Urology and Renal Transplantation

Urology and Renal Transplantation

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Overview
Facilities
Achievements
Services Offered
Diseases Treated
Specialities
What We Offer
Why Choose Us
Features
Facilities
Our Philosophy
Services Offered
Diagnostic Tests and Procedures
Treatments
Achievements
Contact Us
Doctors

Overview

The Urology Department at Amrita Hospital provides top-notch facilities for diagnosing and treating male genitourinary and female urinary diseases across all age ranges. Our team consists of highly skilled and experienced urologists and resident surgeons who are available round-the-clock. We boast the latest cutting-edge technology and equipment to ensure the best possible care. Our faculty specializes in various subspecialties within the field. 

  • Uro-oncology (cancers of the urinary tract) 
  • Congenital Urological disorders (Children, Adolescents and Adults) 
  • Urinary stone diseases (Kidney, Ureteral and Bladder stones) 
  • Prostate and Urethral stricture related Urination Problems 
  • Urologic trauma and reconstruction  
  • Female Urology (Female Pelvic Medicine and Reconstructive Surgery) 
  • Neuro-Urology (Urinary problems in Nervous Disorders) 
  • Male sexual and reproductive health (Andrology) 
  • Renal (kidney) transplantation 
  • Gender-Reassignment Surgery 

Facilities

Out Patient Procedures

The outpatient department has facilities to take care of all office urology procedures. It is supported by trained staff including two staff nurses, blood draw facilities, full-fledged procedure rooms, dedicated X-ray machines, ultrasound equipment, etc.

Uro Radiology 

Ultra sound machine: The department has its own B-K ultrasound machine apart from the facility available in Radiology to do ultra sound guided procedures like TRUSS guided prostate biopsy, percutaneous nephrostomy, ultrasound-guided aspirations, etc. It has a dedicated TRUSS probe for an accurate prostate biopsy to diagnose prostate cancer. The department has a separate radiology suite for doing procedures like MCU (micturating cystourethrogram) and RGU (retrograde urethrogram). It is supported by a radiology department with all modern equipment including:

  • CT: MD CT ( Seimens sensation 64) , Seimens CT scan
  • MRI: GE HD xT, Magnotom symphony classic
  • Most modern invasive radiology suite
  • Ultra sound section having 4 ultra sound machine
  • A mobile USG and X ray unit
  • Image guided radiofrequency ablation equipment
  • Seimens double head Gamma camera: Used for all procedures including diagnostic services like bone scan, DTPA scan, DMSA scan, MAG3 and therapeutic procedures in carcinoma prostate.

Uro Dynamics

Two uroflow meters and Labourie Janus urodynamics machines are used for assessing the urine flow and evaluating neurogenic bladder

Flexible Cystoscopy

Two Karl Storz flexible cystoscopes are used in the evaluation of hematuria to rule out bladder malignancies and in the follow up of bladder cancer to diagnose early recurrence. They help to avoid anaesthesia during routine cystoscopy as the procedure is painless.

Extracorporeal Shock Wave Lithotripsy (ESPWL)

A Dornier compact sigma lithotripter is used for extra corporeal lithotripsy

Achievements

  • Kerala’s first Centre to start Retroperitoneoscopic kidney surgery
  • Kerala’s first pelvic dysfunction clinic.
  • Kerala’s first Robot-assisted Retroperitoneoscopic lymph node dissection for testicular malignancy.
  • First in Kerala to offer BMG (Buccal mucosal graft) urethroplasty for women for treating female urethral stricture (narrowing of the urethra) in 2022

Services Offered

Endourology

Endoscopic treatment of stones and diseases of the kidney, ureter, bladder, prostate and urethra is performed through natural openings in the body avoiding the pain associated with open operations.

Laparoscopic Urology 

Key – hole surgery to remove and reconstruct urinary organs avoiding pain and long bed rest associated with open surgery. Nephrectomy, radical and partial nephrectomy, stone extraction, correction of hydronephrosis due to PUJ obstruction and re-implantation of the ureters are performed. More than 200 laparoscopic live donor nephrectomies and over 130 (the largest Indian experience) laparoscopic adrenalectomies have been successfully performed. We are one of the few centres in India who perform laparoscopic radical prostatectomy regularly for organ confined prostatic cancer.

Urological Oncology 

The Department of Urology has a separate division for urological malignancies. The cancers of kidney, bladder, prostate, ureters, adrenals, testis and penis are taken care by this section. A subspecialty clinic in Uro-oncology is a unique venture in India. In cases where multimodality treatment is required, our institution has medical oncologists, radiation oncologists, state-of-the-art radiology, pathology and nuclear medicine departments, all under one roof. There are facilities for brachytherapy, conformal radiotherapy, Intensity-Modulated Radiation Therapy (IMRT) and therapeutic nuclear medicine procedures. The Uro-oncologists, radiation oncologists, medical oncologists and Uro-pathologists discuss the cases and make combined decisions on the management of all the cases at the Tumour Board. Follow up and further management are done as per the current protocols.

