Frequently Asked Questions on Urology, Andrology and Robotic Surgery
av fistula faq-arteriovenous fistula faq
What are the chances of a successful av fistula surgery? – Answered.
The best time to get a av fistula surgery is two to three months before you are expected to begin hemodialysis. That would be when your serum creatinine is around 8 and eGFR is about 15 to 20.
The best time to get a av fistula surgery is two to three months before you are expected to begin hemodialysis. That would be when your serum creatinine is around 8 and eGFR is about 15 to 20. At this time your body is most likely to heal, complications are minimal and you will get two months for the fistula to mature.
Otherwise, earlier in the course of hemodialysis, earlier the better.
bladder cancer treatment
BCG or Bacillus Calmette Guerin is a bacteria (variant of tuberculosis).
It is used as a vaccine in children to protect against TB.
It was found that putting it in urinary bladder in bladder cancer patients, cures them.
The strategy of putting bcg in bladder cancer patients is called intravesical BCG.
Dr Vijayant Govinda Gupta is an expert in bladder cancer treatment and intravesical bcg in DElhi NCR. . On this page he curates his experience and information for patients. Get free E Consult via email or leave a message.
It is the treatment of bladder cancer.
The bladder is removed and replaced with an artificial bladder made of intestine.
Dr Vijayant Govinda Gupta is an expert urologist specialised in radical cystectomy.
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bph symptoms diagnosis
WHAT IS BPH? – BPH DELHI-BPH GURGAON
BENIGN PROSTATIC HYPERTROPHY DELHI NCR GURGAON
Dr Vijayant Govinda Gupta is a Urologist in Delhi NCR who is an expert in diagnosing and managing BPH or Benign Prostatic hypertrophy in Delhi NCR and Gurgaon. If you are looking for information on BPH Delhi/BPH Gurgaon or Benign Prostatic Hypertrophy Delhi NCR and Gurgaon, then you have reached the right place.
I have written a detailed article on BPH and Benign prostate hypertrophy here. BPH or Benign prostatic hypertrophy is a very common problem of old age. My page here discusses in detail about bph and its symptoms. If you require treatment for bph then contact me or visit my website here.
This article here is meant to display my expertise on BPH and Benign Prostate Hypertrophy in Delhi NCR and Gurgaon.
BEST PARTIAL NEPHRECTOMY DELHI-PARTIAL NEPHRECTOMY GURGAON
WHAT IS PARTIAL NEPHRECTOMY?
Partial nephrectomy is the emerging gold standard for management of kidney cancer worldwide. It is the new standard of care for small kidney tumors, or kidney tumors less than 4 cm in size.
In this surgery, instead of removing the entire kidney, only the kidney tumor is removed, hence preserving the kidney.
INDICATIONS OF PARTIAL NEPHRECTOMY
- Small renal masses – less than 4 cm
- Single kidney – patients with only one kidney
- Multiple tumors
- Tumors in both kidneys
- Patient choice
- Patient at risk of kidney failure in the future – Diabetics and hypertensives
ADVANTAGES OF PARTIAL NEPHRECTOMY
- Saves the kidney – tomorrow if you lose the other kidney, you will have a back up
- Prevents damage to other kidney – It is theorized that removal of one kidney puts extra stress on the other kidney, and may lead to kidney failure.
DISADVANTAGES OF PARTIAL NEPHRECTOMY
- More blood loss
- Technically demanding procedure
- Longer operating time
- Higher complications – like urine leak, fever etc
But with refinement of technique, partial nephrectomy is almost equivalent to radical nephrectomy today.
APPROACHES TO PARTIAL NEPHRECTOMY
- OPEN PARTIAL NEPHRECTOMY – Using a subcostal incision, under vision the tumor is removed carefully
- ROBOTIC PARTIAL NEPHRECTOMY – Emerging gold standard
- LAPAROSCOPIC PARTIAL NEPHRECTOMY – Losing to robotics
WHAT IS NSS OR NEPHRON SPARING SURGERY
Nephron sparing surgery or NSS is a synonym for partial nephrectomy.
