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ABO incompatible kidney transplants in India.

ABO incompatible Kidney transplants in India - CMCS health.

The need for ABO incompatible kidney transplants :

Living donor kidney transplants in India are usually done with a healthy blood-related (close relative) donor from the family of chronic renal failure (CRF) or end-stage renal disease (ESRD) patient. The preferred living kidney donor must be of the same blood group as that of the recipient or of the universally accepted “O” blood group. In the past, If an ESRD patient did not have a donor of the same blood group or of the “O” blood group, there was no hope of having a kidney transplant. The recent path-breaking advancement in Kidney transplantation, an ABO incompatible kidney transplant in India has ushered hope for such ESRD patients. Many of the Top Indian kidney transplant hospitals offer ABO-incompatible kidney transplants in India.

India is one of the most favored countries for patients seeking a living donor kidney transplant in a well-equipped and well-managed kidney transplant hospital. Most Indian kidney transplant hospitals offer hassle-free and truly global-class kidney transplant surgery with success rates that are at par with the best Kidney transplant hospitals in the world. The reasonable cost of kidney transplant surgery with almost no waiting period has made Indian Kidney transplant hospitals a favorite place for kidney transplant needing foreigners.

The first successful Kidney transplant took place in India in 1971 at Christian medical college Vellore. Since then many Indian hospitals have performed successful kidney transplants year after year for Indian and foreign patients.

ABO incompatible kidney transplant in India:

India's first successful ABO kidney transplant took place in 2011 at Kamineni Super Specialty Hospital in Hyderabad city between a father son duo. Father, who was a living kidney donor had Blood group "A+" where as his kidney recipient son had a blood group " O+".

Now many Top hospitals in India are performing ABO incompatible kidney transplants in India for both Indian and foreign patients seeking kidney transplant in India.

ABO incompatible kidney transplants are universally accepted for those young ESRD patients who does not have a blood group matching donor.

ABO incompatible Kidney transplant involves desensitization of the recipient before the kidney transplant surgery to overcome the ABO incompatible antibody induced kidney graft rejection. For a successful and long lasting ABO-incompatible kidney transplantation, temporary elimination of the anti-ABO antibodies from the recipient's serum is an absolute must.

Desensitizing an ESRD patient before ABO incompatible kidney transplants :

The process of desensitizing an ESRD patient before ABO incompatible kidney transplants in India is aimed to reduce Anti A/B antibody levels to achieve titers between 1:8 and 1:32.

Desensitizing an ESRD patient before an ABO incompatible kidney transplant involves following key stages:

B- Cell depletion before ABO incompatible Kidney transplants :

Monoclonal antibody therapy with an anti-CD20 drug rituximab have eliminated the earlier practice of splenectomy. In addition therapy with rituximab, prior to ABO incompatible kidney transplant deplete B-cells and plasma cells by complementing dependent cytotoxicity (CDC) , and antibody dependent cellular cytotoxicity.

Apheresis before ABO incompatible kidney transplants:

The therapeutic apheresis is a cornerstone for ABO blood group incompatible kidney transplants.Therapeutic apheresis consists of separating and selectively removing the pathogenic material from the patient by an extracorporeal aphaeresis system. The two most common and universally accepted methods used for apheresis are:

1. Double-filtration plasmapheresis (DFPP):

Double filtration plasmapheresis is done by using two plasma filters. The second filter allows smaller molecules to return back to the patient. DFPP helps in avoiding many complications associated with the ordinary therapeutic plasma exchange. DFPP uses centrifugation or a plasma separator, and double-filtration plasmapheresis (DFPP).

Double filtration plasmapheresis technique aims at selectively removing the immunoglobulin fraction from the serum and minimizing the volume of substitution fluid required. Human plasma albumin is used in this technique is used as replacement fluid.

Immunosuppression is also started in pre transplant ABO incompatible recipients 7 days before the transplant surgery as a pre transplant conditioning. Immunosuppression drugs generally used in India for ABO incompatible kidney transplants are tacrolimus , mycophenolate mofetil and methyl prednisolone .