Kidney Cancer 

Surgeries like laparoscopic and open radical nephrectomies are the mainstay of treatment in kidney cancer. Complicated surgeries that require IVC exploration in locally extensive kidney cancers, open and laparoscopic partial nephrectomies (nephron sparing surgeries), and immunotherapy for advanced renal cancers are regularly done.

Prostate Cancer 

Diagnosis of prostate cancer by TRUSS-guided multicore biopsy, and staging by bone scan, PET CT, 1.5 Tesla MRI, MD CT have greatly improved the detection of early disease and improved the outcome. Laparoscopic prostatectomy, conformal radiotherapy, IMRT (Image modulated radiotherapy) and brachytherapy all are routinely performed here.

Bladder Cancer 

The gold standard for the treatment of advanced bladder cancer is radical cystectomy with orthotopic neobladder reconstruction. After removal of the diseased bladder, the bladder is reconstructed with a loop of intestine in the same sitting so that the patient is able to pass urine naturally. The quality of life is greatly improved as the patient is free from using a pouch to collect urine and the resultant social embarrassments. In a certain subset of patients, bladder preservation is done with the help of chemo radiation after endoscopic resection of the tumour.

Testicualr Cancer 

The gold standard for the treatment of advanced bladder cancer is radical cystectomy with orthotopic neobladder reconstruction. After removal of the diseased bladder, the bladder is reconstructed with a loop of intestine in the same sitting so that the patient is able to pass urine naturally. The quality of life is greatly improved as the patient is free from using a pouch to collect urine and the resultant social embarrassments. In a certain subset of patients, bladder preservation is done with the help of chemo radiation after endoscopic resection of the tumor.

Adrenal Tumors 

Key hole surgery has replaced open adrenelectomy as there is better visualisation and enhances early recovery. We have the largest series of laparoscopic adrenalectomies in India . Retroperitoneoscopic adrenelectomy is done only in a handful of centres in the world with Amrita Hospital being one.

Penile Cancer 

Partial or total penectomy and radical lymph node dissection is the standard treatment in carcinoma of penis. Recent advances in the treatments have reduced the treatment morbidity considerably. With the help of plastic surgery team, penis can be reconstructed with forearm flap which makes the life of these unfortunate people comfortable. They can have a normal sexual life with the help of penile implants.

Laparoscopic Surgeries in Uro-oncology 

The laparoscopic surgery has changed the surgical concept in Uro-oncology. Most of the open surgeries like radical nephrectomy, nephroureterectomy, radical prostectomy and radical cystectomy are now done more and more with minimum morbidity and early return to work.

Paediatric Urology 

Expertise for the surgical reconstruction of congenital defects of the urinary tract either by open surgery or laparoscopy is available. Hypospadias, vesico ureteric reflux, hydronephrosis, stone disease, urethral valves, etc. are routinely corrected at Amrita Hospital. The neonatal anaesthesia and ICU support facilities are excellent. We are the only centre in South India who has an active paediatric laparoscopic urology program.

Renal Transplantation and Access Surgery

Renal transplantation is routinely performed once or twice a week with a dedicated transplant ICU. Laparoscopic kidney retrieval, vascular access and fistula creation are also done routinely. The hospital is involved in cadaveric multiorgan retrieval and transplantation program in association with SORT (Society for Organ Retrieval and Transplantation), a voluntary NGO in Kerala.

Female Urology and Neuro-urology

Treatment of women with incontinence of urine and management of urinary problems in patients with neurological disease or injury is practiced as a sub-specialty. “Life tech Janus IV” urodynamic equipment available at the center correctly aids in managing these unfortunate patients. Expertise for sling operations, TVT (TransVaginal Tape), TOT (TransObturator Tape), SPARC (SupraPubic Arc sling) and augmentation and continent urinary diversion procedures are available.

Andrology

Evaluation methods for erectile dysfunction including pharmacocavernosometry, pharmacocavernosography and procedures like penile implantation surgery are done regularly.

General Urology

Stones in the kidney, ureter, bladder, common diseases of the urethra (stricture), prostate (cancer, enlargement) and bladder are routinely treated. All the advanced treatment options for stones in the kidney and other parts of the urinary tract are available. The latest “Dornier Compact Delta” ESWL machine is available for the most effective crushing of stones without surgery.

Ancillary Services

Advanced urological imaging, pathology, microbiology, nuclear medicine, anaesthesia, cardiology, nephrology, oncology and paediatric services contribute to complete team approach to our patients.

