CENTER OF EXCELLENCE - Kidney Cancer

Kidney stones can increase your risk of chronic kidney disease, which is why fast detection and treatment is important when painful symptoms occur. Primus urologists use advanced technology to determine your type of kidney stone, its cause, and any conditions that require treatment to prevent a recurrence. Our goal is to quickly return you to a pain-free life and minimize your risk for kidney-related problems in the future.

Treatment for Kidney Stones

Kidney stones don’t always require surgery. We’ll work closely with you to minimize their impact and educate you about preventative options. Small, pain-free kidney stones may be passed naturally with help from diet changes, medication, and guidance from your urologist. Larger kidney stones may require more intervention.

PCNL/PNL refers to Percutaneous nephrolithotomy (PNL) which is a minimally-invasive technique of removing stones from the kidney with the help of making a small puncture (less than 1 cm) in size through the skin from the back (as shown). It is suitable for the removal of stones, which are greater than 2 cm in size. This is usually done under general anaesthesia or spinal anaesthesia.

Ureteroscopy is a technique of inspecting the upper urinary tract (ureter and kidney). This procedure is generally performed with a ureteroscope (semi-rigid or flexible)that is passed through the urethra and the bladder, that directly enters into the ureter & kidney.

URS(Ureteroscopy and stone removal) : The Kidney stones that are smaller in size and are present in the ureter as well can be removed successfully in one piece, and the bigger ones are generally fragmented by laser before removing it with the help of ureteroscopy.

RIRS or flexible ureteroscopy:

Retrograde intrarenal surgery (RIRS) is a relatively newer technique for the removal of stones. Retrograde intrarenal surgery (RIRS) is a method of removing kidney stone with the help of a fiberoptic endoscope. RIRS Surgery permits a surgeon to perform surgery inside the kidney without an incision. The RIRS has proved to be quite effective for cases that are difficult-to-treat such as bleeding disorders and the occurrence of stones in children.

Indications for RIRS

  • Tumours present in the upper urinary tract(TCC)
  • Occurrence of stones in children
  • Stones larger in size for ESWL (lithotripsy)/Lithotripsy failures
  • Extreme obesity with multiple co-morbidities.
  • Patients having bleeding disorders or on anticoagulants.

Procedure of RIRS

RIRS is a procedure that is performed by an experienced urologist in India with unique expertise in RIRS. The method is carried out under general or spinal anaesthesia.

Ureteric access sheath is passed on a guidewire under continuous fluoroscopy.

Flexible Ureteroscope scope is then passed through the urethra (the urinary opening) in the bladder and then into the ureter and kidney.

The stone can be then seen through the Ureteroscope and fragmented with Holmium laser.

Small fragments are grasped by baskets (Nitinol Baskets) and taken out.

After the completion of RIRS Procedure, Double J stent is placed to facilitate the smooth drainage from kidney and avoid blocking in the ureter.

Advantages of RIRS

  • No need for a skin incision
  • Rates of Stone clearance rates are very high
  • Safe removal of a Kidney stone
  • Faster Recovery
  • Short hospital stay
  • Low-risk procedure
  • Lower operating time
  • No injury to renal tissue
  • No bleeding
Why Choose Primus

Where you receive your care matters. Primus Hospital is proud of our team and the exceptional care they provide

We Offer Personalized Care

We develop personalized treatment plans that take into account your age and lifestyle. Together we choose the best option for you.

We Are Leaders in Enhanced Recovery After Surgery

We are one of just a handful of hospitals in Delhi with an enhanced recovery program that adheres to guidelines to keep you healthier and get you back to the comfort of home sooner. This program is designed to reduce your in-hospital time and lessen the chance of complications, as well as monitor your need for pain medication and fluid levels for digestion.

Fast Evaluation

We offer a comprehensive, one-day evaluation. You’ll be seen by all the necessary specialists - a Urologist, Uro-Oncologist and Nephrologist.

