DEPARTMENT OF UROLOGY

CENTURY HOSPITAL

CENTURY HOSPITAL





Dr. K V R Prasad


M.S., M.Ch (Urology) - PGIMER CHANDIGARH


23 yrs experience as consultant Urologist and Transplant surgeon


Expert in Andrology and Male Sexual Dysfunction


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Dr. Lalitha


MBBS, MD (Gynaecology) and Mch (Urology)


Dr. Lalitha has done her M.B.B.S. from kakatiya medical college from where she has passed out as the 'best outgoing student in the year 1987 with 10 gold medals in M.B.B.S


She Obtained Second Rank In Andhra Pradesh State Postgraduate Medical Entrance


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  • Stones are a common problem affecting the urinary tract. They commonly occur in the kidney or the ureter (the tube that conducts urine from the kidneys to the bladder) but can occur at other sites such as the bladder or urethra (tube through which we pass urine from the bladder).


    These stones are ‘real’ stones just like the stones one sees in nature! Patients with stones commonly present with pain, blood in the urine, burning sensation in urine or fever. Rarely there may be no symptoms and the stone is identified incidentally on imaging done for some other problem. Confirmation of diagnosis may require various combinations of ultrasonography, X-rays, IVU (intravenous urogram) or CT scan.


    Small stones may be managed by medication alone. Larger stones or those causing swelling in the kidney or infection need to be treated, sometimes urgently. Removal of stones can be accomplished by ESWL (extracorporeal shock wave lithotripsy), keyhole removal (PCNL), removal by ureteroscopy (URS) or rarely by laparoscopy. Small stones are well suited to ESWL which is non invasive although some patients may require the placement of a small tube in the kidney called a stent. Larger stones are best removed by PCNL or URS.


    We remove even large and complex stones (such as staghorn stones) by minimally invasive methods and have a large experience with the removal of such stones in normal or even congenitally malformed kidneys such as horseshoe kidneys or malrotated kidneys.













  • Andrology and infertility consists of treatment of genital, fertility and sexual problems in men. Problems of erection (erectile dysfunction or ‘ED’ in medical parlance) are common and a source of severe embarrassment to men and marital discord in society. ED is treatable! In a vast majority of men, problems related to sexual function can be managed by simple methods without resorting to surgery or costly treatments! ED is also preventable by following the simple rule “whatever is good for your heart is good for erections”. A healthy lifestyle, avoiding smoking, regular exercise, good sleep and stress management are all steps to ensure a healthy heart and a healthy erection. Smokers are very likely to develop erectile dysfunction, hence smoking is not cool!. Male infertility evaluation is a cardinal part of the evaluation of any infertile couple. Isolated evaluation of the wife is to be condemned as bad medical practice. Evaluation consists of a stepwise logical check up of the possible reasons for infertility. One of the common medical problems leading to male infertility is varicocele. Varicocele surgery can be performed by various techniques. Some couples may require a referral for artificial reproductive technologies.













  • Laser ProstatectomyLaparoscopic urology has made a big impact on the practice of urology. Urology was traditionally at the forefront of all endoscopic advancements in surgery. The first laparoscopy was done using urological endoscopes! Laparoscopic urology made its presence felt around the early 1990s but it isn’t until the late 90s and early part of this century that laparoscopic urology got adopted more widely. One of the main hurdles has been that laparoscopic urology, unlike general surgery and surgical gastroenterology, has no ‘easy’ procedures (such as lap cholecystectomy or appendicectomy, with due apologies to the general surgeons!). All the lap urology procedures fall under the category of advanced laparoscopy. Hence, the learning curve has been steep and a vast majority of urologists in India still do not perform lap urology.


    Since 2005 we have now performed a large number of laparoscopic urology procedures ranging from ablative removal of diseased kidneys to complex reconstructions such as pyeloplasty. Laparoscopic procedures often take longer to perform than their open counterparts and may occasionally require conversion. Laparoscopic right reimplantation in patient who had left open implant done elsewhere earlier.


    Laparoscopic view while performing anastomosis (re-joining) of the renal pelvis to the ureter in a 58y woman with pelviureteric junction obstruction.













