  • Scheduled transplant surgery: Deceased donor kidneys have a short window during which they must be transplanted, leading to unscheduled and urgent surgery. On the other hand, with a living donor, the transplant can be planned and scheduled ahead of time.

During a living donor kidney transplant, the donor kidney is positioned within the patient’s lower abdomen. Its blood vessels are connected to those in the lower abdomen or above one of the legs. The ureter, a tube that carries urine, is then attached from the new kidney to the bladder to enable urine flow. Typically, the patient’s non-functioning kidneys are left within the body.

  • The surgery is followed by a hospital stay of a few days to a week
  • An immune-suppressing medication regimen to prevent the immune system from rejecting the kidney is prescribed
  • Additionally, antibacterial, antiviral, and antifungal medicines are provided to prevent an infection
  • The medication regimen needs to be followed carefully because skipping them for even a short period can cause the body to reject the kidney
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Laser Prostatectomy

Management Team

Laser Prostatectomy

Overview

This is a laser-enabled surgery used to treat moderate-to-severe symptoms caused by benign prostate enlargement or hyperplasia (BPE or BPH). As the prostate surrounds the urethra, the tube through which urine exits the body, an enlarged prostate restricts the flow of urine from the bladder. BPE/H is a non-cancerous enlargement of the prostate gland.

Laser surgery tends to be non-invasive or minimally invasive. Moreover, unlike pharmaceutical treatments, surgical treatments offer immediate improvements in symptoms. Laser surgery also provides many benefits over other surgical methods of treating BPE/H, such as:

  • Lower risk of bleeding: This makes it suitable for people who take blood thinners or who have bleeding disorders that cause abnormal clotting
  • Shorter hospital stay/outpatient procedure: As the surgery and recovery are quick, it can be performed on an outpatient basis or requiring only an overnight hospital stay
  • Quicker recovery: Recovery following laser surgery is generally compared to open surgery or trans-urethral resection of the prostate
  • Reduced need for catheter: Unlike other surgical treatments for BPE/H, which often require a catheter (tube) to drain urine from the bladder after surgery for extended period, laser surgery typically necessitates a catheter for less than 24 hours.

This is a surgical procedure during which a scope is gently inserted through the penile tip into the urethral opening. As the laser is carefully passed through the scope it reduces or shrinks excess tissue from the prostate and removes the restrictions on urine flow. The different types of laser prostate surgery include:

  • Green light laser vaporisation: The urinary tract is enlarged by melting away/vaporising the excess tissue of the prostate. Mild-to-moderate BPE/H can be treated using this technique
  • Holmium laser enucleation (HoLEP): Here, the excess prostate tissue restricting the urethra is cut and removed using a laser. Following this process, another instrument slices the prostate tissue into small pieces, which can then easily removed. HoLEP is typically used to treat severely enlarged prostates.
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Cystoscopy

Management Team

Cystoscopy

Overview

A cystoscopy examines the lining of the bladder and urethra (the tube through which urine exits the body). It is used to diagnose, monitor, and treat a number of urinary conditions.

  • It can be done a simple outpatient procedure, which takes between 5–15 minutes
  • The procedure can also be performed in a hospital under sedation or general anaesthesia. In these cases it takes around 15–30 minutes

Cystoscopy can be used for the following:

  • Investigation of underlying causes for certain urinary symptoms
  • Diagnosis and treatment of bladder diseases and conditions
  • Diagnosis of prostate enlargement
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Urinary tract infections

Management Team

Urinary tract infections

Overview

Urinary tract infection (UTI) is an infection of the tissues in the urinary system that is especially common in women.

UTIs are typically accompanied by the following symptoms:

  • Abnormal urination, such as increased frequency, bladder urgency, excessive night-time urination, poor urine flow, or intermittent urine flow
  • Fever with chills
  • Burning sensation during urination
  • Blood in urine
  • Pain in the flank (side of the abdomen)
  • Suprapubic pain, or pain in the area below the belly button and above the pubic bone

UTIs can be diagnosed using the following techniques:

  • Urinalysis: A routine urine test
  • Kidney function test, complete blood count, and c-reactive protein: A blood test that detects common indicators of UTIs
  • Ultrasound abdomen/KUB/pelvis: An ultrasound examination of the abdomen, kidneys, ureters and bladder, or pelvis
  • Urine culture and sensitivity: The cells present in the urine are cultured and studied
  • CT KUB: A CT scan of the kidneys, ureters, and bladder

UTIs can be treated in the following ways:

  • Conservative management using medication
  • Surgical management depending upon the underlying cause for the UTI
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U

Urinary incontinence

Management Team

Urinary incontinence

Overview

Unintentional urination or leaking or urine is referred to as urinary incontinence. Underlying medical conditions, physical problems, childbirth, or everyday habits can contribute to urinary incontinence.

