All posts by admin

A DELIGHTED PATIENT’S TESTIMONIAL

I would like to thank SCI International hospital for providing us the international service that was more than our expectation. We were treated with the utmost courtesy and understanding by all staffs. The friendly smiling face of Ms Shivani Tyagi to greet us and personal touch by staff will be in my memory throughout my life.  I am impressed with with the highly efficient  doctor Gautam banga ,his smiley face and friendly staff and their warm hospitality. All these beautiful atmosphere which i felt here here would definitely drive me here in the future. I would like to
Thanks Dr. Gautam so much for making my son well and successful one touch Hypospadias surgery . I wish  more success of this organization.

Binod Aryal, Nepal
 IMG_2093

First Karl Storz VITOM by a Urology unit in India at SCI International Hospital

SCI International Hospital is proud to announce the installation of the first Karl Storz VITOM by a Urology unit in India for Reconstructive Urology.

This is a new concept in high-resolution visualization for open surgery with minimal access.

The new VITOM telescopes provide enhanced visualization and greater depth of field hence offer the surgeon to find the best and most convenient solution for their application so as to get best patient outcome.

IMG_6698

Hypospadias Surgery Best & Affordable

Hypospadias Surgery Best & Affordable

Hypospadias Surgery is done on those who has it as a birth defect in baby boy in which the penis neither works well nor looks normal. It is the defect of the urethra in the male where the urinary opening is not at the usual location on the head of the penis. It is the second most common birth abnormality in boys, affecting approximately 1 of every 250 new born boys.

Hypospadias Surgery

The urethra normally travels in the male through the full length of the penis so that the stream of urine comes from the urethral opening at the tip of the penis. However, in hypospadias the urethra does not go all the way through the penis but, instead, opens on the underside of the shaft of the penis or below the penis hence the urine comes from an opening that is on the underside of the penis or below the penis.

Causes: The exact reason of this defect is unknown. Sometimes hypospadias is genetic.

 

Symptoms of Hypospadias:

 

  • Opening of the urethra at a location other than the tip of the penis
  • Abnormal spraying during urination
  • Downward curve of the penis (chordee)
  • Hooded appearance of the penis as only the top half of the penis is covered by foreskin

 

Association with Psycho-social aspect on Hypospadias

Hypospadias if untreated influence a man’s psycho-social status. Affected man often feels like he has got this horrible secret in his pants and if others will find out, they would make fun of him. Hypospadias leads to shame and aloneness that a guy can feel when he’s growing up. One of the reasons for feeling so different is because he needs to sit down to pee unlike other males.

 

Need for the Hypospadias Surgery

Parents usually ask the Urologist that their child urinates finely and has bowel movements just fine. So why are we having the surgery done if it doesn’t hurt him and he urinates just fine? Simple answer to these parents is Surgery is essential because Hypospadias can cause problems as he gets older. Problems are listed below: 1. Irregular urine stream .He would have to pee sitting down his whole life. 2. His penis would look different than other boys. 3. It could potentially create fertility issues. The opening of the penis is not close to the cervix as a result of which the sperm is not in the right place to cause pregnancy. 4. If the penis has chordee (downward curvature of the penis) it becomes very painful, difficult or even impossible to have intercourse as an adult.

If the hypospadias needs to be repaired, this is done by surgery. The aim is to repair and reconstruct the urethra. Depending on the degree of the hypospadias, the surgery can range from relatively simple to very challenging. It is usually performed by the paediatric urologist when the baby is between 6 to 15 months old.  General anaesthesia is used to keep the baby asleep during surgery and additional medications provide post-operative pain relief.

I would like parents who have a son born with hypospadias to be reassured that the anatomy can be reconstructed, the surgery is safe and well tolerated, and a good outcome with a normal or near normal, penis appearance and function can be achieved.

As a Urologist, I owe it to our team for excellent results and patient happiness. For parents It is not easy to get their young child in Operation theatre. I really wish to express my gratitude to the parents and families who give their little ones in our hands trusting us to do the right thing for their child.

