Dr. Pawan Kesarwani

Dr. Pawan Kesarwani

Urinary Specialist - Urosurgeon,Kidney Transplant Surgeon

  Max Super Speciality Hospital, Patparganj, Delhi, India

  18 Years of experience

BIOGRAPHY

Dr. Pawan Kesarwani is one of the finest Urinary Specialist in India. He is an experienced Urosurgeon in the India. The Medical practitioner has been associated with various reputed hospitals in the India. The physician is currently working as a Director - Urology, Max Super Speciality Hospital, Patparganj, India. The doctor is a well-reputed and sought after medical expert and is

  • M.Ch in Urology, All India Institute of Medical Sciences, New Delhi
  • MS in General Surgery , King George Medical College, Lucknow.
  • MBBS, Moti Lal Nehru Medical College Allahabad.

qualified. Dr. Pawan Kesarwani has been associated with many hospitals over the course of his illustrious and experienced career.

The hospitals include:

  • Senior Resident in General Surgery, King George Medical College, Lucknow
  • Senior Resident in Urology, Sanjay Gandhi Post Graduate Institute, New Delhi.

Dr. Pawan Kesarwani has more than 18 Years of clinic experience. The Clinician specializes in and performs the following surgeries:

  • Kidney Transplant
  • Prostatectomy
  • Trans Urethral Resection of Bladder Tumor (TURBT)
  • Trans Urethral Resection of Prostrate (TURP)
  • Oncology
  • Transplants
  • Urology
MEMBERSHIPS (5)
  • Urology Society of India (USI)
  • USI North Zone
  • S.I.U (Society International Urology)
  • S.U.N.G (Society of Urologist of Noida and Ghaziabad)
  • UPUA (UP Urology Association)
Procedures
Kidney Transplant

 

There are many options when it comes to the treatment of a kidney that fails to maintain normal function in the body. Kidney transplant surgery is one of the most successful ways to restore normal functioning of the affected kidneys as it allows for an access to greater freedom and a better quality of life.

A kidney transplant patient is more likely to enjoy bouts of energy and follow the less strict diet as compared to patients who choose an alternative treatment.

The kidney performs several important functions in the human body. Even slight damage to the kidneys can, therefore, cause a lot of problems. When the kidney is rendered incapable of its main function, that is, removal of waste products from the blood, a condition called uremia develops.

Unfortunately, the symptoms of this condition do not develop unless 90 percent of the kidney is damaged. This is the time when an individual would require a kidney transplantation surgery or dialysis to restore the normal functioning.

There are several other kidney diseases that warrant the need for a kidney transplantation. Some of these conditions include the following:

    • Deep-rooted problem in the anatomy of the urinary tract
    • Extremely high blood pressure
    • Glomerulonephritis
    • Polycystic kidney disease
    • Diabetes mellitus

 

Symptoms of Kidney Dysfunction

Some of the common symptoms observed in the case of kidney diseases include the following:

  • Shortness of breath and general fatigue
  • Retention of fluid causing swelling (edema)
  • Foamy and dark orange,  brown, red or tea-colored urine
  • Increased frequency of urination
  • Back pain
  • Restless legs and inability to sleep due to leg cramps
  • Metallic taste
  • Breathing problems due to urea build up in blood
  • Loss of appetite
  • Numbness in the toes or fingertips and tingling sensation
  • Problem concentrating
Prostatectomy

The prostate gland is present below the urinary bladder in men. It surrounds the urethra and produces fluid that helps in the movement of the semen. Prostatectomy is a surgery that involves total or partial removal of the prostate gland. It is commonly performed as a part of treatment for prostate cancer.

Types of Prostatectomy

Radical prostatectomy: This surgery involves the removal of the entire prostate gland along with the surrounding lymph nodes. The surgical techniques used to conduct radical prostatectomy include the following:

  • Robot-assisted surgery: In this technique, several small incisions are made in the lower abdomen to remove the prostate gland.
  • Open surgery: In this technique, an incision is made in the lower abdomen between the anus and scrotum to remove the prostate gland.
  • Laparoscopic: In this technique, special surgical tools are inserted in the lower abdomen to remove the prostate gland.

Open simple prostatectomy: This surgical procedure involves removal of just the affected part of the prostate gland and is recommended for men with the cancerous prostate gland or benign prostatic hyperplasia (BPH).

Indications

  • Prostate cancer
  • Urinary tract infection
  • Bladder stones
  • Hematuria
Trans Urethral Resection of Bladder Tumor (TURBT)

Cancer in Bladder can be found to vary depending on the type of its origins. It can arise from the lining of the epithelium which is the inner lining of the urinary bladder or the urothelium. Rare forms of cancer are not of epithelial origins like the sarcoma or lymphoma. Tumours in bladder is found to be the 9th leading type of cancer in United States as per a survey conducted in 2012 with 430,000 new cases and mortality of 165000 deaths annually.

About Trans Urethral Resection of Bladder Tumor

The first and foremost question to ask is where is your bladder located? The sac like muscular urinary bladder is located in the pelvis region above the pelvic bone. It is connected to the kidneys through the two ureters that transfer the urine from the kidney to the bladder for storage. An abnormal growth of cells in the inner lining causes a tumour requiring diagnosis and then followed by a turbt surgery.