  • Adrenal tumors may present because of the hormones that they produce, or more commonly, they get identified incidentally on imaging done for some other reason (the so-called incidentallomas). There is no secure method of distinguishing a benign (non-cancerous) tumor from a cancer and the most widely accepted indication for surgery is an incidental mass that is more than 5cm in size. Functioning tumors (tumors that produce abnormal amounts of hormones) may require removal even if they are smaller. Adrenal tumors can be removed by conventional open surgery. More recently, adrenal tumors are being operated laparoscopically with much less morbidity and with rapid recovery and discharge from hospital.













  • We are managing the entire range of Pediatric Urology diseases including reconstructive pediatric urology, congenital malformations and pediatric neurogenic bladder. We have a large number of children with neurogenic bladder under our care (arguably one of the largest numbers in the country!) and have vast experience with urodynamics in children. We are regularly performing augmentation cystoplasty surgery and have initial experience with botulinum toxin injection into the bladder in children with neurogenic bladder. We are performing pediatric laparoscopies and have experience with laparoscopic pyeloplasty and nephrectomy in older children.


    Hydronephrosis (swelling of the kidney) and PUJ Obstruction (pelviureteric junction obstruction) are common problems in children. About 20% of fetus will show swelling in one kidney in an antenatal scan of the mother. However, many of these will resolve with time. In all children who had fetal hydronephrosis, an ultrasonogram is indicated after birth. Depending on the findings, this may be followed up in some children by a nuclear scan at about 6weeks. Some children will also need to undergo an Xray called the micturating cystourethrogram. Children with drop in kidney function or worsening hydronephrosis may require surgical correction called a pyeloplasty. This can now be accomplished laparoscopically esp in older children. Following surgery, hydronephrosis shows a slow regression and the kidney function usually either stabilizes or improves in about 95% of children.
















Stones are a common problem affecting the urinary tract. They commonly occur in the kidney or the ureter (the tube that conducts urine from the kidneys to the bladder) but can occur at other sites such as the bladder or urethra (tube through which we pass urine from the bladder).


These stones are ‘real’ stones just like the stones one sees in nature! Patients with stones commonly present with pain, blood in the urine, burning sensation in urine or fever. Rarely there may be no symptoms and the stone is identified incidentally on imaging done for some other problem. Confirmation of diagnosis may require various combinations of ultrasonography, X-rays, IVU (intravenous urogram) or CT scan.


Small stones may be managed by medication alone. Larger stones or those causing swelling in the kidney or infection need to be treated, sometimes urgently. Removal of stones can be accomplished by ESWL (extracorporeal shock wave lithotripsy), keyhole removal (PCNL), removal by ureteroscopy (URS) or rarely by laparoscopy. Small stones are well suited to ESWL which is non invasive although some patients may require the placement of a small tube in the kidney called a stent. Larger stones are best removed by PCNL or URS.


We remove even large and complex stones (such as staghorn stones) by minimally invasive methods and have a large experience with the removal of such stones in normal or even congenitally malformed kidneys such as horseshoe kidneys or malrotated kidneys.



Best Urologist in Hyderabad Best Urology Department in Hyderabad













Prostate gland is found exclusively in men and is often the site of the disease in men. A large proportion of men will develop enlargement of the prostate as they age. Most of these men have a benign (non-malignant) enlargement called BPH but some men develop cancer. One can differentiate between these two by a physical examination and blood test (called the PSA or prostate specific antigen). In men with BPH, treatment may consist of reassurance alone, medication or rarely, endoscopic surgery (called TUR). For cancer prostate, the treatment is based on the extent of disease. In early cancer, radical prostatectomy or radiation therapy are the treatment of choice while for advanced cancer, hormonal therapy forms the mainstay of treatment.


Dr KVR Prasad contributed a chapter entitled ‘Diagnosis of early prostate cancer’ to the book Advances in Oncology in 2004.



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We treat all Female Urology and Urogynecology problems including urinary incontinence, pelvic organ prolapse, pelvic pain, urinary tract fistulae, urinary tract infection and dyspareunia (painful intercourse). We have been treating such problems by a team approach along with an experienced Gynecologist with a strong interest in Urogynecology, Dr Rooma Sinha, MD for the last 14years. We have the largest experience of stress incontinence surgery including synthetic tapes in AP and one of the largest in India.


Dr KVR Prasad is on the Editorial Board of the prestigious ‘International Urogynecology Journal’, the official journal for the International Urogynecology Association and the British Urogynecology Society. This is the first time anyone from India has been on the board. Dr Sinha is also on the Education Committee of the IUGA, which, amongst other activities, recommends training guidelines for Urogynecology worldwide.