Post- surgical complications

Pain: Most of the time the babies are slightly cranky but manageable. Analgesic (pain-killer) syrup is prescribed to help in pain relief.

Spasms: Babies may have intermittent spasms due to irritation by the catheter. For this reason a small dose of bladder relaxant is usually prescribed.

Blood spotting in the diaper/ catheter may occur in the first few days. A few drops of the blood are acceptable. In case of continuing ooze, a hospital visit may be required, but this is very infrequent.

Dressing issues: Dressing loosening up may occur in some babies. If it happens during first 2-3 days, then a new dressing is placed. After that, the dressing is just removed.

Infection may happen and is the most common cause of the failure of surgery. To prevent this, broad spectrum antibiotic syrup is usually prescribed for 7-10 days. It is vital to prevent stool smearing up the dressing in immediate post-operative period.

Fistula: Fistula is a small area of breakdown in the operated area, leading to sideways leakage of urine. Fistulas may heal in due course of time.

Stenosis/ Stricture: During healing period, the new urinary tube may become tight. Mostly this happens at the tip of penis and can be easily managed by daily calibration at home with a small feeding tube.

These complications are typically 5% if the surgery is performed by an experienced Urologist.

 

Adult hypospadias/ Re-do hypospadias Surgery

 

Most cases of adult hypospadias are those who live with hypospadias all their life. They know they are different, but they suffer with it because of their misbelief that there was nothing to be done about it when they were infants. But as they grow old, it causes a lot of anxiety growing up, and into adulthood. It has nothing to do with fathering a child although usually it is near to difficult.

As far as I have practiced I have realized that the adult patient with hypospadias ignores the disease as he is already into middle age now. He had his children. But such patients should be educated about connecting adult hypospadias with chronic prostatitis and urinary tract infections, painful intercourse, abnormal look of penis. I would recommend not suffering needlessly with a regret that you went through your life ignorant to options.  This is absolutely treatable disorder. You can have a normal penis. You can pee normally and not spray all over the place. You can have pain free sex.

Hypsopadias Surgery

Hypospadias surgery in adults- Differences from surgery in children:

Longer healing time than children:  comparable to hypospadias repair in children, the healing of penis in adults takes longer time. Though one can start passing urine normally in 2-3 weeks, it may take upto 2-3 months for the penis skin to heal fully.

Longer time for indwelling urine catheter: Catheter is kept inside for 10-14 days for distal hypospadias repair in adults and 14-21 days for severe hypospadias repair in adults which is quite more with respect to children where most of the catheters are removed in 5-10 days.

Higher risk of infections: The chances of skin infections at hypospadias surgery site is higher in adults as there is hair growth in penile area and more sweating in adults.

Pain after surgery: There may be episodes of severe pain during healing phase in first one month as adults have night time erections during a certain phase of the sleep.

Abstinence from sex: It is advisable to refrain from sex and masturbation for almost 3 months after hypospadias surgery in adults.

Off from work: Since most of the adults are in a job or business, it is important to take atleast 4 weeks off from work before planning hypospadias surgery.

Uroflowmetery: It is recommended to undergo a test called uroflowmetry to check the speed of urine passage at 3 months and one year of surgery to make sure that the new passage is of good caliber.

 

Hypospadias cripples :. In some cases even after hypospadias repair some functional complications prevail in patient that condition is termed as ‘hypospadias cripples’.

This condition is a challenge to reconstructive surgeons because of the complexity of the problem and limited options for reconstruction.

These patients have usually undergone multiple  urethral surgeries leaving the blood supply compromised and healthy  tissue scarce. While the repairs are technically challenging, these patients  often also have physical and psychosocial issues.

The repair of hypospadias cripples is of particular concern to the  reconstructive urologist. Given the variability  involved in Re-do hypospadias repair, the reconstructive urologist should  be familiar with several techniques. A number of surgical techniques are  available for Re-do hypospadias repairs. Re-operative hypospadias repair is fraught with challenges given the intraoperative complexity and long-term risk of complications.