2. Immunoadsorption (IA):

Immunoadsorption is a more effective with least side effects in removing anti A/B antibodies. Immunoadsorption (latest the apheresis method) , combined with hemodialysis is used to decrease donor-specific alloantibodies in ABO incompatible kidney transplant recipients before kidney transplant. Different types of columns are used in the process.

  • A Therasorb column contains polyclonal sheep anti-human IgG antibodies .
  • Immobilized staphylococcal protein A using columns.
  • Immobilized antigens and synthetic epitopes using columns

The major advantage of immunoadsorption over other apheresis techniques is that, it minimizes the need for replacement of factors such as albumin and plasma. 

Studies demonstrate that Desensitization of the human-leukocyte antigen using this immunoadsorption procedure effectively reduced or eliminated donor-specific alloantibodies in 71% of patients undergoing ABO incompatible kidney transplants.

Rise in numbers of ABO incompatible kidney transplants:

Earlier the Living donor Kidney transplants were done with only donors having same blood group as that of the recipient. This was restricting the pool of available living kidney donor for an ESRD or CRF patient who were not having a matching blood group donor. Many ESRD patients who had a willing and healthy kidney donor from the family, could not have a kidney transplant because of blood groups not matching.

With the newer Plasma apheresis techniques and protocols that can successfully bring down the A/B blood group antibodies in ABO incompatible ESRD patients , It is possible now to have a successful Kidney transplant with an otherwise fit kidney donor having a different blood group.

Recent studies have shown that with proper pre transplant treatments for ABO incompatibility , patients undergoing the ABO incompatible kidney transplants have almost the same success rate as that of same blood group recipient and donor. Even the longevity of newly grafted kidney was found to be almost the same.

Which ESRD patients are ideal for an ABO incompatible kidney transplants :

Any ESRD patient who have a fit blood related living donor but with the different blood group can be considered for ABO incompatible kidney transplants. The feasibility of an ABO incompatible kidney transplant depends on the quantity of donor specific ABO incompatible antibodies present in recipient in the beginning , and how much the desensitization programs will help in reducing the ABO incompatibility induced antibodies.

If even after the desensitization programs the ABO incompatibility induced donor specific antibodies does not fall below the specified levels , doctors may not recommend an ABO incompatible kidney transplant.

Other parameters remains same as that in a same blood group matching donors.

An ESRD patient can not have a kidney transplant if he/she is having following medical conditions:

  • An ESRD patient who is too weak and frail to cope up with surgery and post transplant management protocols.
  • If the ESRD patient is known to have serious cardiovascular deficiency or has a recent heart failure or stroke episode.
  • An ESRD patient who had a recent serious infection or cancer.

Precautions posts a successful ABO incompatible kidney transplant :

The Nephrology doctors team monitor the progress and functioning of newly grafted kidney in a successfully ABO incompatible kidney transplanted recipient.

The first two weeks are crucial after a successful ABO incompatible kidney transplant surgery for the acceptance of newly grafted kidney. After the first two weeks the chances of kidney graft rejection due to A/B blood group incompatibility induced antibodies start diminishing significantly.

Doctors recommend frequent blood tests to monitor the newly grafted kidney's function.

Post successful ABO incompatible kidney transplant the precaution remains same as that of a blood group matching transplants. To know more about precautions for a newly grafted kidney last your life time ,read our exhaustive blog on the subject.

Cost of ABO incompatible kidney transplant in India:

There may be variations in ABO incompatible kidney transplant cost . This variation could be because of the process of B-cell depletion , plasma apheresis or immunoadsorption techniques adopted for every individual patient.

Cost of pre transplant investigations800-1500 USD
Cost of Desensitization for reducing A/B blood group incompatibility induced antibodies (Conditioning)6000-10000 USD
Cost of ABO incompatible kidney transplant 13500-15500 USD
Cost of ABO incompatible kidney transplant in India .