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urogynecologist in hyderabad

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Bladder endometriosis is a rare cause of bleeding in the urine in women. Classically, it presents with cyclical bleeding at the time of the periods. There may be bladder pain. Ultrasonography may show a bladder mass. This might be mistaken for bladder cancer. The patient in question was treated for cancer before the correct diagnosis was established. Cystoscopy showed classical blue nodules denoting submucosal hemorrhage. At transurethral resection, chocolate colored material could be noted effluxing from the bladder wall.
Watch: http://www.youtube.com/watch?v=YKykaMqDdUI&feature=related













Painful bladder syndrome (also called Interstitial cystitis) is a notoriously difficult condition to treat. The symptom complex is one of pain associated with the bladder, pelvic pain, urinary frequency and vaginal pain or vaginismus in women. There is no specific diagnostic test. Diagnosis hinges on detailed clinical evaluation and exclusion of other causes of pain. Patients will often be asked to fill questionnaires regarding their problem or may be asked to prepare diary records. Some patients may undergo urodynamics, imaging and cystoscopy with bladder distension and evaluation of bladder wall changes. A biopsy may also be taken from the bladder. Treatment is complex and no single treatment works for all patients. A step-wise approach consists of oral medication, hydrodistension of the bladder under anesthesia and periodic instillation of medication into the bladder. For patients who fail to respond to these therapies, botulinum toxin injections into the bladder or surgical treatment may rarely be required.


Dr KVR Prasad along with Dr Rooma Sinha, Gynecologist has extensive experience in the management of such patients. These patients get the best of combined urological and gynecological management.



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Best urogynecologist in hyderabad






















Urinary incontinence is an uncontrolled leak of urine which can be very distressing and embarrassing for an adult. It is more common in women but elderly men may suffer too. There are several causes for incontinence including overactive bladder, stress incontinence and overflow incontinence. Diagnosis requires a careful discussion and examination of the patient followed by diary records, ultrasonography and, in select patients, urodynamics evaluation. It is almost always possible to make a patient dry by a combination of lifestyle changes, medication and occasionally surgery. Some individuals with urinary incontinence may be suffering from a different medical condition called neurogenic bladder. It is crucial to identify individuals with neurogenic bladder since their management is entirely different.






 Overactive bladder & Urge Incontinence


Overactive bladder is a distressing lifestyle problem that can afflict both men and women. Women with overactive bladder are more likely to have difficulty controlling the leak (the so-called OAB-wet). Overactive bladder is presumably due to an ‘irritability’ of the bladder (detrusor overactivity) but there are many individuals in whom such irritability cannot be demonstrated. Excessive fluid intake can aggravate the symptoms. Diagnosis rests on a careful clinical assessment to rule out other causes of the symptoms, preparation of 24hr diary records, ultrasonography and rarely urodynamics. Treatment consists of lifestyle changes, fluid restriction, use of anticholinergic medication and pelvic floor training. In some patients one may have to resort to more aggressive treatments such as botulinum toxin injections into the bladder wall or rarely even surgery.


Dr KVR Prasad was invited by the South African Urogynecological Association in 2008 to conduct an International workshop on overactive bladder. He has demonstrated botulinum toxin injection in a live operative workshop at Post Graduate Institute Chandigarh PGIMER in 2009.




 Post-prostatectomy Incontinence



Best Urologist in Hyderabad


Urinary incontinence following prostatectomy surgery can be devastating for the patient. This usually follows operation for cancer (radical prostatectomy) but can rarely occur after endoscopic surgery for benign disease (TURP). Pelvic exercises, fluid management, medication and a allowing a few months to pass by may help. However for severe incontinence the only really effective solution is an artificial sphincter. In 2005, Dr KVR Prasad implanted the first artificial urinary sphincter in South India for a post-prostatectomy incontinence (outside a workshop or conference). Experience with this problem remains low in India since radical prostatectomy remains an uncommon operation and the artificial sphincter is very expensive.






 Stress Urinary Incontinence




Stress urinary incontinence is a distressing condition in which women leak urine on coughing, straining or even on minimal activity such as getting up from bed. The condition is common and can be diagnosed by a clinical evaluation combined with ultrasonography. In most patients, a urodynamics test (test for bladder function) is recommended prior to any surgical intervention. In women who opt for surgical correction, placement of a synthetic tape is the procedure of choice. Such tapes can be placed by a minimally invasive approach either through the lower part of the abdomen (retropubic tapes such as TVT or Sparc) or from below (by a transobturator approach). In some women, one may opt for an autologous rectus fascia sling fashioned out of the woman’s own tissues. This may be preferable in women with very poor urethral function or those with prior failed procedures with an unhealthy vagina.
