Hypospadias Surgery Result

 

Currently, more than 90% of the children with penile hypospadias get successful results after single stage hypospadias surgery and children are able to stand and pee like a normal kid a few days after surgery.

During hypospadias surgery, we usually take some tissue from extra foreskin on top and use the rest of it to provide equal skin cover on all sides to penis. Hence, after Hypospadias surgery, the penis has a circumcised appearance. Also, if there has been any bend in penis, that is corrected leading to straight penis after hypospadias repair. So in nutshell, in most of the cases a few weeks after surgery, penis looks like just that a circumcision has been done.

Generally with current hypospadias surgery techniques preserving nerve and blood supply, the hypospadias repairs have resulted in very good outcomes both from cosmetic and functional perspective. Some children who have undergone a flap procedure for a severe hypospadias such as for scrotal hypospadias may need an evaluation as the force of semen ejaculation may not be very good. Also a check-up is mandatory later on after puberty at about 13-24 years of age and after 2-3 years of sexual life/ marriage to ensure that the urethra is functioning well.

Dr. Gautam Banga at

91-9999062316, 011-41041131,
Email : gautambanga@gmail.com,

URETHROPLASTY SURGERY, BEST AND AFFORDABLE

WHAT IS URETHROPLASTY

Urethroplasty surgery is an operative procedure where the urethra is reconstructed to cure problems like Urethral Stricture/ Urethral Injury. The types of surgeries are varied and depend upon the location, cause, and length of the stricture. Most surgeries take between three to six hours to complete.

urethroplasty surgery

SUCCESS RATE OF URETHROPLASTY SURGERY

Urethroplasty has highest success rates compared to other modalities of treatment like Internal (Optical) Urethrotomy, Urethral dilatation and Urethral stent. Buccal Mucosa has given the best results in Augmentation Urethroplasty in present time.

COMPLICATIONS IN URETHROPLASTY

Technique of Urethroplasty has evolved over time and it varies with the kind of stricture. It is a complex surgery and result of procedure depends on various factors like Surgeon’s skills, Set up (operation theatre), post-operative care but trained and skilled surgeon is the most important factor in deciding the outcome. Recovery time depends a lot on the type of surgery that was performed. Typical patients will be in the hospital overnight after surgery. As soon as they can eat, walk, and care for their catheter they can leave the hospital. It is important to limit activities after Urethroplasty until adequate healing has occurred. This means no heavy lifting, strenuous exercise, or work for at least two weeks.

URETHROPLASTY SURGERY IS APPLICABLE WHERE

Different surgeries have different success rates. Generally, strictures can be resolved in more than 90 percent of cases in first attempt if done by a skilled Reconstructive Urologist.

Success rate decreases with multiple failures and treatments so the first surgery is very important for the patient. In pelvic fracture associated Urethral injury, Urethroplasty is done after an interval of 4 months post-surgery to define the extent of fibrosis.

Success rate of this kind of Urethroplasty is in the range of 85-90% if properly performed.

FOLLOWUP ON URETHROPLASTY SURGERY

The follow-up after Urethroplasty is very important; this is because most Urethral Strictures recur within the first year or two after surgery.

Patients are seen every three to six months in their first year after surgery.

Urethroplasty is the best procedure for patient with Stricture Urethra and a ray of hope for those who have been suffering with repeated dilatation and endoscopic procedures over many years.

Urethroplasty can make the patient with stricture accept his life in a better way and live with respect in society.

EXPERIENCED URETHROPLASTY SUGERY CENTRE

The only Tertiary referral centre in Northern India exclusively specialized in male Urethral and Penile/ Reconstructive Surgery.

  • More than 50 Urologists across the country have referred patients with complex urological problems.
  • More than 800 Urethroplasty surgery have been performed
  • 90% success rates
  • Well trained Urologists
  • State of the Art Facilities
  • Proper follow up

DOCTOR FOR URETHROPLASTY SURGERY

Dr Gautam Banga is among the very few Urologists in India who are exclusively devoted to surgery of urethra and external genitalia.