Why choose India for an ABO incompatible kidney transplant:

Many ESRD patients who do not have a blood group matching donor but an otherwise fit and blood related family member willing to donate a kidney for the patient are preferring India for ABO incompatible kidney transplants. The reasons for choosing India for ABO incompatible kidney transplants are as follows:

  • The competency and expertise of Indian doctors.
  • Globally at par success rates for ABO incompatible kidney transplants.
  • Globally at par technological innovations and state of art infrastructure for conducting ABO incompatible kidney transplants.
  • Lower cost of ABO incompatible kidney transplants in India.
  • Comprehensive and well monitored and documented ABO kidney transplant programs.
  • Prompt followup post successful ABO incompatible kidney transplant surgery in India throughout the lifetime of patient.
  • Prompt start of treatment process .
  • Low cost of accommodation rentals in the vicinity of treating hospitals.

Top Hospitals for ABO incompatible kidney transplants in India:

Although most of the reputed Indian hospitals offering kidney transplants, perform ABO incompatible kidney transplants for Indian and global patients. Here are the top Indian hospitals offering ABO incompatible kidney transplants.

Delhi-NCR ( National capital region) Hospitals offering ABO incompatible Kidney transplants:

Max super specialty hospital - Best Indian hospitals for ABO incompatible kidney transplants | CMCS health.
Max super specialty Hospital
Press enclave , Saket , New Delhi.

Indraprastha Apollo Hospital - Best Delhi hospital for ABO incompatible kidney transplant | CMCS health.
Indraprastha Apollo  Hospital
Jasola , New Delhi.

Medanta = The medicity - ABO incompatible kidney transplant in India - CMCS Health.
Medanta - The Medicity.
Gurugram , India.

Sanar International Hospital
Gurugram, India.

Manipal Hospital
Dwarka , New Delhi.

Top Mumbai hospitals for ABO incompatible kidney transplants in India:

Fortis Hospital
Mulund , Mumbai.

Global Hospital
Parel, Mumbai.

    

Jaslok Hospital.
 Mumbai, India.

Top Bangalore Hospitals for ABO incompatible kidney transplants in India:

Manipal Hospital
Bangalore,India.

Nu hospitals
Bangalore, India.

Top Chennai hospitals for ABO incompatible kidney transplants :

Apollo Hospital
Chennai, India.

Miot hospital
Chennai, India.

Best doctors for ABO incompatible kidney transplants :

At CMCS Health , we are associated with top kidney transplant doctors for ABO incompatible kidney kidney transplant in India. We offer globally at par success rates in ABO incompatible kidney transplants in India.

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CyberKnife treatments in India.

Best CyberKnife treatments in India.

Although the name knife suggests incision or surgery but in reality CyberKnife procedure does not require any incision or surgery. A Cyber-Knife is a non-invasive procedure and an alternative to surgery for treating both malignant (cancerous) and benign (non-cancerous) tumors of the prostate, lung, brain, spine, liver, pancreas, kidneys and trigeminal Neuralgia. At CMCS Health, we are associated with Best Indian CyberKnife treatment hospitals and with the most experienced and well-versed CyberKnife specialist doctors. We offer the best CyberKnife treatments in India for our global guests.

Best  CyberKnife treatments in India for tumors of brain,prostate , lung, liver, spine,pancreas ,kidneys and trigeminal neuralgia.
Best CyberKnife treatments in India - CMCS health.

CyberKnife is the latest radiation therapy that delivers beams of high-dose radiation from different angles, with great precision to tumors all across the body and minimizing harm to surrounding tissues.

Best CyberKnife treatments in India:

CyberKnife treatment has brought hope to patients who have inoperable or surgically complex tumors, or who may be looking for an alternative to surgery. CyberKnife provides a pain-free, non-surgical option for the treatment of tumors of the prostate, lung, brain, spine, liver, pancreas, and kidneys . and trigeminal neuralgia. For the Best CyberKnife treatments in India, Send your queries to us.

