xqnsZ dh iFkjh % yst+j }kjk mipkj

xqnsZ esa cuus okyh iFkfj;ksa esa eq[;r% dSyf'k;e Calcium o vkWDt+ysV Oxalate ik;k tkrk gSA ikuh dh deh ls ew= xk<+k gksus ij buds d.k ctjh ds :i esa xqnsZ esa tek gksus yxrs gSa vkSj /khjs&/khjs tqM+ dj iFkjh cuk ysrs gSaA ;g iFkjh /khjs&/khjs cM+h gksrh tkrh gS vkSj is'kkc ds jkLrs esa #dkoV iSnk dj nsrh gSA vxj nksuksa xqnksZa esa iFkjh ls #dkoV gks tk;s rks xqnsZ Qsy gksus dh ukScr Hkh vk ldrh gSA

xqnsZ dh iFkjh ds y{k.k

• vk/kh dej esa nnZ tks ped ds lkFk isMw ;k v.Mdks"k dh rjQ vkrk gSA ;g nnZ vpkud gh mBrk gS o cgqr rst gks tkrk gSA dHkh&dHkh blds LFkku ij /khek&/khek nnZ yxkrkj jgrk gSA
• is'kkc esa tyu] ckj&ckj is'kkc vkuk] is'kkc esa #dkoV eglwl gksuk] is'kkc esa [kwu vkukA
• izkjEHk esa ;g rdyhQ dbZ gQ~rksa ;k eghuksa ds vUrjky ls gksrh gS vkSj dqN nokb;k¡ ysus ij Bhd gks tkrh gSA ejht fuf'pUr gks tkrk gS fd Bhd gks x;k] tcfd iFkjh Hkhrj gh Hkhrj xqnsZ dks [kjkc djrh jgrh gSA
  
  

yst+j }kjk nwjchu ls fyFkksfVªIlh

Mini PCNL (feuh ih-lh-,u-,y)&bl fof/k esa cgqr okjhd fNnz }kjk nwjchu Mkydkj ystj }kjk xqnsZ dh iFkjh dks rksM+dj mlh le; fudky fn;k tkrk gSA
RIRS & URS (vkj-vkbZ-vkj-,l ,.M ;w-vkj-,l-)&bl fof/k ls xqnZs dh uyh esa fdruh Hkh cM+h iFkjh dks fcuk phj&QkM+ ds is'kkc ds jkLrs gh yst+j ls rksM+dj fudky fn;k tkrk gSA

yst+j }kjk nwjchu ls fyFkksfVªIlh ds ykHk

• bl i)fr dk lcls cM+k ykHk ;g gS fd ejht fcuk phj&QkM+ ds viuh iFkjh ls eqfDr ik ysrk gSA cM+s vkWijs'kuksa dh rqyuk esa bl fof/k esa Vk¡dksa esa nnZ gksus ;k Vk¡ds id tkus tSlh ijs'kkuh dh dksbZ lEHkkouk ugha jgrh gSA
• ysst+j }kjk nwjchu i)fr esa 1 ls 2 fnu HkrhZ dh vko';drk gksrh gS] o ejht 5-7 fnu esaa LoLFk gksdj dke ij tk ldrk gSA
• Mk;fcVht] nek] jDrpki ;k g`n; jksxhs o vfr o`) o detksj jksfx;ksa ds fy, bl rduhd dk iz;ksx vklkuh ls fd;k tk ldrk gSA vkWijs'ku ds ckn fQj nksckjk cu tkus okyh iFkfj;ksa ds fy,] tgk¡ nksckjk vkWijs'ku vR;Ur tfVy o [krjukd gks ldrk gS] yst+j nwjchu mruh gh ljyrk ls iFkjh ls eqfDr fnyk ldrh gSA
• vke /kkj.kk ds foijhr yst+j nwjchu cgqr e¡gxh Hkh ugha gSA 'kq: dk [kpZ cM+s vkWijs'ku ls FkksM+k vf/kd vo'; gS ijUrq le; dh cpr o thfodksiktZu dh cpr dkQh gn rd bl vfrfjDr [kpZ dh vkiwfrZ dj nsrh gSA
  