TO KNOW MORE ABOUT URETHROPLASTY SURGERY REACH OUT TO :

Dr. Gautam Banga at

91-9999062316, 011-41041131,
Email : gautambanga@gmail.com,

 

Urethral Stricture Best Treatment by Best Urologist

What is Urethral Stricture

Urethral Stricture Treatment is required for a condition marked by narrowing of Urethra is impacting the flow of urine out of the bladder. It is considered rare in females.

 

How to diagnose urethral stricture

Investigations to be done in patient with stricture:

  • Retrograde urethrogram with Micturating Cystourethrogram (RGU+MCU) to define the length and site of the stricture. This is the most important diagnostic tool in case of stricture urethra.
  • Urine examination to rule out infection
  • Ultrasound
  • Uroflowmetry to check for urine flow
  • Cystourethroscopy
  • MRI pelvis and Perineal region.
Urethral Stricture Treatment
Urethral Stricture Treatment

 

SYMPTOMS OF URETHRAL STRICTURE

 

  • Poor urinary system.
  • Passing urine with very thin stream or passing urine in drops.
  • Need more than usual time to pass urine.
  • Sudden urge to pass urine.
  • Have to go frequently to pass urine.
  • Sense of incomplete emptying of bladder.
  • Recurrent urinary infection.
  • Retention or inability to pass urine.
  • Pus discharge from urethral meatus.
  • Abscess (urethra-cutaneous Fistula).
  • Swelling and infection in prostate (Prostatitis) or in testes (epididymorchitis)
  • Rarely flank pain while urinating.

 

How does urethral stricture occur

 

Main causing factors of stricture urethra are:

  • Infection
  • Catheter induced inflammation
  • Straddle injury to urethra
  • Pelvic bone fracture posterior urethral disruption defects(PFUDD)
  • Any previous endoscopic surgery done through urethra
  • Previously operated Hypospadias

 

Can we prevent urethral stricture

 

Yes, it can be prevented by treating urethritis, by treating sexually transmitted diseases, by using good quality catheter.

 

Doctor for urethral stricture treatment

 

Urethral stricture treatment is managed by a reconstructive Urologist who is trained and specialized in urethra and external genitalia.

 

Options for Urethral Stricture Treatment

 

Urethral Stricture Treatment depends on certain factors like site and the length of the stricture and age of the patient. This condition is not curable with medicinal/conservative treatment only. Surgical options available for treating urethral stricture are :

  • Open urethral reconstruction
  • Urethroplasty
  • Urethral Dilation
  • Urethrostomy
  • Urethral stent placement

 

Prevention of Urethral Stricture

It is crucial to see a urologist if you are experiencing symptoms of stricture urethra. Treating the condition right away is the best way to prevent/avoid complications. First surgery has the highest success rate.

Recurrence of Urethral Stricture

Surgery if done by trained reconstructive urologist has success rate in the range of 90-95%. Success rate decreases with repeated  surgeries(75-80%). Success rate is also on lower side if surgery is done by routine urologist.

Infections by Urethral Stricture Treatment

Yes it can cause infection to others who get in contact sexually with the patient.

 

 

To know more please contact :

Gautam Banga
at 91-9999062316, 011-41041131,
Email : gautambanga@gmail.com

BEST HYPOSPADIAS TREATMENT, MINIMUM COST

BEST HYPOSPADIAS TREATMENT

WHAT IS HYPOSPADIAS

Hypospadias Treatment is almost risk free. Hypospadias is a congenital deformity of the penis and external genitals in which urinary opening is located proximal to its normal location along with curvature of the penis and abnormal distribution of penis skin. It is sometimes associated with undescended testis on one or both sides. It is one of the commonest malformations of male children, affecting approximately 1 of every 250 approximately. Undescended testes or inguinal hernia or upper urinary tract anomalies may be associated with hypospadias.

Hypospadias Treatment
Hypospadias Treatment in Delhi

CAUSES OF HYPOSPADIAS

The environment and hormones may be the factors that may influence the development of this defect.