What is CyberKnife Treatment for tumors:

CyberKnife is a modern radiation technique that consists of a lightweight linear accelerator that is mounted on a robotic arm. An image-guided system tracks the real-time location of the tumor in the patient’s body and the linear accelerator targets high doses of radiation beams at the tumor from different angles. With Cyberknife the clinician has better maneuverability to deliver high doses of radiation to the tumor with great accuracy and precision, and with negligible harm to surrounding tissues.

What are advantages of CyberKnife SRS treatments:

The biggest fear in the minds of those diagnosed with cancer was that of immediate surgery. True! Surgery remains the gold standard for many early-stage, non-metastatic cancers. The advent of the latest modern technologies has provided many effective treatment alternatives for surgery. CyberKnife robotic radio-static surgery system has emerged as a very useful alternative to surgery for many tumor patients.

Advantages of Cyber-Knife treatments - Best Cyber-knife treatments in India - CMCS Health.

Many top hospitals in India for cancer treatments offer the best CyberKnife treatments in India.Majority of patients who were advised and opted for CyberKnife treatments, instead of other forms of treatments like surgery or conventional radiation therapy have reported better patient compliance, no side effects or at least negligible side effects.As CyberKnife is a day care procedure, patient does not require hospital stay and can go back home immediately after the treatment. Patient can resume their routine activities immediately after reaching home.

Major benefits of CyberKnife treatments are:

  • An effective , pain free treatment that is alternative to surgery. Cyber-Knife is a robotic radiosurgery system that can deliver precise and high dose targeted radiation from many angles anywhere in the body, with near minimal harm to surrounding tissues.
  • CyberKnife radiosurgery system can effectively treat hard-to-find spots in the brain, head, neck, spine, lung, prostate, liver, pancreas, and other soft tissue. Most importantly, one can trust that Cyber-Knife will work, as it is clinically proven effective in treating tumors that are complex and inoperable.
  • CyberKnife treatment offers better patient compliance. CyberKnife is a highly sophisticated radiation delivery system because of it's real-time imaging system and a flexible robotic arm . CyberKnife SRS system can position itself to the exact location and angle to deliver high dose radiation beams at different angles to the tumor. Because of pin pointed precision and accuracy it targets only the tumor cells and avoids damaging the surrounding healthy tissue, creating less potential side effects than traditional radiation. Moreover CyberKnife is made to move with patient's body and the tumor, thus there is no need for stabilizing frames pinned to patient's head, body casts or breathing-limitation devices that are needed to limit patient's movement.

The tumors and medical conditions that are treated with CyberKnife treatment in India:

Inoperable and surgically complex Tumors treated with CyberKnife-CMCS Health.

Because of precision , accuracy and greater maneuverability to deliver high doses of radiation to the tumor, CyberKnife treatments in India are successfully done for tumors of brain, spine , Liver , lung , prostate , pancreas , head and neck tumors , recurrent tumors and metastatic tumor

CyberKnife treatments for brain tumors and other brain condition:

The advent of CyberKnife has paved way for treatment of certain brain tumors and medical conditions which were considered inoperable earlier. CyberKnife treatment for brain tumors and brain conditions are globally accepted.

At CMCS Health , our associated CyberKnife specialist doctors are offering best CyberKnife treatments in India for following brain conditions:

  • Both benign ( non cancerous ) and primary Malignant ( cancerous ) tumors as well as brain metastases.
  • Trigeminal neuralgia.
  • Acoustic Neuromas
  • Arteriovenous malformation ( AVM)
  • CyberKnife radiosurgery is also used to treat complicated neurosurgical cases, while maximally sparing healthy brain tissues involved in important functions such as motor control, touching, hearing and vision.

CyberKnife treatment in India for Spine tumors:

  • The CyberKnife Systems ensures effective tumor control and provide significant pain relief following treatment of spine tumors. The unrivaled, sub-millimeter accuracy of CyberKnife SRS enables patients who are ineligible for surgery, or whose tumors cannot be completely removed surgically, to receive treatment.
  • CyberKnife is also effective for intramedullary and intradural lesions as well and arteriovenous malformations of the spine.
  • CyberKnife treatment for Spinal metastases is well documented.

