Urological and renal disease frequently converge as a patient requiring radical cystectomy needs pre-operative renal reserve assessment and a p...
Urological and renal disease frequently converge as a patient requiring radical cystectomy needs pre-operative renal reserve assessment and a patient with staghorn calculi and declining GFR needs metabolic nephrology alongside stone clearance. Medanta Lucknow's Department of Urology and Nephrology manages both surgical and medical renal disease within a single unit. The team covers laparoscopic and robotic urological surgery, endourology, urological oncology, reconstructive and paediatric urology, CKD and glomerulonephritis, dialysis, and renal transplant medicine providing tertiary-level care for patients across Uttar Pradesh without referral to Delhi.
Urological Surgery and Oncology
Radical nephrectomy, partial nephrectomy for nephron-sparing, radical prostatectomy, and radical cystectomy with urinary diversion are performed laparoscopically and robotically. Robotic assistance is particularly relevant in nerve-sparing prostatectomy, where instrument dexterity and three-dimensional visualisation reduce the margin for error in neurovascular bundle dissection. Urological oncology decisions including active surveillance versus intervention for prostate cancer, TURBT staging for bladder cancer, and the feasibility of nephron-sparing for renal tumours are made through multidisciplinary review with oncology and radiology.
Endourology and Stone Disease
Percutaneous nephrolithotomy manages large-volume and staghorn calculi whereas ureteroscopy with holmium laser lithotripsy addresses ureteric and smaller renal stones. Stone composition analysis and 24-hour urine metabolic evaluation(calcium, oxalate, uric acid, citrate) follow every surgical episode to identify recurrence risk and guide prophylaxis.
Reconstructive and Paediatric Urology
Urethroplasty for stricture disease, neurogenic bladder management and vesico-vaginal fistula repair constitute the reconstructive scope. Paediatric cases like posterior urethral valve ablation, pyeloplasty for PUJ obstruction, ureteric reimplantation for vesico-ureteric reflux, and hypospadias correction require surgical familiarity with developmental anatomy and timely intervention to protect renal parenchyma during childhood growth.
Nephrology, Dialysis, and Renal Transplant
CKD evaluation identifies causes like IgA nephropathy, lupus nephritis, FSGS and membranous nephropathy through renal biopsy and directs specific immunosuppressive protocols. Doctors give medications, control blood pressure, correct metabolic acidosis, and prescribe SGLT2 inhibitors to halt their progression. Both haemodialysis and peritoneal dialysis are available. Living donor renal transplantation is performed, with post-transplant management covering tacrolimus titration, rejection surveillance, BK virus monitoring, and long-term graft protection.
Dr. Aneesh Srivastava - Director, Urology
Done MCh Urology, SGPGI Lucknow. Specialised in laparoscopic and robotic urological surgery, uro-oncology, radical prostatectomy, cystectomy with urinary diversion, and complex urethroplasty.
Dr. Rahul Janak Sinha - Director, Urology
Done MCh Urology, SGPGI Lucknow. Subspecialty training in paediatric urology and endourology. Manages PUJ obstruction, vesico-ureteric reflux, posterior urethral valves, and hypospadias in children alongside adult stone disease and urological malignancy.
Dr. Manav Suryavanshi - Senior Consultant, Urology
MCh Urology. Specialised in PCNL for complex and staghorn calculi, flexible ureteroscopy with laser lithotripsy, laparoscopic urology, BPH and bladder outlet obstruction, and male infertility.
Dr. Vivek Vasudeva - Consultant, Nephrology
Done DM Nephrology, SGPGI Lucknow. Specialised in CKD management, glomerulonephritis (lupus nephritis, IgA nephropathy, FSGS), AKI, haemodialysis, peritoneal dialysis, and post-transplant medical management.
Dr. Prashant Rajput - Consultant, Nephrology
Done DM Nephrology, King George's Medical University Lucknow. Specialised in diabetic and hypertensive nephropathy, advanced CKD, renal biopsy, AV access planning, dialysis initiation, and pre-transplant recipient evaluation.
What is the difference between urology and nephrology?
Urology is a surgical speciality managing structural and oncological diseases of the kidney, ureter, bladder, prostate, and urethra. Nephrology is a medical speciality covering renal function, glomerular disease, dialysis, and transplant medicine. Many patients require both surgical resolution of the structural problem and medical management of its renal function consequences.
My CT scan shows a large kidney stone. What are my options?
Stones above 20 mm or those forming a staghorn configuration are managed by percutaneous nephrolithotomy. Smaller renal and ureteric stones are treated by ureteroscopy with laser lithotripsy. Shockwave lithotripsy applies to selected cases below 20 mm with favourable stone density. Metabolic evaluation follows to address recurrence risk.
At what point is dialysis necessary, and what does AV fistula formation involve?
Dialysis is initiated when GFR falls below 10-15 ml/min/1.73m2 or when uraemic symptoms, refractory fluid overload, or hyperkalaemia supervene. AV fistula formation (forearm radiocephalic preferred) is planned when GFR is below 20 ml/min/1.73m2, since a native fistula requires six to twelve weeks to mature before it can be used for haemodialysis.
Is robotic prostatectomy available at Medanta Lucknow?
Yes robotic-assisted radical prostatectomy is performed for localised prostate cancer. The decision between surgery and radiation therapy is made through multidisciplinary review accounting for tumour risk stratification, patient age, comorbidity profile, and patient preference.
When should a patient with CKD be referred to a nephrologist?
Nephrology referral is appropriate at GFR below 60 ml/min/1.73m2 (CKD stage 3) in the presence of proteinuria, haematuria, accelerating GFR decline, or hypertension resistant to two agents. Early referral allows identification of treatable glomerular disease, initiation of progression-retarding therapy, and timely preparation for renal replacement therapy before decompensation occurs.