Urinary incontinence has the following symptoms:

  • Inadvertent leaking of urine
  • Accidental leaking or urine
  • Bladder urgency, or the sudden, intense urge to urinate
  • Nocturnal/Night-time leaking of urine
  • Suprapubic discomfort, or discomfort in the area below the belly button and above the pubic area
  • Recurrent urinary infections

Urinary incontinence can be investigated using the following techniques:

  • Ultrasound KUB or PVR: An ultrasound examination of the kidneys, ureters, and bladder or post-void residual (PVR) test that analyses the volume of urine left in the bladder after urination
  • Uroflowmetry: An analysis of the flow, amount, and duration of urination
  • Urodynamic study: This is a procedure that examines how the muscles and other parts of the urinary tract participate in the storage and release of urine
  • Bladder diary maintenance: The patient keeps a diary of urination and incontinence events and discusses it with their physician

Urinary incontinence can be treated in the following ways:

  • Conservative management using medication, pelvic floor muscle exercises, and bladder training
  • Surgical management based on the underlying cause for urinary incontinence
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U

Prostate Cancer

Management Team

Prostate Cancer

Overview

The Prostate Cancer Clinic at Sir H. N. Reliance Foundation Hospital is Mumbai’s first specialised centre for diagnosing and managing prostate-related diseases and cancer.

Our team of expert urologists and state-of-the-art technology offers advanced diagnosis, treatment, and rehabilitation under one roof, ensuring comprehensive care from prevention to post-surgery recovery. 

We also provide educational sessions to help men understand and manage prostate conditions confidently and without stigma. Our goal is to empower men to lead healthier, more comfortable lives while receiving world-class care for prostate-related concerns.

Location: Level 3, Tower Building

  • Our Services
  • Conditions We Treat

Our clinic provides a wide range of specialised services aimed at the management, diagnosis, and treatment of various prostate diseases.

  • Comprehensive diagnostic examinations:
    • Physical examinations of the prostate
    • Urine and blood tests
    • Imaging studies
  • Fusion Prostate biopsy: combines MRI and ultrasound imaging to target suspicious areas within the prostate gland for cancer detection
  • Robotic-assisted radical prostatectomy (RARP): A minimally invasive robotic system-guided surgical procedure to remove the entire prostate gland and the surrounding tissues; this procedure is associated with reduced pain, shorter durations of hospital stay, and quicker recovery.
  • Pre- and post-surgery care: Our team offers comprehensive care to patients before and after surgery, including assistance with pre- and post-surgery to-dos, precautionary measures, rehabilitation, nutrition, and well-being.
  • Educational consultations with urologists: Our team offers exclusive one-on-one sessions for our patients; these include the dissemination of information regarding various conditions and counselling sessions to help patients deal with the psychological issues associated with their condition.
  • Consultations with the multidisciplinary tumour board (MDTB) for multidisciplinary care: Our team ensures that complex cases are reviewed by the MDTB to ensure that a more accurate treatment plan may be followed.

Our clinic is equipped to diagnose, treat, and manage a wide variety of prostate disorders.

  • Prostate cancers
  • Benign prostatic hyperplasia: The non-cancerous enlargement of the prostate that is common with ageing; this causes trouble with urination and ejaculation.
  • Prostatitis: Inflammation of the prostate gland, causing pain while urination, groin pain, and discomfort in the genitals and/or pelvic region.
  • Prostate stones: Occurrence of mineral deposits (primarily calcium phosphate) in the prostate.
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Bladder Stone

Management Team

Bladder Stone

Overview

These are accumulated deposits of minerals and salts in the bladder. Bladder stones can cause urinary discomfort and can be treated in several ways.