Benefits of Cyberknife treatment for prostate cancer:

The CyberKnife is commonly used for treating low- to intermediate-risk prostate cancer. The major benefits of CyberKnife treatment for prostate tumor are:

  • Proven and documented long term cancer control
  • Unlike other prostate cancer treatments , it is documented that CyberKnife treatment for prostate cancer reduced side effects related to sexual , urinary and bowel function.
  • With CyberKnife treatments for prostate cancer,treatments are completed in as little as 4-5 sessions across 1-2 weeks
  • Patients continue their routine life even while getting CyberKnife treatment for prostate cancer

Frequently asked questions about CyberKnife treatment

CyberKnife can be an alternative to surgery or even conventional radiotherapy, it can also be combined with other treatments for best treatment outcome. The frequently asked questions about CyberKnife treatments in India:

How do i know that my medical condition can be treated with cyberknife ?

Once we receive your medical reports , we discuss the reports with leading Indian specialists about treatment course . You may be asked to do certain diagnostic tests and investigations , once the doctors study all your reports they will give their opinion if you are the right candidate to receive CyberKnife treatment for your medical condition.

What happen during Cyberknife Treatment and what will be the duration?

CyberKnife delivers precise and accurate high dose radiation beams from different angles to tumors. It usually does not cause any discomfort or pain. It is successfully used to treat brain tumors and other brain conditions , pancreatic tumors , prostate tumors, liver and kidney tumors , spine tumors and several other medical conditions. A session may last for upto one hour and depending on medical condition the patient may have to undergo maximum five sessions.

Will i loose hair with CyberKnife treatment ?

Usually CyberKnife does not cause hair loss but if you are being treated for cancers close to the scalp, you may lose hair in the adjacent region but they will regrow once the treatment is over.

Can i eat before my CyberKnife treatment session?

Yes , you can eat and drink before your cyberknife session as it does not require anasthesia.

Why should i choose India for CyberKnife treatment ?

Many of the top Indian hospitals accredited with NABH and Joint commission international offers CyberKnife treatment routinely for various medical conditions. The state of art and ultra modern diagnostic facilities , support of other therapeutic segments and best in class Cyberknife radio surgery systems operated by the most experienced and well versed clinician supported by the best technician , competitive cost of treatment , no waiting period for commencement of CyberKnife therapy , and flexible accommodation rentals have made India a preferred destination for CyberKnife treatments.

For how long i will be staying in India for my CyberKnife treatment ?

The ideal India stay will be 14 to 21 dyas for CyberKnife treatments. The pre treatment diagnostics may take 3-4 days to assess the suitability of a patient for CyberKnife treatment . Once the result are out treating doctor will decide if the patient is going to benefit from CyberKnife treatment and number of sessions required for treatment.

Patient should stay in India for a few more days post the CyberKnife treatment so that doctors can ascertain the treatment outcome and follow up of patient.

Cost of Cyberknife treatment in India:

Cost of CyberKnife treatment in India depends on the city , center where a patient is getting CyberKnife treatment , cost of pre treatment diagnostics for ascertaining the suitability of patient for CyberKnife treatment , medical condition for which CyberKnife treatment is given and number of sessions required.

Usually the cost may vary between 6000 USD to 10'000 USD for best CyberKnife treatment in India.

Best CyberKnife treatment hospitals in India:

Many top Indian hospitals are offering cost effective best CyberKnife treatments in India for various complex tumors where surgery is too risky because of the location of tumor. Top Indian hospitals offering Cyberknife treatments in India are:

Medanta the medicity is one of the top multispecialty hospitals of India. Located in the national capital region ( NCR ) , Gurugram , it is just at 20 minutes drive from Indira Gandhi international airport. With high-end technologies such as CyberKnife VSI Robotic Radiosurgery in India, VMAT, IGRT, Tomotheraphy and other high end diagnostic and imaging equipment, cancer treatment specialist doctors at Medanta leave no stone unturned to make sure they are giving patients the best possible treatment available anywhere in the world.