In most cases the tumour cannot be assessed in the primary stages. There are hardly any notable evidences found when the patient is harbouring a primary tumour.

The next stage is designated as Oa and categorized as a non invasive type papillary cancer.
In the stage next of the stage 0 or the carcinoma in situ the inner lining of the bladder is affected and is still considered non invasive.
In stage I the cancer has spread into the lining of the bladder further but has not affected the muscular wall of the bladder.
While in Stage II the inside part gets affected including the muscles of the bladder making it now invasive.
And when the cancer has spread enough in muscles and the tissues around the bladder like the reproductive organs it is considered to be in stage III.
And in the final or stage IV the cancer will spread to the lymph nodes affecting the organs around it as well.

Causes of developing a tumour in bladder

The causes of tumour in bladder are not always very clear and well defined but it has been linked with smoking, chemical exposure and radiation or a parasitic infection. The abnormal cells undergo some mutation that allows them to multiply in a non orderly fashion and goes beyond control and they do not die thus giving rise to the tumour.

Symptoms of the TURBT

A person suffering from a tumour will experience mild sensation of burning and discomfort in the times of urination for quite a few days. The force of the urinary stream may also undergo significant changes which can be observed for a week to a fortnight. Usually there could be none of the symptoms and in certain cases all symptoms even if experienced may not lead to the conclusion that it is a bladder cancer. There can be blood or clots of blood in the urine along with a tendency of urinating too frequently. Tendency of urinating at night may be felt more but there can be general problems in urine passing. Associated along with this the patient can experience pain on either side of the body.

What is transurethral resection of bladder tumour?

This procedure aims at removing bladder tumours at an early stage by inserting a scope through the urethra leading to the bladder. In the TURBT procedure bladder cancer can be detected by the urologist and potentially allow the urologist to treat various other kinds of bladder related disorders. But 75% of the cancer of bladders that are detected are superficial in nature causing growth only on the surface of the walls of the bladder and does not get very deep. So this facilitates the surgeon to have the tumour removed at the bladder wall level causing no damage to the deeper layers of the organ. The information that is collected while executing the procedure will help the surgeons to decide the type of the abnormality of the tumour and the extent of the tumour. This later allows the urologist surgeons to decide whether further treatments will be required or not.

What are the alternatives for TURBT procedure?

Some of the other treatment alternatives for TURBT are being worked upon while some of them have tremendous side effects

Blue light fluorescent cystoscopy : Enhanced tumour visualization is possible and detection of tumour chances are increased by almost 20 to 25% with this method where an ultraviolet blue light is used. A dye is injected an hour prior to the procedure.

Adjuvant bladder cancer therapy: TURBT is not suitable for many who have high chances of suffering a recurrence within 12 months from the treatment. In this case adjuvant therapy is recommended. It includes intravesicle chemotherapy. Chemotherapy for bladder cancer includes giving medication to curb the abnormal growth of cells. But it also has its sets of side effects like experiencing irritation in bladder and loss of hair, nails and feeling debilitated for a very long period of time.

Trans Urethral Resection of Prostrate (TURP)

The enlarged prostate gland can become a subject of concern after a certain age in men. It causes trouble while urinating and that is one of the main reason why such men are advised to undergo trans urethral resection of prostate (TURP) surgery.

What is Trans-Urethral Resection of Prostate (TURP)?

The prostate gland goes through two phases as a man grows old. The growth phase occurs during puberty when the gland assumes double its size. The second phase of growth takes place after a man has attained the age of 25. This final size at this stage continues to remain the same throughout the life. But when men suffer from benign prostatic hyperplasia, the prostate gland gets further enlarged.

When the gland enlarges, it squeezes the urethra and as a result, the wall of the bladder grows thick. With time, the bladder grows weak and loses its ability to empty the urine completely. This allows some urine to stay back in the bladder at all times. Along with this, the urethra also narrows and hence, all the problems associated with urination keep coming back.

As of now, it is not totally clear why most men develop BPH but it mainly indicates an imbalance of hormones and sexual activities with advanced age. Apart from that, there can be urinary tract infection, narrowing of the urethra known as urethral stricture, inflammation of the prostate, bladder or stones in the kidney, nerve problems in controlling the bladder, or scarring in the neck of the bladder as a result of previous surgery.

The following are some of the symptoms of BPH:

  • Frequent urge to urinate

  • Difficulty in initiating urination
  • The urine stream that flows is weak and stops and starts in the session
  • At the end of urination, dribbling is often experienced
  • Straining is felt at the time of urination
  • Blood in the urine
  • Inability to completely empty the bladder
  • Infection in the urinary tract

Some of these above symptoms can occur even in men whose prostate has not enlarged significantly.

Frequently Asked Questions
What area of specialization does Dr. Pawan Kesarwani have?
Dr. Pawan Kesarwani is specialized in India and of the most sought after doctors in Urinary Specialist.
Does Dr. Pawan Kesarwani offer Telemedicine Consultation through Medigence?
No, this doctor dose not offer telemedicine via MediGence
How many years of experience does Dr. Pawan Kesarwani have?
Dr. Pawan Kesarwani is one of the most sought after specialists in India and has over 18 Years years of experience.
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