Neurogenic bladder is an abnormality of bladder function that follows damage to the neurological control of the bladder and control muscles. This may result from a birth defect, trauma such as a road side accident or fall from a height, tumor, or infections like tuberculosis. In some individuals, there may be classical findings consistent with neurogenic bladder without an obvious identifiable neurological problem. Neurogenic bladder can have a significant impact on lifestyle. Untreated neurogenic bladder can lead to kidney failure. In fact, long term serious problems in patients with spinal disease come from the kidneys rather than the spine. It is a sad fact that we continue to find patients walking into our clinic with established kidney failure due to neglected or mis-managed neurogenic bladder with disconcerting regularity.


We have an entire team for managing such patients and have a state-of-the-art urodynamics machine (MMS, Denmark). Dr KVR Prasad has spoken in invited symposia of the Urological Society of India in the Neurourology subsection in the past and conducted workshops for the training of urologists and gynecologists in Urodynamics techniques at Hyderabad, PGI Chandigarh, Jhansi, New Delhi, Taipei and Johannesburg.






For some patients with neurogenic bladder whose bladders have unsafe storage pressures despite medication, augmentation cystoplasty is a standard and potentially life saving procedure. Such patients are at high risk of damaging their kidneys. Timely surgery can prevent such damage. Of note, once the kidneys have already got damaged such surgery may no longer be feasible condemning the patient to long-term kidney failure. Urodynamics evaluation can easily help in predicting and avoiding this problem.


Dr KVR Prasad has extensive experience in augmentation cystoplasty for neurogenic bladder both in children and in adults.






In some patients with neurogenic bladder, botulinum toxin injections into the bladder can be very useful. Again, these injections are used only in patients who fail to respond adequately to medication. Such patients are at high risk for damage to the kidneys. Botulinum injections are given directly into the bladder wall under endoscopic guidance under anesthesia. They are very effective. However, the effect of the injection lasts for between 6-12months and then the procedure needs to be repeated. It is also expensive.


Such injections are specifically very useful for those who want to avoid an operation either temporarily (eg an unmarried child) or in the long term. It is crucial for those with poor bladder function in whom the kidneys have already got damaged. In this situation the standard augmentation cystoplasty surgery cannot be done. Botulinum toxin injections can offer an effective last option in such patients.


Dr KVR Prasad has a large experience with the use of botulinum toxin in adults and children both for the bladder as well as for the sphincter.

















Best Kidney Transplantation in Hyderabad


Every year lakhs of Indians are afflicted by kidney failure. A vast majority of these patients continue to die of the problem due to lack of access to tertiary care or an inability to afford it. Patients suffering from kidney failure require surgical care at every step. Most patients will undergo vascular access surgery called AV Fistula or arteriovenous fistula. This forms the cornerstone of dialysis treatment and enables easy dialysis. Patients who opt for peritoneal dialysis can have a CAPD catheter placed for longterm home dialysis. But the best option for treatment remains kidney transplantation. Transplantation surgery is now a very successful procedure.


Dr KVR Prasad Sinha has performed about 375 transplantations in all kinds of patients including those with abnormal lower urinary tracts and in children. One of the early transplantations was a child whose grandfather donated a kidney! In 2009, the unit started performing laparoscopic donor nephrectomies to reduce donor morbidity further.













We are managing the entire range of Pediatric Urology diseases including reconstructive pediatric urology, congenital malformations and pediatric neurogenic bladder. We have a large number of children with neurogenic bladder under our care (arguably one of the largest numbers in the country!) and have vast experience with urodynamics in children. We are regularly performing augmentation cystoplasty surgery and have initial experience with botulinum toxin injection into the bladder in children with neurogenic bladder. We are performing pediatric laparoscopies and have experience with laparoscopic pyeloplasty and nephrectomy in older children.