  

nksckjk iFkjh cuus ls jksdus ds fy, ijgst

• iku] lqikjh] iku elkyk o rEckdw&,dne cUn dj nsuk pkfg,A
• ikyd] I;kt] vkaoyk] vaxwj o fd'kfe'k&de ls de lsou djsaA vU; lc Qy o lCth ys ldrs gSaA
• pk; ;k dkWQh fnu esa 1-2 ckj ls vf/kd u ysaA iuhj] v.Mk] eklkgkj&lhfer j[kuk pkfg,A
• nw/k o ngh dk lsou fnu esa yxHkx 300 xzke rd lhfer j[kuk pkfg,A ?kh] eD[ku dk iz;ksx fd;k tk ldrk gSA
• ikuh bruk ihuk pkfg, fd ,d iwjs fnu esa is'kkc dh ek=k de ls de 2-2-5 yhVj gksuh pkfg,A
• ikuh [kkjk gks rks mls mckydj iz;ksx djuk pkfg,A [kkus esa ued dk iz;ksx de ls de djuk pkfg;sA
• tkS o ukfj;y dk ikuh] dsyk] vUukukl dk twl o uhcw iFkjh nksckjk cuus ls jksdus esa mi;ksxh gSaA

izksLVsV xzfUFk % yst+j }kjk mipkj Laser TURP

izksLVsV iq#"kksa esa ik;h tkus okyh ,d xzfUFk gS tks ew=k'k; ds uhps jgrh gS o ew= uyh bl xzfUFk ds e/; ls fudyrh gSA izksLVsV xzfUFk dks ^ikS#"k xzfUFk* ;k lkekU; Hkk"kk esa ^xnwn* Hkh dgrs gSaA 50 o"kZ dh mez ds ckn vf/kdka'k yksxksa esa izksLVsV xzfUFk ds vkdkj esa o`f) gksus yxrh gSA ;g vk¡[kksa ds eksfr;kfcUn o ckyksa ds lQsn gksus dh rjg ,d izdkj ls mez c<+us dk gh y{k.k gSA izksVsLV xzfUFk ds vkdkj esa o`f) gksus ij ;g xzfUFk ew= uyh ij ncko ds dkj.k is'kkc esa #dkoV iSnk djus yxrh gSA vc vR;k/kqfud fpfdRlk fof/k ls nwjchu }kjk fcuk phjQkM+ izksLVsV dk mipkj lEHko gSA



izksLVsV xzfUFk c<+us ds y{k.k



• is'kkc tYnh&tYnh vkuk o jkr esa dbZ ckj is'kkc djus ds fy;s mBukA
• is'kkc dks nsj rd ugha jksd ikuk] ,dne Hkkxdj is'kkc djus dh t:jr eglwl gksukA
• is'kkc 'kq: djus esa le; yxuk] /kkj dk /khek gks tkuk o chp esa #ddj fQj 'kq: gksukA
• is'kkc vkf[kj esa cw¡n&cw¡n djds vkuk] is'kkc Hkjs jgus dk vglkl cus jguk] diM+ksa esa is'kkc fudy tkukA
• is'kkc esa [kwu ;k eokn ¼il½ vkukA
• is'kkc ,dne #d tkukA ,sls esa uyh Mkydj is'kkc mrkjuh iM+rh gSA
  
  

izksLVsV xzfUFk mipkj dh fof/k;k¡

nokvksa }kjk % izksLVsV xzfUFk ds c<+us dh izkjfEHkd fLFkfr esa dqN gn rd y{k.k nokvksa ls jksds tk ldrs gSa] o vkWijs'ku dqN le; ds fy, Vkyk tk ldrk gSA ijUrq ;g nok;sa yxkrkj ysus dh vko';drk gksrh gS vU;Fkk nok ds cUn djrs gh fLFkfr igys tSlh gks tkrh gSA
 nwjchu fof/k % ystj }kjk bl fof/k esa dksbZ phjk ;k Vkadk ugha yxk;k tkrk gSA bl fof/k esa is'kkc dh uyh ds jkLrs nwjchu Mkydj yst+j }kjk c<+h gqbZ izksLVsV xzfUFk fudky nh tkrh gSA nwjchu ls gh vUnj dk jDrlzko jksd fn;k tkrk gSA vkWijs'ku esa ejht dks ijs'kkuh Hkh cgqr de gksrh gSA vkt lkjs fo'o esa 98-99% izksLVsV xzfUFkksa dk bykt nwjchu fof/k }kjk gh fd;k tkrk gSA