The symptoms of bladder stones include:

  • Increased frequency of urination
  • Bladder urgency, or the sudden, intense urge to pass urine
  • Poor urine flow
  • Suprapubic pain, or pain between the belly button and pubic bone area
  • Abrupt cut-off in urinary stream

Bladder stones can be diagnosed using the following methods:

  • X-ray KUB: An x-ray of the kidneys, ureters, and bladder
  • NCCT KUB: A non-contrast CT scan of the kidneys, ureters, and bladder

Bladder stones can be treated using the following methods:

Cystolithotripsy: This is a surgical procedure to remove small- to medium-sized bladder stones

Cystolitholapaxy: This is a procedure in which a laser is used to break down the bladder stones into smaller pieces

Percutaneous cystolithotripsy: This is a minimally invasive procedure to remove bladder stones

Cystolithotomy: This is a surgical procedure used to remove large and/or numerous bladder stones. Cystolithotomy can be either open, laparoscopic, or robotic-assisted

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B

Kidney Cancer

Management Team

Kidney Cancer

Overview

This is a condition where the cells of the kidney begin to divide uncontrollably. There are many treatment options for kidney cancer.

The following are symptoms of kidney cancer:

  • Incidental detection of the tumour mass during imaging
  • Blood in the urine
  • Unexplained weight loss
  • A mass or bulge on the side of the abdomen

Kidney cancer can be diagnosed using the following investigations:

  • CT urogram: A CT scan of the kidneys, ureters, and bladder
  • Cystoscopy: A surgical procedure to examine the lining of the bladder, urethra, and ureters

The following options exist to treat kidney cancer:

  • Robot-assisted partial nephrectomy: A surgical procedure to remove the tumour from the kidney using robotic assistance
  • Open partial nephrectomy: A surgical procedure to excise the cancerous tissue from the kidney
  • Laparoscopic/robotic radical nephrectomy: A robot-assisted surgical procedure to remove the complete kidney, along with adjacent organs such as adrenal glands, fat tissues, and lymph nodes
  • Open radical nephrectomy: This is a surgical procedure in which the entire kidney, along with nearby fat tissue, adrenal glands, and lymph nodes, are removed
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K

Kidney Stones

Management Team

Kidney Stones

Overview

This is the accumulation of mineral and salt deposits within the kidney. It is a painful condition. The risk of kidney stones is increased by certain dietary choices, excess body weight, as well as certain medications and supplements.

The symptoms of kidney stones include:

  • Pain in the flank (between the back and abdomen/upper belly)
  • Blood in the urine
  • Lithuria, which refers to excess acid or salts in the urine
  • Fever with chills
  • Burning sensation during urination

Kidney stones can be diagnosed using the following methods:

  • Ultrasound KUB: An ultrasound of the kidneys, ureters, and bladder
  • NCCT KUB: A non-contrast CT scan of the kidneys, ureters, and bladder
  • Urinalysis: A routine urine test
  • Kidney function test, C-reactive protein, and complete blood count: These are blood tests that check for the markers of kidney dysfunction 

The following treatment options exist for kidney stones:

  • Ureteroscopic laser lithotripsy: A non-invasive procedure that uses a laser to break down the kidney stones
  • Retrograde intrarenal surgery (RIRS): Surgery is performed on the kidney to treat kidney stones
  • Percutaneous nephrolithotomy (PCNL): This is a surgery that is used when the kidney stones are large and other non-invasive methods of treatment cannot be used
  • Extracorporeal shockwave lithotripsy: This is a non-invasive method that breaks up kidney stones using shockwaves  
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K

Bladder Cancer

Management Team

Bladder Cancer

Overview

This is a type of cancer that occurs when the cells in the bladder begin to grow uncontrollably. It is a relatively rare form of cancer with a variety of treatment options.

The symptoms of bladder cancer may include: 

  • Blood in the urine
  • Abnormal urination, including frequent urination, bladder urgency, and poor flow

Bladder cancer can be diagnosed using the following techniques:

  • Urine cytology: A urine test that checks for the presence of cancerous cells
  • CT urogram: A CT scan of the kidneys, ureters, and bladder
  • Ultrasound KUB: A diagnostic ultrasound to assess the kidneys, ureters, and bladder.

Bladder cancer is treatable. The following options exist for patients with bladder cancer:

  • Trans-urethral resection of bladder tumour (TURBT): A surgical procedure used to remove the cancerous part of the bladder through the urethra
  • En bloc laser enucleation of bladder tumour: This is a minimally invasive technique in which the cancerous tumour is excised using lasers
  • Radical cystectomy: This is a surgical procedure to remove the entire bladder. It also usually includes the removal of adjacent organs such as the prostate and seminal vesicles, or the ovaries, fallopian tubes, uterus, and/or parts of the vagina
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