 Hydronephrosis/PUJ Obstruction


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Hydronephrosis (swelling of the kidney) and PUJ Obstruction (pelviureteric junction obstruction) are common problems in children. About 20% of fetus will show swelling in one kidney in an antenatal scan of the mother. However, many of these will resolve with time. In all children who had fetal hydronephrosis, an ultrasonogram is indicated after birth. Depending on the findings, this may be followed up in some children by a nuclear scan at about 6weeks. Some children will also need to undergo an Xray called the micturating cystourethrogram. Children with drop in kidney function or worsening hydronephrosis may require surgical correction called a pyeloplasty. This can now be accomplished laparoscopically esp in older children. Following surgery, hydronephrosis shows a slow regression and the kidney function usually either stabilizes or improves in about 95% of children.




 Posterior urethral valves



Pediatric urology in hyderabad

Pediatric Urologist in Hyderabad

Urology in Hyderabad




 Stress Urinary Incontinence


Vesicoureteral reflux is a relatively common problem affecting children. It is characterized by a reverse flow (reflux) of urine back toward the kidney at the time of passing urine. Ordinarily this is prevented by a natural valve mechanism at the junction of the ureter and bladder. VUR can predispose to urinary infections and is associated in some children with bladder function abnormalities (which might perpetuate the reflux). Some children can develop long term kidney function problems (reflux nephropathy). A large number of children will spontaneously outgrow their reflux and non-surgical treatment is appropriate for children without obvious kidney damage (scars), in whom the reflux is of lower severity (upto grades III). However in children who fail to outgrow the reflux, or if there are recurrent infections or if the kidney shows damage, then a ureteric reimplantation is recommended.




 Neurogenic bladder



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Bladder dysfunction in children is an important cause of preventable kidney failure. Serious life threatening problems in patients with spinal problems do not usually come from the spine-they come from the bladder! Unrecognized or untreated neurogenic bladder can rapidly damage kidney function. Once there is irreparable function loss, the long term consequences are tragic. Most such children will develop advanced kidney failure around the time of puberty. This distressing problem is completely preventable! Management of neurogenic bladder management CANNOT wait for the child to grow up. It must be managed on priority before any kidney damage occurs. Urodynamics is an important component of assessment. Careful, systematic treatment is the key to good quality care.






Dr KVR Prasad is handling one of the busiest urodynamics centres in India and the centre gets referrals from across the length and breadth of India.






 Megaureter


Megaureter is not really a specific diagnosis. It indicates that the ureter is markedly swollen up. This can happen in children with obstruction at the junction of the ureter and bladder (obstructed megaureter), severe reflux (VUR) or rarely without either obstruction or reflux. Treatment is based on the cause and may entail a ureteric reimplantation. This may be accomplished by open surgery or, in older children, by laparoscopy.















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Andrology and infertility consists of treatment of genital, fertility and sexual problems in men. Problems of erection (erectile dysfunction or ‘ED’ in medical parlance) are common and a source of severe embarrassment to men and marital discord in society. ED is treatable! In a vast majority of men, problems related to sexual function can be managed by simple methods without resorting to surgery or costly treatments! ED is also preventable by following the simple rule “whatever is good for your heart is good for erections”. A healthy lifestyle, avoiding smoking, regular exercise, good sleep and stress management are all steps to ensure a healthy heart and a healthy erection. Smokers are very likely to develop erectile dysfunction, hence smoking is not cool!













Pelvic pain is a notoriously difficult entity to diagnose and treat! This is partly because the condition is not a single disease but a group of conditions that can cause pain. The treatment consists of careful assessment to exclude the various causes of pain one-by-one followed by treatment directed at the most probable cause of pain. Several such individuals land up in the Urologist’s clinic. In selected individuals, pelvic floor stimulation therapy using the Urostym device may help. In those with intractable bladder pain, intravesical instillation of medication, hydrodistension of bladder under anesthesia, or botulinum toxin injections may help.











There are several congenital (inherited) and acquired diseases of the urogenital tract which require reconstructive surgery such as birth abnormalities of the genitalia or pelviureteric junction obstruction. Some of these conditions can be tackled by minimally invasive surgery now such as hydronephrosis. Others require painstaking meticulous conventional surgical reconstruction.













Laparoscopic urology has made a big impact on the practice of urology. Urology was traditionally at the forefront of all endoscopic advancements in surgery. The first laparoscopy was done using urological endoscopes! Laparoscopic urology made its presence felt around the early 1990s but it isn’t until the late 90s and early part of this century that laparoscopic urology got adopted more widely. One of the main hurdles has been that laparoscopic urology, unlike general surgery and surgical gastroenterology, has no ‘easy’ procedures (such as lap cholecystectomy or appendicectomy, with due apologies to the general surgeons!). All the lap urology procedures fall under the category of advanced laparoscopy. Hence, the learning curve has been steep and a vast majority of urologists in India still do not perform lap urology.