BEST PARTIAL NEPHRECTOMY DELHI
Dr Vijayant Govinda Gupta provides the best treatment for kidney cancer in Delhi and Gurgaon. Take an appointment.
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BEST RADICAL NEPHRECTOMY DELHI-RADICAL NEPHRECTOMY GURGAON
For the best radical nephrecrtomy Delhi and Gurgaon, take a free E Consult or take an appointment today. Dr Vijayant Govinda Gupta, Mch Urology, is a Urologist in Delhi NCR with significant experience in managing kidney cancer and performing radical nephrectomy.
WHAT IS RADICAL NEPHRECTOMY?
Radical Nephrectomy is a urooncological surgery procedure in which the diseased kidney is removed en tota with all its draining lymphatics. This ensures complete disease removal along with all ways for kidney cancer to spread.
WHAT ARE THE ADVANTAGES OF RADICAL NEPHRECTOMY?
Radical nephrectomy is the gold standard procedure for management of kidney tumors. Its advantages are
- Complete kidney cancer removal
- Minimal risk of recurrence
- early recovery
- Less Complications
WHAT ARE THE DISADVANTAGES OF RADICAL NEPHRECTOMY?
The disadvantages of radical nephrectomy are that it entails complete removal of the kidney. If you are diabetic or hypertensive and at risk of loss to another kidney, this places you at a risk of kidney failure. And there is always a small risk of getting cancer in the other kidney too.
The solution to this partial nephrectomy or nephron sparing surgery.
OPEN RADICAL NEPHRECTOMY OR LAPAROSCOPIC RADICAL NEPHRECTOMY?
Open Radical Nephrectomy is the removal of the kidney via an incision in the flank or below the chest (subcostal). It is necessary for larger or bulky kidney tumors. But it leaves a large scar, is a little more painful and may cause hernia later.
Laparoscopic radical nephrectomy is the standard of care today. Via two small incisions and 5 mm pfannensteil incision the kidney can be delivered with minimal scarring and excellent pain relief.
The choice of approach depends on the size of the kidney tumor, and is best decided by your urologist. Do not choose laparoscopic when not indicated as it can compromise results.
BEST RADICAL NEPHRECTOMY DELHI – WHAT TO EXPECT?
If you choose me as your surgeon for performing radical nephrectomy, then we shall try to make your treatment course as smooth as possible.
The surgery takes place under anaesthesia and you shall remain in the hospital for 2 days prior and 3 days after surgery. The final decision for further treatment shall be taken after the histopathology report is available.
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kidney stone treatment
NON SURGICAL MANAGEMENT OF KIDNEY STONES
MEDICAL DISSOLUTION THERAPY/CONSERVATIVE THERAPY
Dr Vijayant Govinda Gupta is an Urologist and kidney stone expert in Delhi NCR and Gurgaon. Here he discusses medical dissolution therapy as a non surgical approach to kidney stones in contrast to RIRS/PNL or ESWL.
Kidney stones are common in North India and Kidney stone treatment is a fine art, requiring expert opinion and advice. In general, all kidney stones require active treatment.
There are some situations where you may choose conservative therapy.
- Not willing for surgery – Exams, pregnancy, travel, work, family situation. Endless reasons why you may wish to postpone surgery for some time. I understand.
- Failed or Too many surgeries -Sometime even after the best effort of an urologist, some small stones may be left behind in the kidney
- Recurrent stones – You may have already undergone surgery in the past and do not wish for surgey right now
- Unfit for surgery – old age, heart disease, diabetes
- Very tiny stone – the risk of surgery is more than the risk of waiting
In the above situation you may decide to wait. I would advice the same, but caution needs to be exercised. There are very specific precautions during waiting for treatment. And some stones cannot wait. They will cause infection or worse lead to damaged kidneys.
Your urologist is the best person to advice you regarding conservative therapy. based on tests he will determine the size of your stone, number, whether they are infected, whether they can damage your kidneys, and if they will grow bigger on waiting.