ystj }kjk nwjchu ls vkWijs'ku ds ykHk



• bl i)fr dk lcls cM+k ykHk ;g gS fd ejht fcuk phj&QkM+ ds is'kkc dh #dkoV ls eqfDr ik ysrk gSA
• nwjchu i)fr esa ek= 2 ;k 3 fnu HkrhZ dh vko';drk gksrh gS] o ejht 8-10 fnu esa iw.kZ LoLFk gks tkrk gSA
• nwjchu fof/k esa jDrlzko dkQh de gksrk gS o jksxh dks [kwu p<+kus dh t:jr Hkh ;nk&dnk gh iM+rh gSA
• nwjchu i)fr esa iwjh csgks'kh dh t:jr ugha gksrh] dsoy 'kjhj dk fupyk fgLlk lqUu dj fn;k tkrk gSA
• yst+j }kjk nwjchu fof/k esa Vk¡dksa esa nnZ gksus ;k id tkus tSlh dksbZ ijs'kkuh ugha jgrh gSA
• Mk;fcVht] nek] jDrpki ;k g`n; jksxh o vfr o`) o detksj jksfx;ksa ds fy,] ftuesa cM+k vkWijs'ku [krjs ls [kkyh ugha gS] bl fof/k dk iz;ksx fu%ladksp fd;k tk ldrk gSA




Benign Prostate Hypertrophy – Prostate Enlargement

It is a male urological problem, where the prostate gland enlarges slowly with the age and under the influence of testosterone. This results in narrowing of the urethra causing obstruction to the flow of urine. It manifests as frequency of urination, urgency, nocturia, hesitancy, straining to void. Patient presenting with such symptoms are thoroughly evaluated with blood and urine investigations as well as ultrasound and uroflowmetry which helps to decide the management. The options include either medicines or endoscopic intervention – TURP. Malignancy of the prostate can also present with similar symptoms and needs early evaluation as well as intervention.

Stone Diseases

The stone disease of the urinary tract is very common in this part of India (North India). Usually presents with back pain, pain radiating to thigh, genitalia, blood in urine or fever. Patients are investigated with blood and urine assays followed by ultrasound and CT of the abdomen. The options available are endoscopic interventions in the form of URS / PCNL/ Mini-PCNL/ and RIRS. The stones are fragmented using laser and retrieved fragments are sent for chemical analysis. Based on analysis patients are further treated to prevent the recurrence.

Stricture Urethra

Narrowing of the urethra results in difficulty in passage of urine. Patients presenting with such symptoms are evaluated using uroflowmetry and ascending urethrogram apart from blood and urine tests. Based on the investigations, patients are offered wither endoscopic surgery (OIU – Optical Internal Urethrotome) or urethroplasty. Following surgery, the patients are re-evaluated after a month and are advised about self dilatation that the patient can carry out by him at home.

Kidney Tumor

The presentation of a kidney tumor may be a back pain or blood in urine or incidentally diagnosed for the investigation done for some other symptoms. Patients are evaluated with CT/ MRI scan apart from regular blood investigations. Based on the reports if the tumor is small patients are offered partial nephrectomy (tumor along with part of kidney is removed) or radical nephrectomy (entire kidney along with tumor is removed) if tumor is large. Tumor is sent for pathological examination. Patients shall undergo follow up based on the pathological report.

Pelviuretric Junction Obstruction

It is mostly, a congenital disorder resulting from the abnormal development of pelviureteric junction, there by resulting in failure of passage of urine from kidney to the ureter. The patient may be asymptomatic diagnosed during the evaluation of other problems. Patient may also have back pain, fever, recurrent UTI or stones. These patients are investigated with blood and urine test followed by Ultrasounogram, IVP, CT urography. Renal scan is done to evaluate the function of the kidney. The surgery in the form either endopyelotomy or pyeloplasty is advised where the abnormal narrowed segment is removed and the two ends are rejoined. Stent (plastic tube) is left inside the ureter, usually removed after 6 weeks endoscopically. After the surgery the patients are advised to undergo periodic followup.