Surgery for Prostate Enlargement
Dr Raj provides comprehensive assessment and treatment for benign prostate obstruction commonly known as ‘prostatism’ or ‘BPH’ which causes urinary symptoms in men.
The surgical treatment chosen is individualized for each patient.
Patients can select from a range of different surgical options including: Transurethral Resection of the Prostate (TURP), Green light laser resection of the prostate or the insertion of Urolift.
If you are experiencing urinary symptoms including – poor urine stream, feeling of incomplete bladder emptying, frequent need to urinate or waking up repeatedly overnight to urinate then contact our office for an appointment and evaluation.
TURP (Transurethral Resection of Prostate)
A TURP operation involves passing a special instrument called a resectoscope through the natural urine pipe (from the penis and into the bladder), while the patient is asleep under an anaesthetic. The overgrown prostate tissue, which is blocking the flow of urine, is then shaved away and removed.
TURP surgery is performed either under a general anaesthetic or spinal anaesthetic. TURP surgery helps to improve the urinary flow because it creates a wider urinary channel and is a common surgery performed by Dr Raj.
If you are experiencing urinary symptoms including – poor urine stream, feeling of incomplete bladder emptying, frequent need to urinate or waking up repeatedly overnight to urinate then contact our office for an appointment & evaluation.
Green light laser resection of the prostate
A green light laser resection involves passing a resectoscope through the natural urine pipe in the penis and then the bladder. A laser wand is used to vaporize the overgrown prostate tissue (BPH), which is blocking urine flow. This surgery is carried out under a general or spinal anaesthetic. This type of surgery is another option available to men who are experiencing troublesome symptoms from prostate enlargement and want surgery to treat their symptoms.
Dr Raj will assess and discuss with you your suitability for greenlight laser treatment at the time of your consultation.
Dr Raj is one of the few Urologists in Melbourne who commonly performs this minimally invasive surgery for men who have troublesome urinary symptoms because of prostate enlargement, which is blocking their urinary flow.
This surgery involves placement of sterile clips into the prostate to hold back the overgrown prostate tissue. It is performed as a day surgery under a general anaesthetic. (See diagram)
During your consultation Dr Raj will discuss your suitability for this surgery based on your test results.
Prostate Biopsy for Cancer Diagnosis
Dr Raj offers appointments for rapid diagnosis for patients who want investigation for prostate cancer.
All prostate biopsies to identify prostate cancer are performed by Dr Raj under general anaesthetic with pre-surgery antibiotics given to all patients. Patients are discharged home the same day and will have a follow up review appointment a few days later to obtain their biopsy results.
Some patients may require an MRI scan of the prostate to assist with their investigations for prostate cancer. Dr Raj will discuss your testing requirements with you during your consultation. Call our office today if you are concerned about prostate cancer or have a family history of prostate cancer and want to obtain a specialist urology review regarding your own prostate cancer risk.
(diagram of prostate ultrasound)
Bladder Tumour Resection
Dr Raj diagnoses and treats all stages of bladder cancer.
If you have had a cancerous growth in your bladder diagnosed, then you will need surgery to remove this growth. This surgery is performed under general anaesthetic. It involves passing a cystoscope through the natural urine pipe into the bladder, then by using a small electrical loop the bladder growth is scraped off the bladder. This removes the growth from your bladder and the specimen is sent to the pathology laboratory for the Pathologist to provide further information about the diagnosis.
You will have a review appointment with Dr Raj shortly after the bladder tumour resection so that she can discuss the pathology results with you.
Dr Raj has a team of Cancer Specialists that work with our patients to provide any additional treatment that may be needed to fully treat their bladder cancer. Cancer Specialists Dr Shirley Wong and Dr Mario Guerreri can provide patients with chemotherapy or radiotherapy treatment for bladder cancer if needed.
If you have any risk factors for bladder cancer or are experiencing symptoms such as visible blood in the urine or urinary tract symptoms please contact our office for an appointment.