Laparoscopic urology in Hyderabad











Urological cancers are an important cause of cancers. In men, prostate cancer is the commonest cancer. Other urological cancers are bladder cancer, kidney cancer, testicular cancer and adrenal tumors. Prostate cancer can be diagnosed early by a combination of a physical examination and blood test (the PSA or prostate specific antigen). Kidney cancers are often identified early on imaging of the abdomen done for reasons such as a health screening. Bladder tumors herald themselves by bleeding in the urine. Most of these conditions can be treated effectively with excellent long term cure provided they are diagnosed in time.






 Adrenal tumors




Adrenal tumors may present because of the hormones that they produce, or more commonly, they get identified incidentally on imaging done for some other reason (the so-called incidentallomas). There is no secure method of distinguishing a benign (non-cancerous) tumor from a cancer and the most widely accepted indication for surgery is an incidental mass that is more than 5cm in size. Functioning tumors (tumors that produce abnormal amounts of hormones) may require removal even if they are smaller. Adrenal tumors can be removed by conventional open surgery. More recently, adrenal tumors are being operated laparoscopically with much less morbidity and with rapid recovery and discharge from hospital.





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 Bladder tumors



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Bladder tumors are an important cause of blood in the urine (hematuria). They are more common in smokers. Most tumors are cancerous and are a form of transitional cell carcinoma. These cancers can be classified as invasive or non-invasive, depending on whether they have involved the bladder muscle layer. Tumors that are non-invasive are less likely to become life-threatening but may need careful followup since they have a strong tendency to recur. Tumors that invade muscle need more aggressive treatments such as bladder removal, radiation therapy with or without chemotherapy.


Dr KVR Prasad Sinha was a member of the Urological Society of India panel for the formulation of national guidelines for bladder tumors.






 Prostate cancer




Prostate cancer is a common cancer in men. Early cancer may not cause any symptoms or the symptoms may be similar to those in a man with benign prostatic hypertrophy (BPH). Hence, the only way to diagnose this disease early is by getting an evaluation by a urologist. A physical examination and a blood test known as serum PSA or prostate specific antigen may indicate need for biopsy (examination of small bits of tissue). Biopsy does not need an operation and is carried out by the urologist under ultrasonographic guidance. Men with confirmed cancer may need surgery, radiation therapy or medication. Radical prostatectomy is done for men with early cancer prostate who are otherwise fit.







 Kidney Cancer


Coming soon...!




 Ureteric or Pelvic Cancer




Ureteric and renal pelvic tumors are an uncommon urological cancer. They are usually composed of transitional cell carcinoma (similar to the bladder) but the implications may be more serious. Such tumors need to be removed and the common surgery performed is a nephroureterectomy. This can be safely accomplished laparoscopically these days.





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Retrograde Intrarenal Surgery represents a triumphant convergence of cutting edge medicine and engineering. Incredible miniaturization, precise optics and matching accessories, chiefly Holmium Laser provides the technology. Surgical skill takes care of the rest! RIRS and mini-PERC (miniature drill removal of stones) are the latest in urological stone management.



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Stones sitting in calyces or occasionally in the renal pelvis that are not easily amenable to shock wave lithotripsy can be challenging. RIRS can help avoid the use of percutaneous drilling in many patients. Select tumors can also be managed.



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Intracorporeal lithotripsy has undergone several advancements over the recent years. Holmium laser lithotripsy has been a key breakthrough. Ever increasing miniaturization has led to the need for a flexible and extremely small caliber energy delivery mechanism. This is specifically true for RIRS. Retrograde Intrarenal Surgery (RIRS) throws several challenges- the instrumentation is delicate and expensive and must be handled with care. More importantly, it demands the use of a flexible mechanism for delivering energy at the tip of the scope. This is where the Holmium Laser comes in. With optical fibers that are as fine as 200microns, yet capable of conducting incredibly powerful energy to break stones or treat tumors.














Stones are a common problem affecting the urinary tract. They commonly occur in the kidney or the ureter (the tube that conducts urine from the kidneys to the bladder) but can occur at other sites such as the bladder or urethra (tube through which we pass urine from the bladder).