Artemis Hospital is one of the most popular hospital among the global medical travelers to India. Located in the national capital region ( NCR ) , Gurugram , it is just at 20 minutes drive from Indira Gandhi international airport. Artemis hospital offer the state of art and north India's first M6 CyberKnife for brain and full body robotic stereotactic radiosurgery .

Indraprastha Apollo is the pioneer hospital in New Delhi India offering specialized medical treatment to global medical travelers. Located in Sarita Vihar , New Delhi , Indraprastha Apollo is one of the trusted hospitals for quality healthcare services. Apollo Hospitals Group has introduced the most advanced CyberKnife Robotic Radio Surgery System in the Asia Pacific. First and only robotic radiosurgery device in the world that minimizes exposure to nearby healthy tissue while treating tumors anywhere in the body. CyberKnife procedure precisely directs stronger radiation doses to the targeted region with sub-millimeter accuracy. It brings an unparalleled approach to treating inoperable cancers such as tumor located in critical parts of brain and spinal cord. CyberKnife surgery is not only a comparatively safer alternative to radiation but it also helps in keeping real-time track of tumor cells and consists of advanced imaging for further treatment planning.

Best CyberKnife treatment in India - Max healthcare - CMCS Health.

Max

Hospital

Max group of hospitals are one of the largest hospital chains in India. With many super specialty hospitals in Delhi and Mumbai , Max superspecialty hospitals also offer quality CyberKnife treatment in India .

HCG oncology in India is dedicated to provide quality cancer treatments . HCG oncology hospitals also offer best CyberKnife treatments in India.

Best Doctors for CyberKnife treatments in India:

Here are few of the best doctors for CyberKnife treatments in India.

Why Choose CMCS Health for best CyberKnife treatment in India:

Since our inception as a medical and healthcare consultancy firm, almost a decade back , we have established a benchmark for quality services with best specialized medical treatments for our global guests.

Today CMCS Health is a synonym for value for money , professionalism , total transparency and quality specialized medical treatments among the medical travelers to India.

With thousands of successfully treated happy and content medical travelers from all across the globe , CMCS Health is an admired and well respected name among the global medical travelers to India.

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Prostate cancer treatment Indian specialist.

Prostate Cancer treatment in India.

Prostate cancer treatment in India :

Prostate Cancer is a one of the serious and life threatening medical condition affecting prostate. Prostate cancer usually affect elderly and above 65 year old men but it may affect younger men too. Prostate cancer is the second largest cancer in men.Prostate cancer generally metastasizes to bones. Since the growth of prostate cancer is slow it may not affect or diagnosed in early stages but there are instances where the cancerous prostate cells have grown rapidly. We are associated with Best Indian Urology surgeon well versed with da Vinci robotic surgery , Medical oncologist well versed with chemotherapy and immunotherapy and Radiation oncologist for comprehensive and complete Prostate cancer treatment in India.

Who are at risk for prostate Cancer?

Prostate cancer affects men above 50 years of age.Over a period of time the survival rate in prostate cancer have improved dramatically from 30% in 1970's to 80% presently.
Prostate cancer may affect any men above the age of 50 years,but the African or African Caribbean are at a three fold higher risk than white people.The man whose father or brother have been diagnosed with prostate cancer stand two and a half time higher chances than the men who never had a prostate cancer family history.
Black men are at three times higher risk of being diagnosed with prostate cancer as compared to white men.
Some studies suggest that men among the populations where consumption of "red meat" is more common are at a higher risk of developing prostate cancer.
 

Prevention of Prostate Cancer

Certain life style changes may reduce risk of prostate cancer. Quitting smoking and regular physical exercises at least for 30 minutes a day and five days a week can cut down risk of prostate cancer. Reduction in consumption of animal fat or red meat also cut down the risk for prostate cancer. A study although not confirmed that a diet high in tomatoes may also be helpful in reducing the risk of prostate cancer.
 
