Urological Treatments

Kidney Stone Treatment in Ghaziabad & Noida

Kidney stones (renal calculi) are one of the most common urological conditions in India, particularly in the northern states. Dr. Keshav Agarwal provides comprehensive kidney stone management using the latest minimally invasive techniques at Kailash Hospital, Noida and Uro-Clinic, Ghaziabad.

Symptoms of Kidney Stones

• Severe pain in the back, side, or lower abdomen (renal colic)
• Blood in urine (haematuria)
• Nausea and vomiting
• Pain during urination
• Frequent urge to urinate
• Fever and chills (if infection is present)

Treatment Options

• Conservative Management — Small stones (under 5mm) may pass naturally with increased fluid intake, pain management, and medical expulsive therapy.
• ESWL (Extracorporeal Shock Wave Lithotripsy) — Non-invasive treatment using shock waves to break stones into smaller fragments that can pass naturally. Suitable for stones up to 2cm in the kidney.
• URS/RIRS (Ureteroscopy / Retrograde Intrarenal Surgery) — A thin scope is passed through the urinary tract to directly visualize and fragment stones using laser energy. No external incisions. Ideal for ureteric stones and small-to-medium kidney stones.
• PCNL (Percutaneous Nephrolithotomy) — For large kidney stones (>2cm), a small puncture is made in the back to access and remove stones. Dr. Agarwal uses his innovative cranio-caudal bull's eye technique for superior calyceal access, improving accuracy and reducing complications.
• Laser Lithotripsy — High-powered holmium laser used during URS or PCNL to fragment stones of any composition. Effective for hard stones that resist shock wave treatment.

When to See a Urologist

Seek immediate medical attention if you experience severe pain that doesn't respond to pain medication, blood in your urine, fever with stone symptoms, or if you are unable to urinate. Even if symptoms are mild, stones larger than 5mm typically require intervention.

Prostate Treatment in Ghaziabad & Noida — BPH & Prostate Cancer

Prostate conditions are among the most common urological issues affecting men over 50 in India. Dr. Agarwal provides expert diagnosis and treatment for both benign prostatic hyperplasia (BPH) and prostate cancer.

Symptoms of BPH (Enlarged Prostate)

• Frequent urination, especially at night (nocturia)
• Weak or interrupted urine stream
• Difficulty starting urination (hesitancy)
• Feeling of incomplete bladder emptying
• Urgency — sudden, strong need to urinate
• Dribbling at the end of urination

Treatment Options for BPH

• Medications — Alpha-blockers (tamsulosin) and 5-alpha reductase inhibitors (finasteride/dutasteride) are first-line treatments for mild-to-moderate symptoms.
• TURP (Transurethral Resection of Prostate) — The gold standard surgical treatment. A scope is passed through the urethra to remove excess prostate tissue blocking urine flow. No external incisions.
• HoLEP (Holmium Laser Enucleation of Prostate) — Advanced laser technique for larger prostates, offering better tissue removal with less bleeding and shorter catheterization time.
• Laser Vaporization — Green light laser for smaller prostates, suitable for patients on blood thinners.

Prostate Cancer Screening & Treatment

Prostate cancer is one of the most common cancers in Indian men over 50. Early detection through PSA (Prostate Specific Antigen) blood test and digital rectal examination significantly improves outcomes. Treatment options include active surveillance for low-risk cancer, robotic radical prostatectomy for localized disease, and radiation therapy referral when appropriate.

Robotic Kidney Transplantation in Noida

Dr. Keshav Agarwal is one of the few surgeons in Delhi-NCR trained in robot-assisted kidney transplantation. This advanced technique is performed at Kailash Hospital, Noida using the Da Vinci robotic surgical system.

Advantages of Robotic Kidney Transplantation

• Smaller Incisions — Compared to the traditional 15-20cm incision, robotic approach uses 5-6 small incisions of 1-2cm each.
• Less Blood Loss — Precision of robotic instruments significantly reduces intraoperative bleeding.
• Faster Recovery — Most patients can mobilize within 24-48 hours and are discharged sooner.
• Reduced Wound Complications — Smaller incisions mean lower risk of wound infection, hernia, and delayed healing — especially beneficial for obese patients and diabetics.
• Better Cosmetic Outcome — Minimal scarring compared to open surgery.

EP-RAKT: Dr. Agarwal's Published Technique

Dr. Agarwal has published research on the Extraperitoneal Robot-Assisted Kidney Transplant (EP-RAKT) technique in the Journal of Endourology. This novel approach avoids entering the peritoneal cavity, reducing the risk of intra-abdominal complications and allowing faster bowel recovery.

