Dr. Rohan S. Valsangkar

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Urology and Urolgists

Urology focuses on surgical and medical diseases of the urinary tract(kidneys, adrenals, ureter,urinary bladder, uretha) and male reproductive system (testis, epididymis, vas deferens, prostate and penis). .  Urology is one of the most coveted and competitive superspecialisation for surgeons, requiring a high level of skill and training. Urologists  have been pioneers in the innovation of surgical technology.  The field of Urology has ushered in the advent of minimimally invasive(telescope guided)  surgery , lasers ,laparoscopic(keyhole)  surgery and now robotic surgery into medical science as a whole. The aim is to avoid large incisions on abdomen to promote faster recovery, reduced pain and resume normal activity quickly after surgery.

Major urological  diseases include:

  1. Kidney : Kidney stones, kidney cancer, kidney cysts,hydronephrosis etc.
  2. Ureter problems: ureteric stones, pelviureteric junction obstruction, reflux etc.
  3. Urinary bladder: Bladder cancer, bladder infections, bladder stones etc.
  4. Prostate: Benign prostate enlargement, prostate cancer
  5. Testis: Testicular cancer, male infertility
  6. Penis: Erectile dysfunction, hypospadias etc.
Urology
Urology covers a vast range of diseases.  Depending on the nature of the disease, patient profile and technique of surgery, urology  has been divided into many sub specialities  which often overlap, as the same disease can be treated with more than one approach. Many urological conditions can be treated also  with medicines. (medical management) The type of treatment (medical or surgical and if surgical, which approach) is tailored according to patient’s age, any pre-existing diseases of patient, exact nature of urological condition of patient  etc.  It requires a lot of judgement, experience and training for urologist  to individualise the  treatment to a particular patient.
  • Endourology
  • As opposed to open surgery, endourology involves surgery using small telescopes and small instruments for kidney stones (ureteroscopy, PCNL , flexible renal scopy-RIRS using lasers) , endoscopic prostate removal (TURP) or bladder cancer resection(TURBT).  These surgeries avoid large incisions and have increased patient comfort considerably but requires specialised trainin
  • Laparoscopic urology
  • This is a relatively new offshoot of endoscopic urology  that involves making small incisions in abdomen for surgery of kidney(for kidney removal-nephrectomy, for kidney cancer removal- radical nephrectomy, laparoscopic pyeloplasty etc. ) and less commonly for bladder and prostate. It requires a totally different  skill set and special training as compared to endourology but benefits for the patient are substantial. Robotic surgery is a part of laparoscopic urology, but it is still quite expensive and in the hands of expert laparoscopic urologist, the benefits are the same.
  • Urologic oncology (Uro-oncology)
  • This involves management  urolgical cancers( of kidney, adrenals, urinary bladder, testis , penis etc.) by surgery, chemothrapy or radiotherapy.  The surgery can be done by open, laparoscopic or recently robotic approach. It often involves close collaboration  with medical oncologists( for chemothrapy) and/or radiation oncologists.( for radiation therapy)
  • Neurourology
  • The study of urinary control ( incontinence) secondary to neurological disorders( spinal cord injury )  or non neurological bladder problems( e.g. bladder overactivity) It involves carrying out urodynamic studies on the patient and their medical or surgical treatment.
  • Pediatric Urology
  • Pediatric urologists deals with urological problem common in  children and congenital abnormalities.  (e.g.  vesicoureteric reflux, undescended testis etc.) and surgical treatment of these disorder.
  • Andrology
  • It deals with disorders of male reproductive system. Patients present with problems of male infertility, erectile dysfunction and ejaculatory disorders. It involves medical management and surgical treatment of these disorders.
  • Reconstructive urology
  • This involves surgical treatment conditions  of  narrowing of urethra, ureter, urinary bladder etc  secondary to trauma, tuberculosis etc.  which require skills of plastic surgery.
  • Female Urology
  • These discipline involves treating urinary leakage in females  and often overlaps with uro-gynecologists. The problems can arise after childbirth or arise without any cause but also require knowledge of urinary bladder conditions and pelvic floor anatomy.
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