Dr. Atul Garg is a recognized doctor / surgeon in the treatment of urological conditions that affect men. Dr. Atul Garg leads groundbreaking research in areas such as incontinence; benign prostatic diseases such as enlarged prostate; prostate, bladder, kidney and other cancers; erectile dysfunction; and minimally invasive surgical techniques.
We at FertiUro Solutions, offer each patient a unique treatment plan designed to achieve an effective cure, an optimal rehabilitation, and an improved quality of life.
A short description of services provided at FertiUro Solutions, is as follows –
- Stone surgeries – LASER
Laser Treatment of Kidney, Ureter and urinary Bladder Stones is done with great expertise.
Treatment options available are: –
- Retrograde Intrarenal Surgery – RIRS – Latest method, minimally invasive, No cut or hole.
- Percutaneous Nephrolithotomy- MINI PERC & PCNL – very popular, minimally invasive, key hole surgery for bigger kidney stones.
- Ureteroscopic Lithotripsy (URSL) – for ureteric stone, minimally invasive, no cut or stitch.
- Cystolithotripsy (CLT) – for urinary bladder stones, minimally invasive, No cut .
- Prostate surgeries: –
Minimal invasive, no cut, quick recovery, minimal blood loss.
- Traditional methods – TURP – MONOPOLAR/ BIPOLAR
- LASER methods: –
- Holmium laser enucleation of prostate (HoLEP)
- Thulium Laser Enucleation of the Prostate (ThuLEP)
- Stricture surgeries
- LASER OIU/DVIU – Optical Internal Urethrotomy
- LASER BNI/BNR – bladder neck incision or Bladder Neck Resection
- URETHROPLASTY- Removal of stricture and formation of new urethra is called urethroplasty. Normally done by using buccal mucosa (BMG).
- KIDNEY CANCER SURGERIES
- Laparoscopic radical nephrectomy/ partial nephrectomy – for tumors in kidney
- Laparoscopic Nephro-Ureterectomy with bladder cuff excision.
- BLADDER CANCER- LASER TREATMENT
- LASER -TURBT – incision less, minimally invasive, Fast Recovery and high cure rate.
- OVER ACTIVE BLADDER TREATMENT
Most of the patients can be managed by medication. Those who are not responsive to medications need procedure. Common procedure are: –
- HYDRODISTENSION OF BLADDER
- BOTOX INJECTION IN BLADDER
- AUGMENTATION CYSTOPLASTY
- BED WETTING (ENURESIS) TREATMENT
Bed wetting in night is very common problem in childhood and aged person. It is treated with bladder rehabilitation and medication. Most of the patients respond very well to medication.
- URINE LEAKAGE TREATMENT (INCONTINENCE)
Urine leakage may be stress incontinence, urge incontinence or mixed incontinence. Based on diagnosis, treatment is tailored either medication or surgery. Majority of patients respond well to medication. Non-responders are offered surgical treatment like:-
STRESS INCONTINENCE –
- Urethral Injections/Bulking Agents
- Sling Surgery- The mid urethral sling is the most common type of surgery used to correct SUI. The sling is made out of a narrow strip of synthetic mesh that is placed under the urethra with a variety of techniques: retropubic, trans-obturator and single-incision.
- Bladder Neck Suspension
- Artificial Sphincter
- BOTOX injection
- LASER TREATMENT OF URETHRAL STRICTURE
Done by Endoscopic LASER method. It’s a no incision or cut surgery , bloodless, day care procedure.
- PUJ OBSTRUCTION TREATMENT
Obstruction at Pelvi ureteric junction (PUJ) is dealt with Pyeloplasty. It is done by Laparoscopy or by conventional open method.
- VESICO URETERIC REFLUX TREATMENT
Reflux of urine from bladder to ureter and Kidney. It needs medical treatment or ureteric reimplant surgery according to its severity/grade.
Non-invasive OPD procedure done for kidney stones. Procedure done under local anesthesia with good result in selected group of patients.
- few more urological problems and surgeries –
- Ureterocoel – LASER incision
- posterior urethral valve – LASER fulguration
- short frenulum – frenuloplasty
- small meatus – meatoplasty
- Torsion testis- orchidopexy
- Fracture of penis – tunica repair
- Scrotal cyst – scrotoplasty
- curved penis – straightening surgery
- Bladder diverticula – laparoscopic excision
- Cancer penis – partial /total penectomy with inguinal lymph node dissection
- Urological tumors – bladder cancer, prostate cancer and kidney cancer, adrenal tumors – endoscopic / laparoscopic excision following international guidelines of management
- Pyonephrosis-JJ stenting or per cutaneous drainage of pus.