These stones are ‘real’ stones just like the stones one sees in nature! Patients with stones commonly present with pain, blood in the urine, burning sensation in urine or fever. Rarely there may be no symptoms and the stone is identified incidentally on imaging done for some other problem. Confirmation of diagnosis may require various combinations of ultrasonography, X-rays, IVU (intravenous urogram) or CT scan.


Small stones may be managed by medication alone. Larger stones or those causing swelling in the kidney or infection need to be treated, sometimes urgently. Removal of stones can be accomplished by ESWL (extracorporeal shock wave lithotripsy), keyhole removal (PCNL), removal by ureteroscopy (URS) or rarely by laparoscopy. Small stones are well suited to ESWL which is non invasive although some patients may require the placement of a small tube in the kidney called a stent. Larger stones are best removed by PCNL or URS.


We remove even large and complex stones (such as staghorn stones) by minimally invasive methods and have a large experience with the removal of such stones in normal or even congenitally malformed kidneys such as horseshoe kidneys or malrotated kidneys.













Stones are a common problem affecting the urinary tract. They commonly occur in the kidney or the ureter (the tube that conducts urine from the kidneys to the bladder) but can occur at other sites such as the bladder or urethra (tube through which we pass urine from the bladder).


These stones are ‘real’ stones just like the stones one sees in nature! Patients with stones commonly present with pain, blood in the urine, burning sensation in urine or fever. Rarely there may be no symptoms and the stone is identified incidentally on imaging done for some other problem. Confirmation of diagnosis may require various combinations of ultrasonography, X-rays, IVU (intravenous urogram) or CT scan.


Small stones may be managed by medication alone. Larger stones or those causing swelling in the kidney or infection need to be treated, sometimes urgently. Removal of stones can be accomplished by ESWL (extracorporeal shock wave lithotripsy), keyhole removal (PCNL), removal by ureteroscopy (URS) or rarely by laparoscopy. Small stones are well suited to ESWL which is non invasive although some patients may require the placement of a small tube in the kidney called a stent. Larger stones are best removed by PCNL or URS.


We remove even large and complex stones (such as staghorn stones) by minimally invasive methods and have a large experience with the removal of such stones in normal or even congenitally malformed kidneys such as horseshoe kidneys or malrotated kidneys.



Best Urologist Urology Clinic in Hyderabad













Prostate gland is found exclusively in men and is often the site of the disease in men. A large proportion of men will develop enlargement of the prostate as they age. Most of these men have a benign (non-malignant) enlargement called BPH but some men develop cancer. One can differentiate between these two by a physical examination and blood test (called the PSA or prostate specific antigen). In men with BPH, treatment may consist of reassurance alone, medication or rarely, endoscopic surgery (called TUR). For cancer prostate, the treatment is based on the extent of disease. In early cancer, radical prostatectomy or radiation therapy are the treatment of choice while for advanced cancer, hormonal therapy forms the mainstay of treatment.


Dr KVR Prasad contributed a chapter entitled ‘Diagnosis of early prostate cancer’ to the book Advances in Oncology in 2004.



Best urologist in Hyderabad











Urological cancers are an important cause of cancers. In men, prostate cancer is the commonest cancer. Other urological cancers are bladder cancer, kidney cancer, testicular cancer and adrenal tumors. Prostate cancer can be diagnosed early by a combination of a physical examination and blood test (the PSA or prostate specific antigen). Kidney cancers are often identified early on imaging of the abdomen done for reasons such as a health screening. Bladder tumors herald themselves by bleeding in the urine. Most of these conditions can be treated effectively with excellent long term cure provided they are diagnosed in time.






 Adrenal tumors




Adrenal tumors may present because of the hormones that they produce, or more commonly, they get identified incidentally on imaging done for some other reason (the so-called incidentallomas). There is no secure method of distinguishing a benign (non-cancerous) tumor from a cancer and the most widely accepted indication for surgery is an incidental mass that is more than 5cm in size. Functioning tumors (tumors that produce abnormal amounts of hormones) may require removal even if they are smaller. Adrenal tumors can be removed by conventional open surgery. More recently, adrenal tumors are being operated laparoscopically with much less morbidity and with rapid recovery and discharge from hospital.