Urology and Uro- Oncology Doctors
pict

Dr. M.S.Jha

Director & HOD - Advanced Urology, Uro-Oncology & Kidney Transplant
OPD Timings
Monday - Saturday
9 A.M to 5 P.M
pict

Dr. ​Prem​ ​Prakash​ ​Varma

Senior Consultant in Department​ ​of​ ​Nephrology
OPD Timings
Monday - Saturday
9 A.M to 5 P.M
pict

Dr. Saurabh Mittal

Senior Consultant in Department of Urology
OPD Timings
Monday - Saturday
9 A.M to 5 P.M
Frequently Asked Questions
What is urinary bladder?

The bladder is an elastic, hollow organ in the pelvic region that collects urine before it moves out from the body during urination, because of this role, it makes the bladder an essential part of the urinary tract.

The bladder, just as the any other part of the urinary tract, is lined with a band of cells known as urothelium. This layer of cells is secluded from the bladder wall muscles called muscularis propria, by a thin, fibrous band known as lamina propria.

What is bladder cancer ?

Bladder cancer is the abnormal growth of healthy cells in the bladder lining that grows excessively and out of control, forming a mass called a tumour.

What are the tumour types?

A tumour is of two types malignant and benign.

  • A malignant or a cancerous tumour means it can grow and expand to join other body parts.
  • A benign tumour grows but does not spread to other body parts.

There are three main types of bladder cancers

  • Urothelial carcinoma(most common). is the most common type of cancer that estimates for about 90% of all bladder cancers. This type of bladder cancer develops in the urothelial cells that are found in the lining of the urinary bladder. Earlier, this cancer was known as transitional cell carcinoma(TCC).
  • Squamous cell carcinoma. in response to irritation and inflammation squamous cells develop in the bladder lining (like patients on prolong catheterization). With time these cells become malignant. About 2-4% of all bladder cancers are squamous cell carcinoma.
  • Adenocarcinoma. About 2% of all bladder cancers are adenocarcinomas that develops from epithelial cells.
  • Bladder cancer is also defined as muscle-invasive, and non-muscle-invasive depending on whether it has spread into or through the muscle of the bladder wall.

What do stage and grade mean?

  • The stage refers to the location of cancer or to the place where it has developed, and whether it is affecting other parts of the body.
  • There are 5 stages of any cancer stage 0 (zero) and stages I to IV (1 through 4). The tumour is also given a grade, that defines how much healthy cancer cells look like when viewed under a microscope.

What is the right treatment for bladder cancer?

The treatment of bladder cancer depends on various factors such as grade, type and stage, of a tumour; potential side effects; and the patient’s decisions considering the overall well-being.

Non-muscle-invasive bladder cancer(NMIBC)

This type of cancer is normally fully removed during a procedure called transurethral bladder tumour resection (TURBT).

The urologist may recommend additional treatments to reduce the risk of a recurrence, such as chemotherapy delivered through a catheter or immunotherapy.

Muscle-invasive bladder cancer

  • MIBC treatment involves surgical intervention for removing the complete bladder & nearby lymph nodes. This process is also called radical cystectomy.
  • The urologist will make way for passing urine out of the body, known as urinary diversion. Talk to the best urologist in Delhi about all treatment options.

Common Terms in Bladder cancer treatments

  • Biopsy it is the removal or obtaining of a tissue sample after examining under a microscope by a pathologist to check the growth of cancer cells
  • Catheter Catheter is a hollow tube that is put through the urethra for draining the urine or for delivering drugs for intravesical chemotherapy.
  • Chemotherapy The method of cancer treatment is extensively used for killing cancer cells
  • Cystoscopy Treatment Method where a urologist places a small, hollow viewing tube known as cystoscope into the urethra for viewing into the bladder.
  • Immunotherapy The use of materials made either by the body or in a laboratory to improve, target, or restore immune system function
  • Metastasis Metastasis refers to the spreading of cancer from its point of origin to another part of the body
  • Prognosis Chance of recovery
  • Radiation therapy The use of high-energy x-rays to destroy cancer cells
  • Tumor An unusual growth of body tissue is called a tumor.
  • TURBT(transurethral resection of bladder tumour) Procedure that removes the tumor with a small wire loop, a laser, or high-energy electricity
  • Urologic oncologist A Urologic Oncologist is a doctor who specializes in treating cancers of the urinary tract.