How Prostate Cancer is diagnosed?
 
Prostate cancer is usually diagnosed through screening as symptoms appear quite late in patients.The usual diagnostic procedures are a blood test called PSA or prostate specific antigen test. A higher PSA test result indicated possibility of prostate cancer. Although it may be non confirmatory too as Prostatitis may also cause elevated PSA levels.
DRE (Digital Rectal examination) may also suggest presence of prostate cancer, where a qualified and experienced doctor puts a gloved lubricated finger inside the rectum of the patient to feel any bump or hard surface on prostate suggesting a cancerous growth.
Transrectal ultrasound (TRUS) or Transrectal ultrasound guided biopsy are more confirmatory and reliable tests for diagnosing the presence of prostate cancer in a patient.
 

Prostate cancer treatment in India:

The treatment options for prostate cancer depend on stage and overall general health of patient.
It may involve watchful waiting or active surveillance.
Prostatectomy the surgical removal of part or whole of prostate.
We offer Laparoscopic or robot assisted surgeries for prostate cancer treatment in India.
Robot assisted prostate surgery are the latest surgical techniques for smaller incision,quicker healing and precise results for prostate cancer . Doctors do consider nerve sparing surgical removal of part or whole prostate that does not affect the normal sexual capacity and active sexual life of patient.
We at CMCS Healthare associated with the most experienced cancer surgeons and well equipped hospitals for prostate cancer treatment in India of our global guests.Expertise of a urological cancer surgeon is very crucial for treatment outcome of prostatectomy.
Other treatment options are Radiation Therapy, it could be external beam radiation therapy. With a 3D conformal radiotherapy assisted with CT scans and MRI for precise results with optimum dose to cancerous cell within the prostate gland.
IMRT or Intensity modulated radiation therapy give more flexibility of dose modulation to Radiation doctors thereby more precise results and avoiding side effect of radiation on bowel and bladder overtime.
Proton therapy is considered superior to external beam radiation therapy for more precise and less side effect associated radiation therapy for prostate cancer treatment.
Brachytherapy for prsoate cancer can be used for patients who want to avoid daily visit to radiation therapy center or do not want to stay in India for long.
The expertise of Radiation Oncology doctor is again vital for treatment outcome. CMCS Health is associated with the most experienced Radiation oncology doctors and hospitals with latest diagnostics and radiation therapy machines for better treatment outcome of prostate cancer for our global guests.
 
Hormonal therapies are also used along with surgical and radiation therapies for better treatment options and results for prostate cancer treatments.
 
Chemotherapy is used for hormone resistant and metastatic or advanced prostate cancer. A combination of chemotherapeutic drugs or single agent therapy are used for better results and lower side effects.
 
Targeted chemotherapy for prostate cancer holds big promise for recurrent and advanced or prolapsed prostate cancer treatment.
 
HIFU is a newly US FDA approved prostate cancer treatment procedure with no surgical incision and better safety profile for prostate cancers which are localized and non metastatic.
 
Dr. Deepak Singla - Medical Oncologist is Unit Chief and consultant Medical Oncologist at Dept. of Medical Oncology at Paras Hospitals,Gurgaon,Haryana,India.
 
 
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Robotic prostatectomy for prostate cancer treatment- Dr. Prof. Anant Kumar.

Pyeloplasty – UPJ obstruction treatment.

Dr ( Prof.) Anant Kumar - Urologist | Kidney Transplant Surgeon is regarded as the best and most experienced Kidney Transplant Surgeon of India and Director-Urology,Kidney Transplantation and Robotics at Max Hospital,Saket,New Delhi,India.

What is Uretero-pelvic junction Obstruction?