Types of Kidney Transplantation

• Living Donor Transplant — Kidney from a healthy family member or compatible donor. This is the most common type in India and offers the best long-term outcomes.
• Deceased Donor Transplant — Kidney from a brain-dead donor through the organ donation network. Wait times vary by region.

Minimally Invasive Urological Surgery in Delhi-NCR

Dr. Agarwal is fellowship-trained in robotic and minimally invasive urology from Max Superspeciality Hospital, New Delhi. He offers the full spectrum of laparoscopic and robotic urological procedures at Kailash Hospital, Noida.

Laparoscopic vs Robotic vs Open Surgery

Minimally invasive approaches (laparoscopic and robotic) offer significant advantages over traditional open surgery:

• Laparoscopic Surgery — Uses small incisions and a camera to perform surgery. Suitable for nephrectomy, pyeloplasty, and many reconstructive procedures.
• Robotic Surgery (Da Vinci) — Enhanced precision with 3D visualization and wristed instruments. Ideal for complex procedures requiring fine dissection, such as partial nephrectomy and radical prostatectomy.
• Benefits over Open Surgery — Less post-operative pain, shorter hospital stay (2-3 days vs 5-7 days), faster return to normal activities, reduced blood loss, and better cosmetic outcomes.

Conditions Treated

• Laparoscopic/Robotic Nephrectomy (kidney removal)
• Robotic Partial Nephrectomy (kidney-sparing surgery for tumors)
• Laparoscopic Pyeloplasty (repair of blocked kidney)
• Laparoscopic Adrenalectomy (adrenal gland removal)
• Robotic Radical Prostatectomy
• Laparoscopic Ureteric Reimplantation

Urological Cancers — Kidney, Bladder & Prostate Cancer Treatment in Noida

Dr. Agarwal provides comprehensive surgical management of urological cancers using advanced robotic and laparoscopic techniques. Early detection and treatment significantly improve outcomes for all urological cancers.

Kidney Cancer (Renal Cell Carcinoma)

Often detected incidentally on ultrasound or CT scan. Treatment depends on tumor size and stage:

• Partial Nephrectomy — For tumors under 7cm, the tumor is removed while preserving the rest of the kidney. Robotic approach offers superior precision for this organ-sparing surgery.
• Radical Nephrectomy — Complete kidney removal for larger or more advanced tumors. Performed laparoscopically in most cases.
• Active Surveillance — For small (<3cm), slow-growing tumors in elderly patients.

Bladder Cancer

Typically presents with painless blood in urine. Diagnosed through cystoscopy and biopsy:

• TURBT (Transurethral Resection of Bladder Tumor) — First-line treatment for non-invasive bladder cancer. The tumor is removed through a scope without any external incision.
• Intravesical Therapy — BCG or chemotherapy instilled directly into the bladder to prevent recurrence.
• Radical Cystectomy — For muscle-invasive bladder cancer, the entire bladder is removed with urinary diversion.

Prostate Cancer

The most common cancer in men over 65. Screening with PSA blood test and digital rectal examination is recommended for men over 50 (or over 45 with family history):

• Active Surveillance — For low-risk, slow-growing cancers. Regular monitoring with PSA and MRI.
• Robotic Radical Prostatectomy — Complete removal of the prostate gland using the Da Vinci robotic system. Offers superior nerve preservation for continence and potency.
• Radiation Therapy — Referral for external beam radiation or brachytherapy when appropriate.

Adrenal Gland Surgery in Delhi-NCR

Dr. Agarwal has extensive experience in adrenal surgery, backed by published research on a 15-year cohort of abdominopelvic paragangliomas (Indian Journal of Surgery, 2024). He performs laparoscopic adrenalectomy at Kailash Hospital, Noida.

Conditions Requiring Adrenal Surgery

• Pheochromocytoma — A rare tumor that produces excess adrenaline, causing episodes of high blood pressure, rapid heartbeat, sweating, and headaches.
• Paraganglioma — Similar to pheochromocytoma but located outside the adrenal gland in the abdomen or pelvis.
• Conn's Syndrome (Primary Aldosteronism) — Excess aldosterone production causing resistant hypertension and low potassium levels.
• Cushing's Syndrome — Excess cortisol production from an adrenal adenoma.
• Adrenal Incidentaloma — Adrenal mass discovered incidentally on imaging. Surgery is recommended for tumors larger than 4cm or those producing excess hormones.

Laparoscopic Adrenalectomy

The standard surgical approach for most adrenal tumors. Performed through 3-4 small incisions, it offers faster recovery (1-2 days hospital stay), less pain, and minimal scarring compared to open surgery. Dr. Agarwal's experience with complex paragangliomas ensures safe management of even challenging cases.