- Renal cyst – laparoscopic excision/ marsupialisation.
- VARICOCELE TREATMENT
Abnormal dilatation of testicular veins is called varicocele. Its diagnosed on clinical ground and scrotal Doppler. It needs treatment if there is scrotal pain and or infertility. Treatment options are:-
- MICROSCOPIC VARICOCELECTOMY
A small cut is made in subinguinal region. Under microscope all abnormal veins are ligated and divided. This is most popular procedure at present in view of high success rate.
- LAPROSCOPIC VARICOCELECTOMY
Testicular veins are ligated and divided by using laparoscopy.
- OTHER OPTION
Embolisation of Varicocele
- Vasectomy –
A male sterilization method. A minor surgery to block sperm from reaching the semen that is ejaculated from the penis.
- Conventional Vasectomy- one or two small cuts are made in the skin of the scrotum to reach the vas deferens.
- No-Scalpel Vasectomy (NSV)- only a tiny hole is made in the skin
- VASECTOMY REVERSAL
Sometimes vasectomy reversal is done in cases of secondary infertility. This is done by microscope and success rate is good.
MICROSCOPIC Vaso Epididymal Anastomosis (VEA)
Vaso Epididymal Anastomosis is done by using microscope. Its done in cases of obstructive Azoospermia to bypass the obstruction.
It’s a treatment of Phimosis (Inability to retract foreskin of penis). Surgery options are-
- CONVENTIONAL CIRCUMCISION- suturing is used
- STAPLER CIRCUMCISION- titanium stapler is used , it takes just 10 minutes and its a bloodless and painless method.
- UNDESCENDED TESTIS
When testis are present at abnormal position its called undescended testis. Orchidopexy is the procedure usually done for undescended testis.
Collection of fluid around testis is diagnosed as Hydrocele. Small hydrocele can be treated medically. Large hydrocele needs surgical intervention.
Abnormal position of urinary opening (meatus) with absence of distal urethra is hypospadias. This needs single stage or staged urethroplasty with or without chordee correction.
- Sperm Retrieval-
Sperm retrieval is done when pregnancy is the goal but not possible without help. It is for men who have little or no sperm in the semen, or men who aren’t able to ejaculate. In these cases, sperm can be collected from other parts of the reproductive tract. For good pregnancy rates, sperm retrieval is used with in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI).
Diagnosis could be Obstructive Azoospermia, Non-obstructive Azoospermia, anejaculation (lack of ejaculation) or Retrograde ejaculation
Methods of sperm retrieval are:
- Penile Vibratory Stimulation (PVS)
- Electroejaculation (EEJ)
- Testis Sperm Retrieval-
- Testicular Sperm Extraction (TESE)
- Testicular Sperm Aspiration (TESA)
- Microsurgical Testicular Sperm Extraction (Micro-TESE)
- Epididymal Sperm Retrieval-
- Microsurgical Epididymal Sperm Aspiration (MESA)
- Percutaneous Epididymal Sperm Aspiration (PESA)
Sexual Health Treatment
- ERECTILE DYSFUNCTION-
Inability to sustain erection is erectile dysfunction. It could be psychogenic or organic. Psychogenic ED could be treated with medication like tadalafil /sildenafil etc. organic ED or non-responsive to medical treatment are candidate for penile implant.
Penile implant – PROSTHESIS are implanted inside penis to give sufficient erection to perform sex.
- NONINFLATABLE IMPLANT: – 2 Pieces of implant are placed in corpora cavernosa.
- INFLATABLE IMPLANT: – They give need base erection as these implants have inflatable mechanism for erection.
- PRE-MATURE EJACULATION: – Early ejaculation could be very well treated with medication and small procedure. Success rate of treatment is quite high.
- PEYRONIE’S DISEASE TREATMENT: – Presence of plaque on dorsal surface of penis leading to painful erection or penile curvature is peyronie’s disease. It needs medical or surgical treatment. Non-surgical treatment includes medication and intra plaque injections. Surgical treatment includes excision of plaque.