If you and your urologist decide to wait, then there are certain lifestyle changes you should consider to optimise your waiting period.
- Increase water intake – drinking upto 4 litres of water is good for you. Remember avoid Tea/Caffeine and sweetened drinks. Carbonated water or Spritzer without sugar is beneficial.
- Decrease your salt intake to 1- 2 g/day. Avoid all achaar and pickles
- Moderate your animal protein especially avoid red meat
- Exercise and maintain ideal body weight – Remember stay well hydrated though during exercise
Apart you will need regular follow up to determine stable stone size.
For further queries feel free to drop a message below or contact me via email.
EXTRACORPOREAL SHOCK WAVE LITHOTRIPSY-Best ESWL Delhi
ESWL Delhi-Best ESWL
ESWL or Extracorporeal shock wave lithotripsy is a modality of kidney stone treatment. Dr Vijayant Govinda Gupta is an urologist in Delhi NCR who specialises in kidney stone surgery and kidney stone treatment Delhi. I am a specialist in ESWL for kidney stones and have performed more than a 100 successful ESWL procedures for kidney stones. Contact today for a free E consult via email for best ESWL Delhi, Delhi NCR and Gurgaon.
What is ESWL?
ESWL is a non invasive modality to treat kidney stones. It is a german technology, originally developed by Dornier. In this technique, a machine produced, very high intensity sound waves. These sound waves are focussed at your stone inside your body. These sound waves will then break the stone and the kidney stone fragment swill pass out into the urine. The lure of ESWL lies in its ability to provide treatment without any incision or anesthesia.
Advantages of ESWL
ESWL was once upon a time the meesiah of urologists everywhere. Due to its simple nature, no incision, no risk of bleeding, surgeons everywhere installed the machines in their clinics. Due to this blinded trust in this modality, all patients would receive one or more sessions of ESWL during the course of their kidney stone treatment.
Today ESWL is truly indicated in the following conditions
- Very small stones – less than 0.5 cm
- Stones not amenable to RIRS or PNL – narrow infundibulum and lower calyx stones
- Stone fragment left behind after PNL
ESWL has certain drawbacks
- It is basically a blind procedure. The wave is focussed on the stone, but with breathing the stone will move in and out of the focus zone.
- The wave will and can cause collateral damage to the kidneys
- Bleeding and infections are known to occure with ESWL
- It also has some pain associated with the procedure
- And ESWL will break apart the stone, but the fragment s have to pass out with urine. Larger stones are not very amenable to ESWL
- And ESWL cannot be given in obese, muscular or pregnant individuals
- Children require general anesthesia
In these circumstances , i would recommend you RIRS or Mini PNL for your kidney stone treatment.
But in highly selected willing patients, where the stone burden is low, or surgery is not possible or if you so wish, I can provide you the Best ESWL Delhi, Best ESWL Gurgaon and Best ESWL in Delhi NCR in terms of results, stone clearance and economy.
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Retrograde Intrarenal Surgery – RIRS- BEST RIRS DELHI
RIRS Delhi-Best RIRS
Dr Vijayant Govinda Gupta is the best urologist in Delhi NCR, who specialises in kidney stone treatment Delhi. In this query he discusses retrograde intrarenal surgery or RIRS in detail. You can get a free econsult via email or leave me a message below.
Retrograde Intrarenal Surgery -What is it?
Retrograde intrarenal surgery or RIRS is the latest modality of kidney stone treatment. It involves introducing a very thin and extremely flexible ureteroscope through the urethra or penis upto the kidney. This involves no cut, scar or incision anywhere. Once the scope has reached the kidney, the urologist uses a laser fibre to dust away the stone. The stone turns to dust and passes down with the urine.
Advantages of RIRS
There is no cut incison or scar. The procedure is totally painless. And the patients can return rapidly to work.