Best Urologist in Hyderabad

Best Kidney Transplant in Hyderabad




 Bladder tumors



Best urology in Hyderabad


Bladder tumors are an important cause of blood in the urine (hematuria). They are more common in smokers. Most tumors are cancerous and are a form of transitional cell carcinoma. These cancers can be classified as invasive or non-invasive, depending on whether they have involved the bladder muscle layer. Tumors that are non-invasive are less likely to become life-threatening but may need careful followup since they have a strong tendency to recur. Tumors that invade muscle need more aggressive treatments such as bladder removal, radiation therapy with or without chemotherapy.


Dr KVR Prasad Sinha was a member of the Urological Society of India panel for the formulation of national guidelines for bladder tumors.






 Prostate cancer




Prostate cancer is a common cancer in men. Early cancer may not cause any symptoms or the symptoms may be similar to those in a man with benign prostatic hypertrophy (BPH). Hence, the only way to diagnose this disease early is by getting an evaluation by a urologist. A physical examination and a blood test known as serum PSA or prostate specific antigen may indicate need for biopsy (examination of small bits of tissue). Biopsy does not need an operation and is carried out by the urologist under ultrasonographic guidance. Men with confirmed cancer may need surgery, radiation therapy or medication. Radical prostatectomy is done for men with early cancer prostate who are otherwise fit.







 Kidney Cancer


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 Ureteric or Pelvic Cancer




Ureteric and renal pelvic tumors are an uncommon urological cancer. They are usually composed of transitional cell carcinoma (similar to the bladder) but the implications may be more serious. Such tumors need to be removed and the common surgery performed is a nephroureterectomy. This can be safely accomplished laparoscopically these days.





urology in Hyderabad

Best Urologist i Hyderabad

Andrology Center in Hyderabad
















Laparoscopic urology has made a big impact on the practice of urology. Urology was traditionally at the forefront of all endoscopic advancements in surgery. The first laparoscopy was done using urological endoscopes! Laparoscopic urology made its presence felt around the early 1990s but it isn’t until the late 90s and early part of this century that laparoscopic urology got adopted more widely. One of the main hurdles has been that laparoscopic urology, unlike general surgery and surgical gastroenterology, has no ‘easy’ procedures (such as lap cholecystectomy or appendicectomy, with due apologies to the general surgeons!). All the lap urology procedures fall under the category of advanced laparoscopy. Hence, the learning curve has been steep and a vast majority of urologists in India still do not perform lap urology.



Laparoscopic urology in Hyderabad












Best Kidney Transplantation in Hyderabad


Every year lakhs of Indians are afflicted by kidney failure. A vast majority of these patients continue to die of the problem due to lack of access to tertiary care or an inability to afford it. Patients suffering from kidney failure require surgical care at every step. Most patients will undergo vascular access surgery called AV Fistula or arteriovenous fistula. This forms the cornerstone of dialysis treatment and enables easy dialysis. Patients who opt for peritoneal dialysis can have a CAPD catheter placed for longterm home dialysis. But the best option for treatment remains kidney transplantation. Transplantation surgery is now a very successful procedure.


Dr KVR Prasad Sinha has performed about 375 transplantations in all kinds of patients including those with abnormal lower urinary tracts and in children. One of the early transplantations was a child whose grandfather donated a kidney! In 2009, the unit started performing laparoscopic donor nephrectomies to reduce donor morbidity further.













Urological cancers are an important cause of cancers. In men, prostate cancer is the commonest cancer. Other urological cancers are bladder cancer, kidney cancer, testicular cancer and adrenal tumors. Prostate cancer can be diagnosed early by a combination of a physical examination and blood test (the PSA or prostate specific antigen). Kidney cancers are often identified early on imaging of the abdomen done for reasons such as a health screening. Bladder tumors herald themselves by bleeding in the urine. Most of these conditions can be treated effectively with excellent long term cure provided they are diagnosed in time.












Best Urologist in Hyderabad


Andrology and infertility consists of treatment of genital, fertility and sexual problems in men. Problems of erection (erectile dysfunction or ‘ED’ in medical parlance) are common and a source of severe embarrassment to men and marital discord in society. ED is treatable! In a vast majority of men, problems related to sexual function can be managed by simple methods without resorting to surgery or costly treatments! ED is also preventable by following the simple rule “whatever is good for your heart is good for erections”. A healthy lifestyle, avoiding smoking, regular exercise, good sleep and stress management are all steps to ensure a healthy heart and a healthy erection. Smokers are very likely to develop erectile dysfunction, hence smoking is not cool!