The Stone Clinic

Hello, I am Dr Anil Agarwal I am a practising neurologist from last 15 years and I specialise in minimally invasive treatment for kidney stones. Kidney stones may cause pain, blood in the urine, infection, obstruction and damage to the kidney. These stones may be located either in the Kidneys along with the line of the ureter in the urine bladder or sometimes it will be stuck in the urethra. Then when there is a patient of urinary stones we investigate either by ultrasound, X-Rays, CT-Scans, kidney function test and urine examination. For very small stones in the Kidneys or in the ureter medications maybe try and they are sometimes very helpful in removing the stones, especially patients who have uric acid stones may be treated with medication. Surgery for kidney and urinary stones has now become very simple it has evolved a lot over the years and now minimally invasive treatment is available which is very safe. For Stones in the urethra and urinary bladder endoscopic surgery is done surgery where there no cuts and stitches patient can go home on the same day and he is back to work on the next day, it is so easy and simple. For Stones in the lower ureter patients undergoes the ureterorenoscopy surgery discharge next day, back to work in two days and treatment is very easy there are no cuts and stitches it is very simple for stones in the upper ureter and kidneys. There are three forms of treatment that we do, one is the ureterorenoscopy surgery second is retrograde internal surgery or RIRS or third is PCNL, now we have come down to mini PCNL, in which there is endoscope that is passed through the urethra into the ureter the stones are broken and remove. In PCNL and it was a small puncture in the kidney in mini PCNL we break the stones and take them out, a patient needs maximum hospitalization of one or two days and then back to work very early. Earlier they used to be open surgery that was the only form of treatment, now open surgery is only reserved for patients very few patients, it may be around 1 in 1000 only. There is one more treatment that is available for kidney and ureteral stones, that is Lithotripsy or ESWL in with shock waves are passed to the stone, the stone is broken by the machine and patient passes small fragment in urine. Now I must also tell that this treatment the success rate is up to 90% in very few selected store. Now in a nutshell what I have told you that don't be afraid of kidney stone, the treatment is very simple you just need to consult an experienced urologist who may help you with treatment options that are available and remove your stones. Now what happens, if you ignore this problem the stones and what happens next? The problems that may arise are repeated infections, now if the stone is obstructing then it may damage the kidney I have seen patients who have damaged their kidneys to extend that they are on dialysis and this is only because they have not followed the proper medication and advice by Neurologist. So I urge you all to consult a Urologist and take a proper remedial step so that your stones are removed and your kidneys are saved. Thank you all for your patience and wish you all a very happy and healthy life and wish to make every person stone free thank you.

Hello, I am Dr Anil Agarwal I am a practising Urologist for the last 15 years, I practice in Rohini in Delhi. Today I am going to talk about urinary problems faced by both men and women. Let's start with problems faced by women first, women may have four types of problems like burning in the urine, difficulty to pass urine, increase frequency to pass urine and sometimes involuntary leakage of urine. Burning in urine is generally due to infection and it is very common starting from a young age to the elderly, this is very common in the very young girls and elderly females, treatment is very simple with medication. Now when women have difficulty to pass urine, they have strain to pass urine it means there is a structure of the urinary pipe i.e. urethra. Third, when women have increased frequency to pass urin that is due to changes in the bladder wall musculature which results in increase times that a woman has to go to pass urine during the day and night, they may have also experience the urgency to pass urine and sometimes during the urgency they may even leak urine. Now, most of the women are hesitate to come to the doctor because they feel what kind of physical examination that will be done, I assure all women that no physical examination is required, it is only some tests that may be required and treatment is with medication. Even if some procedure is required endoscopy which we called cystoscopy toh kripya zizak na karen aur apne doctor se sampark karen, kisi tarah ki physical jaanch nahi ki jati hai. There is another condition called stress urinary incontinence in which women may pass urine during coughing or sneezing, this is due to laxity of the pelvic floor muscles when the muscles become lax they do not support the urethra and the patient may pass urine during sneezing and coughing. The treatment is with some exercises and those people who do not respond to the exercises may need a very simple surgery which is Day Care surgery, in which we put a tape below the urethra and patient can go home the same evening. So that was about women, in short, now let's discuss urinary problems in men. In males generally, they have 5 types of problems like a urinary infection in which they experience burning in the urine treatment is simple with antibiotics under the care of a urologist. Second, they may have prostatitis, prostatitis is the infection and inflammation of the prostate gland, it occurs in young males treatment is simple with antibiotics and other medications. The third thing which is more important and which is very important in an elderly male is BPH that is enlargement of the prostate gland. In young age, the prostate gland is very small and generally, it becomes walnuts size gland at the age of around 50 years, most of the males have problems after 50 years. In which what happens is when the gland enlarges then it compressors from the urethra and there is difficulty to pass urine, generally these patients have a weak stream increased frequency to pass urine during the day and night, they may have sense of incomplete wording, they may have straining, they may have recurrent urinary infections, these patient are first investigated with ultrasound and urine analysis, kidney function test and the euroflomia treatment after that the treatment is started. In my practice and with the experience that I have, that 9 more than 90% of these patients can be treated from medications alone which are very safe. Now, what happens if you ignore these urinary problems in males, the urinary problems if you ignore may have a recurrent urinary infection, stones in the urinary bladder and may even lead to damage to the kidneys. So I urge the people not to ignore this problem and to consult a urologist. Fourth we may have a condition called cancer in the prostate if detected early then it is potentially curable. Fore thing is stricture urethra it might be difficult to treat urethra but now under endoscopic surgery helps a lot. If you have blood in the urine please don't ignore blood in the urine it may be a tumor in a urinary bladder, you have to consult a urologist and I assure you the treatment is very simple and it is endoscopy. Thank you all for a very patient hearing and wish you all the all very happy and healthy life.