Disadvantages of RIRS
Because the scope is so thin and flexible, it is also very very delicate. The scope may malfunction or break inside the patient. Though rare, the surgeon may need to convert to a traditional PNL.
The stone is dusted, not removed, it depends on the patients urine to wash out the stone.
And yo may be required to undergo a dj stenting a week before the procedure.
RIRS – What to expect?
RIRS is performed under general anesthesia. The procedure can be performed under day care. It is not suitable for very large stones. After the procedure you may be on a dj stent for 1 week. You will need rest for atleast 1 week and off from heavy work for 4 weeks.
Dr Vijayant Govinda Gupta is best urologist in Delhi NCR to provide the Best RIRS Delhi.
Contact me today via email for a free e consult. or leave a message.
Percutaneous Nephrolithotomy or PCNL
Best PCNL Delhi-Best PNL Delhi-Best PCNL surgeon Delhi
Dr Vijayant Govinda Gupta is the best PCNl surgeon in Delhi and is an expert in performing percutaneous nephrolithotomy (also called PCNL or PNL). Read more from the surgeon who performs best PCNL delhi.
Percutaneous nephrolithotomy or PCNL or PNL is a surgical procedure for removing kidney stones. It is a kidney stone treatment.
In this procedure, the urologist makes a puncture into the kidney with a needle from your back. With this puncture then he creates a channel from the outside to the inside of your kidney. Using a camera and laser or lithotripter, the urologist will then proceed to break and remove all stones.
PCNL is the gold standard procedure for kidney stone treatment.
It is the gold standard because –
The surgeon has excellent view of the inside of the kidney and can remove all stones under complete vision
Because of a large channel, stones of all sizes can be completely cleared.
But PCNL has certain disadvantages
- Bleeding – The most feared complication. Kidney is basically a bag of water and blood with a thin filter in between. When we create a channel, the chances to injure a blood vessel are very high. But in expert hands bleeding is usually rare and if it happens can be managed.
- Infection – Kidney stones are infected stones. During the procedure, to ensure good visibility and faster clearance, the stones are continuously washed with saline. This can cause infection in some patients. (less than 1%)
To reduce these complications, newer techniques of PCNl have arrived. One of these is the Minimally Invasive PCNL or MIP. Instead of making a large tract of 6 mm, only a 2 or 3 mm tract is made. This reduces bleeding, pain and infection.
I am qualified to perform all variants of PCNL, to give you the best treatment results and fastest recovery.
What to expect during PCNL/PNL?
PCNL is performed under general anesthesia. It is performed in prone position, that means you would be lying on your stomach. After the surgery, your urologist may put a dj stent which will be removed after 2 weeks. You will need bed rest for 1 week and you cannot perform vigorous exercise and heavy work for 6 weeks after the surgery.
You can leave me a mail or a message for a free e consult where we can discuss about your kidney stone treatment options in detail.
no scalpel vasectomy
For a happy family, family planning is essential. In todays times of population growth and expenses, it makes sense to limit the family size in terms of number of children.
Traditionally the woman have been subjected to surgery such as tubectomy or mini lap in an attempt to limit family.
Mens efforts have been limited to condom usage.
But with the advent of no scalpel vasectomy, men today have a painless and reliable alternative.
Smart men today are adopting vasectomy instead of subjecting their wives to tubectomy.
Male sterilization is a family planning method in which instead of the female partner, the male partner or the man chooses a surgical procedure that prevents sperms from coming in the semen.
No scalpel vasectomy is a male sterilization procedure.
Dr Vijayant Govinda Gupta specialises in male sterilization.
No scalpel vasectomy is a surgical technique developed in China and now prevalent world wide. It means cutting the vas and stopping the sperm pathway from the testis to the semen. It is an effective method of male sterilization.
The no scalpel means that no cut or incision is made, the surgery is painless and no sutures are needed.