Uretero-pelvic junction obstruction occurs when the flow of urine from the renal pelvis to proximal ureter have an obstruction. The condition may lead to Hydronephrosis. Hydronephrosis is a medical condition ,where the kidneys are swollen with urine because of narrowing or blocking of ureters. Ureters empty the urine from kidneys into urinary bladder. The resultant back pressure within the renal pelvis may cause progressive kidney damage or deterioration of kidney function.

Uretero-pelvic junction obstruction may appear in children due to a congenital abnormality or even in adults following any previous surgery or any other medical condition that causes inflammation of upper urinary tract.

What causes pediatrics UPJ Obstruction ?

The exact cause of pediatrics uretro pelvic junction obstruction is still not known. Many times the defect is present in an unborn baby and is termed as congenital defect. It is diagnosed during routine prenatal ultrasound.

There may be many reasons for UPJ obstruction during the gestation period. some of them are:

  • During the developing phase the child's ureter is not fully formed resulting in a narrowed section of ureter which may be blocked later on.
  • A faulty muscle in ureter wall which may not squeeze normally.
  • Formation of a "Crossing Vessel" ,i.e., an additional artery feeding the kidney of developing fetus. This may result in kinking or blocking of the ureter.

It can have a genetic component,i.e., it runs in families .Although the responsible gene is not identified yet.

What are symptoms for pediatrics UPJ Obstruction?

Sometimes a UPJ Obstruction in a child does not have any symptoms. A UPJ Obstruction in a developing fetus is usually observed during a routine prenatal ultrasound. It is detected because of hydronephrosis. In majority of cases it is corrected on its own after the child birth.

But in moderate to severe condition the following symptoms may occur and they do need a medical attention as if left untreated,it may cause a permanent damage to kidney or urinary system of child.

  • The renal pelvis or kidneys or both are dilated (hydronephrosis).
  • Abdominal,back or flank ( sides) pain.
  • Frequent UTIs ( Urinary tract infections).
  • Edema
  • Swelling around eyes.
  • Lump in abdomen ( Abdominal mass).
  • Poor or retarded growth in infants.
  • Fever.
  • Rashes.
  • vomitting.
  • Bloody urine or diarrhea.
  • Abnormal urine output.

How UPJ Obstruction is diagnosed?

If Hydronephrosis is observed in a developing fetus during a routine prenatal ultrasound , doctor in charge for delivery of child will do more periodic ultrasound to keep a close vigil on any complications arising of the present medical condition.

Many times this medical condition is resolved on it's own ,once the child is born. But the doctor may do following tests after a few week of birth of child.

  • Creatinine clearance.
  • BUN ( Blood urea Nitrogen).
  • CT Scan.
  • Electrolytes.
  • CT- Urogram.
  • Nuclear scan of Kidneys.
  • Voiding cystourethrogram.
  • Ultrasound.

What causes UPJ Obstruction in adults?

The reasons for UPJ obstruction in adults may be due to scar tissues,infection,any previous surgery or renal calculi (Kidney Stones).

The other reasons may be:

  • A previous renal pelvic trauma.
  • Obstructing calculus immediately distal to PUJ.
  • Previous pyelitis with scarring.
  • Intrinsic malignancy,e.g. upper tract urothelial carcinoma.
  • Extrinsic ureter compression due to

 

1. Fibrosis.

2. Crossing vessel at PUJ.

3.An underlying malignancy.

Symptoms of UPJ Obstruction in adults:

Adults may experience following symptoms because of UPJ Obstruction:

  • Renal colic.
  • Chronic back pain.
  • Other non specific signs may be hematuria,Urinary tract infections and pyelonephritis.

Treatment Options:

Treatment line depends on presence of underlying cause.In Majority of congenital cases,no intervention is required and the condition subsides after some time however in case of a definite structural obstruction ,surgical intervention in the form of pyeloplasty or stenting may be needed.

Surgery is also inevitable in case of deterioration of renal function or when associated symptoms are severe and progressive.Aim of treatment is to normalize renal drainage and if possible,improve if  reversing the damage to kidneys is not possible.

 

 

 

 

 

 

 

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