Hypospadias is a congenital condition, it happens while the baby is developing in the mother’s womb. As the fetus develops, the tissue on the underside of the penis that forms the urethra doesn’t completely close, shortening the passageway. In many cases, the foreskin—the fold of skin covering the penis tip, or glans—also doesn’t develop properly, resulting in extra foreskin on the top side of the penis and none on the underside.

 

WHAT IS HYPOSPADIAS REPAIR

Hypospadias repair is the Hypospadias Treatment of this congenital deformity and it consists of various components, each dealing with correction of one particular deformity.

  1. Chordee correction
  2. Glanuloplasty
  3. Urethroplasty

 

WHAT IS HYPOSPADIAS

Hypospadias is a congenital disorder, so its present in new born.

Hypospadias Chordee
Hypospadias Chordee Treatment

 

SYMPTOMS OF HYPOSPADIAS

Usually, boys with this condition have the opening of the urethra near the tip of the penis on the underside.

Hypospadias is noticed at birth/ during routine Paediatric check- up.

Along with the misplaced opening, the foreskin is often incomplete and forms a hood.

Urine stream may be hard to direct and control.

The penis may curve as it grows, causing sexual dysfunction later in life.

If the urethral opening is near or behind the scrotum, a person may have fertility problems later in life.

 

IS HYPOSPADIAS SURGERY NECESSARY

A Hyospadias Surgery is needed for anatomical, cosmetic and functional aspect of the penis. If surgery is not done, then patient can have

  1. Difficulty in passing urine with urine streams going downwards
  2. Difficulty in insemination during intercourse
  3. Curvature of the penis with erection leading to difficulty with intercourse.
  4. The Patient can go into depression because of abnormal appearance of the penis.

 

BEST TIME FOR HYPOSPADIAS SURGERY

Best time for surgery is between 1 ½ years -4 years.

 

How can I identify the severity of hypospadias?

Severity of hypospadias is very much visible on clinical examination and also at the time of erection.

 

TECHNIQUES FOR HYPOSPADIAS TREATMENT

There are more than 300 types of hypospadias repair and each surgeon has his own personal/ preferred techniques. Two different procedures can be combined to get the best results. The aim of the surgery is to give a cosmetic and functional penis. In some complex Hypospadias Treatment cases, surgery can be done in two stages.

DOCTOR FOR HYPOSPADIAS TREATMENT

A reconstructive urologist who is trained in hypospadias repair and doing a high volume of hypospadias surgeries (8-10 /month) is the right person to approach for such specialized work.

 

 

HYPOSPADIAS TREATMENT PROCEDURE

Duration of procedure varies with the technique and complexity. Duration can vary from 2 hours to 5 hours. In few cases need multiple stages 6-8 months apart.

DURATION OF STAY IN HOSPITAL AFTER HYPOSPADIAS SURGERY

 

The Patient has to stay 2-3 days in hospital. A urinary drainage catheter is kept for 10-14 days.

 

 

CURE AFTER HYPOSPADIAS TREATMENT

Yes, if a proper surgery is done. The Success rate for Hypospadias Treatment is around 85-90% and the patient can pass urine in standing position.  

 

 

 

EFECT OF HYPOSPADIAS SURGERY

A successful surgery never interferes with sexual life and infertility in the future.

 

 

 

COMPLICATION IN HYPOSPADIAS TREATMENT

After Hypospadias Surgery Complications are more likely can include

  • Bleeding
  • Swelling
  • Infection

In long term

  • Failure of repair
  • Urinary fistula formation
  • Residual penile curvature
  • Disfigured penis

2nd surgery is decided during post-operative follow up.

 

 

FOLLOW UP AFTER HYPOSPADIAS TREATMENT

Initial follow up at 15 days and one month, after that yearly follow up is  required in Hypospadias Treatment.

 

 

For further details on Hypospadias. You may reach out to

Dr. Gautam Banga

MBBS,MS,M.Ch (Urology)
Urologist, Andrologist and Genito -Urinary Reconstructive Surgeon
Contact no. : 91- 9886624303 | +91-9999062316
Email:- info@urethraandpenilesurgery.com
Website : www.urethraandpenilesurgery.com