Prostate Specific Antigen (PSA)
Prostate Specific Antigen Delhi-PSA Delhi-PSA Gurgaon
Dr Vijayant Govinda Gupta is a Urologist in Delhi NCR and Gurgaon specialising in prostate cancer diagnosis and prostate cancer treatment. He is the best doctor to full evaluate and advise on elevated PSA levels and to interpret your prostate specific antigen levels. If you have received a PSA test in Delhi or a PSA test in Gurgaon or a PSA test in NCR, contact me today. Get a free e consult via email or drop a message.
PSA Delhi-PSA Gurgaon-PSA NCR
I have written other articles for your consideration.
- Prostate cancer – Symptoms and Diagnosis – Describes in detail the various modalities to diagnose prostate cancer
- Prostate cancer treatment – Radical Prostatectomy – Describes in detail various prostate cancer treatment options.
- Prostate cancer in Delhi-Prostate cancer in Gurgaon – My facilities in Delhi and Gurgaon to treat prostate cancer.
- Prostate cancer treatment in Delhi and NCR – Robotic Radical Prostatectomy Delhi Gurgaon – Describes essential information on robotic radical prostatectomy in Delhi and NCR.
- Serum PSA – Patient resource
If you still have any doubts feel free to contact me via email or drop me a message below.
Robotic Radical Prostatectomy Delhi-Radical Prostatectomy Delhi
Robotic Radical Prostatectomy Gurgaon-Radical Prostatectomy Gurgaon
Dr Vijayant Govinda Gupta is a Urologist and Robotic Surgeon in Delhi specialising in Urooncology and Robotic surgery of Prostate cancer including Robotic Radical prostatectomy Delhi and Robotic Radical Prostatectomy Gurgaon.
What is Radical Prosatectomy – Is Radical Prostatectomy in Delhi and NCR?
Radical prostatectomy is a urooncological surgery in which the diseased prostate gland is removed en toto from the body along with its draining lymphnodes. This surgery is the curative surgery for prostate cancer. A technically complex and a challenging surgery, it requires expert assessment and great care from the operating surgeon. Apart from this, choosing whether you are suitable for this surgery is a challenge, few urologist are trained in.
With the introduction of the Da Vinci surgical robot, thankfully the world class cutting edge technique of Robotic Radical Prostatectomy is now available in Delhi and Gurgaon.
What is a Surgical Robot? Is Robotic Radical prostatectomy Delhi and Robotic Radical Prostatectomy Gurgaon a reality?
A surgical robotic system is specialised cutting edge machine manufactured world over by Intuitive Surgicals, a California based company. It is supplied in India by a company called Vattikutti Institute. Specialised training is recommended before a someone is authorised to work on the console.
In this procedure the surgeon uses his wrist to manipulate the arms of a patient side robot and with high magnification and precise movements. Very intricate procedures can be performed inside the patient with very minimal scars and blood loss.
I have the good fortune to train at PGI Chandigarh, where the Da Vinci HD Si system has been operational since 2014. There I assisted in more than 50 robotic surgeries. The Da Vinci simulator was also operational and as a resident, simulator on time was provided to each of us.
Is Radical Prostatectomy possible without a robot?
Yes, Radical Prostatectomy is possible without a robot. In fact, data worldwide shows that open or laparoscopic conventional radical prostatectomy is superior. But, patient choice drives the decision. I am comfortable doing open, laparoscopic and Robotic Radical prostatectomy. The best option for you is always a decision made with consultation. What is right for you may not be right for some one else.
Who is the Best Robotic Surgeon in Delhi?
Best is a generic term. I believe the surgeon who can provide you relief from your disease in a economical ethical and caring manner is the Best Robotic Surgeon in Delhi and Gurgaon. A surgon who knows when to ask for help at the right time instead of compromising your care is the Best Robotic Surgeon in Delhi NCR.
I have my teachers and stalwarts practicing in Delhi, Gurgaon and NCR. In fron of these giants, I will always be a student. That said, it is my strong belief that prostate cancer is not a disease by a commitment. I will hold your hand through your entire journey to recover from this disease, a stronger man.
To take a free econsult, leave a message or drop a email.