Surgery for Kidney Stones
All patients with stones in the kidney or ureter which are causing symptoms, may be suitable for stone fragmentation surgery. Kidney stones are formed within the urinary tract by crystallization of compounds in the urine of some people.
Dr Raj will discuss with you which type of surgery is most suitable for your kidney stone treatment
Laser stone fragmentation surgery for kidney & ureteric stones
Dr Raj performs laser fragmentation surgery for kidney stones, almost every day, under general anaesthetic as day surgery.
A flexible telescope is passed through the natural urine pipe up to where the ureteric or kidney stone is sitting. The stone is then clearly identified using a camera and a microscopic sized laser fiber is passed through the telescope. This laser fiber uses “laser energy” to break up the stone into sand grain sized pieces. These pieces are then flushed out of the patient’s urinary system. A ureteric stent is usually placed in the kidney and ureter, after the procedure to protect the urine tube & kidney. (see diagram of stent). The stent is removed shortly afterwards.
Extracorporeal Shock Wave Lithotripsy
This surgery for treating kidney stones involves using an ultrasound machine, which is placed, alongside the patient’s flank area (outside the body), while the patient is asleep under a general anaesthetic.
The ultrasound machine sends ultrasound waves into the kidney, which helps to break up the kidney stone into smaller pieces. The patient usually passes outs these small pieces in the urine over the following weeks and months. This procedure is carried out as day surgery
When patients are discharged home after this procedure, they are encouraged to drink at least 2 litres of water every day to help the body to pass out the stone fragments. (see photo of ESWL)
Percutaneous stone surgery
Dr Raj performs this highly specialized surgery for patients who have very large stones in their kidney. Patients are given a general anaesthetic. Using x-ray technology, Dr Raj makes a small keyhole incision in the flank area over the kidney and passes a telescope through into the kidney to find the kidney stone.
A special instrument to break up stones called a lithotripter, is used to break up the large stone in smaller pieces. The pieces are then removed through the keyhole incision which is then closed with a suture. Dr Raj has extensive experience in performing this type of surgery under general anaesthetic.
Laparoscopic kidney surgery
This keyhole surgery is performed under general anaesthetic for patients who need to have one of their kidneys removed due to a cancer diagnosis.
In some patients who have been diagnosed with cancer of the kidney collecting system (called upper tract), the affected kidney and ureter (urine tube which connects the kidney to the bladder on that side) are removed together during the operation.
Dr Raj provides individualized cancer care for patients with kidney cancers. The cancer specialists including (Dr Shirley Wong– Oncologist) who are part of Dr Raj’s team are often involved in the multidisciplinary care of patients with kidney or upper tract cancers.
DR Raj may recommend that you have Urodynamics testing if you have symptoms of an overactive bladder or bladder muscle dysfunction.
This specialized testing is performed by Dr Raj as a day case under local anaesthetic. The test takes approximately 35mins and patients do NOT need to fast for this test. The test involves placing a very small urinary catheter through the natural urine pipe into the bladder. The bladder is then filled with sterile water through the catheter & the bladder muscle reactivity is recorded using a computer, which records the pressure within the bladder muscle. The test is important in determining if there are problems related to bladder muscle function such as with overactive bladder condition. Many patients who have urine leakage due to various different causes will also benefit from this test. The results of the test are explained to the patient on the day that they have the test done. Based on the test results Dr Raj will design an individual treatment plan.
Botox Injection into Bladder
Dr Raj offers this treatment for patients who suffer from symptoms of an overactive bladder. This procedure is carried out under a general anaesthetic.
By using a cystoscope which is inserted into the bladder through the natural urine pipe, multiple injections of diluted medically-approved Botox is injected into different locations within the patient’s bladder muscle. The procedure takes about 5 mins to perform. Patients can return home the same day. Dr Raj will individualise the Botox dose and frequency of future injections for each patient based on their diagnosis and how they respond to the treatment.