PROSTATE CANCER TREATMENT DELHI-PROSTATE CANCER TREATMENT GURGAON
Dr Vijayant Govinda Gupta is a Urologist in Delhi NCR and Gurgaon specialising in Urooncology with special interest in the treatment of prostate cancer. You can read an excellent article on prostate cancer diagnosis here. In this article I write about prostate cancer treatment Delhi, Prostate cancer treatment Gurgaon and prostate cancer treatment in NCR.
Why a Urologist for Prostate Cancer Treatment in Delhi?
A urologist is the best qualified medical specialist to handle your complex condition. Due to efforts and progress in science, today prostate cancer is eminently treatable. A Urologist will not only ensure treatment but will allow you to have a great quality of life too.
Delhi being a Metro, has many Urologist. Choose a Urologist that can provide you the best prostate cancer treatment Delhi and best Prosatate cancer treatment Gurgaon.
I can provide you the best results and a comfortable Prostate cancer treatment in Delhi NCR and Gurgaon, if you do choose me as your treating urologist.
What treatment of Prostate cancer can I offer you in Delhi and Gurgaon?
In Delhi and Gurgaon, I can offer you all the latest modalities of treatment including Robotic Radical Prostatectomy.
Contact me today for further discussion about your problem. Get a free consult via email, or leave a message.
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PROSTATE CANCER DELHI-PROSTATE CANCER NCR-PROSTATE CANCER GURGAON
Dr Vijayant Govinda Gupta is the best urologist in Delhi and NCR for the diagnosis and treatment of Prostate Cancer. Read further for more information on Prostate Cancer Delhi, Prostate Cancer NCR and Prostate Cancer Gurgaon.
PROSTATE CANCER DELHI-PROSTATE CANCER NCR-PROSTATE CANCER GURGAON
Prostate cancer is a rising problem in urban populations, especially in cities like Delhi and the National Capital Region. Gurgaon is seeing a rapid increase in population. And with it, its residents are having to face this dreaded problem.
Prostate cancer is eminently treatable. If caught early, it is completely curable and long term survival is the norm. But, prostate cancer is also an enigma of treatment paradigm. It requires very very careful and nuanced workup by a qualified urologist with significant experience in diagnosis of prostate cancer.
Why should I contact an Urologist for Prostate Cancer in Delhi?
Prostate cancer is a disease with a very long course. You will live for many many years after treatment. A urologist is the one person who is the most qualified to manage all associated complications and life issues. Other specialities may mange your cancer initially, but at some point will always require a urologist to come on board. So consulting a good urologist in your area (Delhi, NCR Gurgaon) for prostate cancer will be in your best interest
Am I competent in evaluating all the latest diagnostic modalities for prostate cancer?
I am fully qualified in evaluating and diagnosing prostate cancer in Delhi, prostate cancer in gurgaon and prostate cancer in NCR. I am comfortable in all latest diagnostic modalities like multiparametric MRI, Serum PSA and TRUS guided Biopsies and routinely offer these tests to my patients in Delhi NCR.
If you are suffering from prostate cancer Delhi, Prostate cancer NCR and Prostate cancer Gurgaon, you can take an appointment or get a free econsult via email.
Or drop a message below.
The testis and all its vessels and vas are very minute structures. Ideally for best results, it is essential that the surgery is done with the help of microsurgery.
In microsurgery the surgeon uses a microscope and with extreme care operates on the structures to give you best results.
Laparoscopic surgery or keyhole surgery is a surgical technique in which the surgeon operates through small holes in your body by using a camera and slender instruments. This assures good cosmesis and early recovery.
Best is a generic term. The best doctor is the one who can provide you the most advanced and correct treatment in the safest and most economical way possible. By that definition, I try hard to be the best urologist in Delhi. If you choose me as your treating doctor I assure you that I shall provide you the best advice and treatment, that you require.
A urologist is a qualified expert in the field of urology. A urologist has received additional training and qualification in urology. That means either a M.Ch degree from a recognized university in India.