Procedures performed

  • Laparoscopic Urology

The department is recognized as one of the apex centres in laparoscopic urology. Both laparoscopic and retroperitoneoscopic surgeries including:

  • Laparoscopic and retroperitoneoscopic adrenalectomy
  • Laparoscopic and retroperitoneoscopic nephrectomy and radical nephrectomy, laparoscopic nephron sparing surgeries
  • Laparoscopic pyeloplasty
  • Laparoscopic radical prostatectomy
  • Laparoscopic donor nephrectomy
  • Endo Urology
    • Ureteroscopy
    • Flexible ureteroscopy and laser lithotripsy
    • Transurethral Resection of the Prostate TURP
    • Transurethral Resection of Bladder Tumour TURBT
    • Endopyelotomy and retrograde endopyelotomy
  • Onco Urology
Prostate Cancer
  • Open and laparoscopic radical prostatectomy
  • Intensity Modulated Radiation Therapy (IMRT) and Conformal Radiotherapy
  • Hormonal treatment
  • Chemotherapy
  • Radio isotope treatment
Kidney Tumours
  • Radical nephrectomy: open and laparoscopic
  • Nephron sparing surgeries: open and laparoscopic
  • Radiofrequency Ablation (RFA)
  • Immunotherapy
Testicular Tumors
  • Inguinal orchiectomy
  • Retroperitoneal lymph node dissection
  • Chemotherapy and radiotherapy
Bladder Cancer
  • Radical cystectomy and conduit
  • Orthotopic neobladder
  • Bladder preservation
Penile Cancer
  • Penectomy and penile reconstruction
  • Reconstructive Urology 
    • Vescico ureteric reflux : STING therapy, laparoscopic and open ureteric reimplanation.
    • Urethral stricture : Perineal urethroplasty, Buccal mucosal graft urethroplasty, Transpubic urethroplasty.
    • Pelvi uretric obstruction : Laparoscopic and open pyeloplasty Endopyelotomy.
    • Female urology : TVT (TransVaginal Tape), TOT (TransObturator Tape), SPARC (SupraPubic Arc sling)  surgery, Reconstructive surgery for Vesicovaginal fistula (VVF) and Urovaginal fistula (UVF).
  • Andrology 
    • Pharmaco cavernosography and cavernosometry
    • Penile prosthesis implantation
    • Penile vascular reconstruction
    • Surgeries for Peyronie’s Disease
  • Paediatric Urology 
    • Paediatric pyeloplasty: Lap/open
    • Paediatric adrenalectomy: Lap/open
    • PUV fulgration
    • Ureteric reimplanation: ( Lap/open) and STING surgery
    • Hypospadias repair

Diseases Treated

  • Kidney stones 
  • Ureteral stones 
  • Bladder stones 
  • Prostate cancer 
  • Enlarged prostate (Benign Prostatic Hyperplasia) 
  • Urethral strictures 
  • Kidney cancer 
  • Bladder cancer 
  • Prostate cancer 
  • Testicular cancer 
  • Penile cancer 
  • Adrenal tumors 
  • Urinary tract infections 
  • Urinary incontinence 
  • Neurogenic bladder 
  • Congenital urological disorders (e.g., hypospadias, vesicoureteral reflux, urethral valves) 
  • Urological trauma and reconstruction needs 
  • Female pelvic medicine and reconstructive surgery conditions 
  • Male sexual and reproductive health issues (e.g., erectile dysfunction, Peyronie's disease) 
  • Urinary problems associated with nervous disorders (Neuro-urology) 
  • Pediatric urological conditions 
  • Renal transplantation needs 
  • Gender reassignment surgery needs 

Specialities

Uro-oncology 

Expertise in treating cancers of the urinary tract. 

Congenital Urological Disorders

  • Specialized care for children, adolescents, and adults with congenital urological conditions. 

Urinary Stone Diseases 

  • Advanced treatment for kidney, ureteral, and bladder stones. 

Prostate and Urethral Stricture Related Urination Problems 

  • Comprehensive management of urination issues due to prostate and urethral strictures. 

Urologic Trauma and Reconstruction 

  • Specialized care for patients with urologic injuries and the need for reconstructive surgery. 

Female Urology

  • Expertise in female pelvic medicine and reconstructive surgery. 

Neuro-Urology 

  • Treatment of urinary problems related to nervous disorders. 

Male Sexual and Reproductive Health (Andrology)

  • Comprehensive care for male sexual and reproductive health issues. 

Renal (Kidney) Transplantation 

  • Advanced renal transplantation services. 

Gender-Reassignment Surgery 

  • Specialized surgery and care for gender-reassignment procedures. 

What We Offer

At Amrita Hospital, Kochi, we provide a wide array of advanced healthcare services. Our surgical capabilities cover a broad spectrum, including open, laparoscopic, and endoscopic procedures for both upper and lower urinary tract conditions.  

We integrate cutting-edge robotic and laser technologies to enhance precision and patient outcomes. Our facility houses nearly all diagnostic laboratory and imaging services, supported by specialized departments such as Pathology, Microbiology, Biochemistry, Toxicology, Immunology, Genetics, Radiology, Nuclear Medicine, and more. Our comprehensive approach ensures that every patient receives holistic and specialized care under one roof. 

Why Choose Us

Our state-of-the-art infrastructure and advanced technological capabilities enable us to deliver outstanding medical services. Our team of dedicated professionals, including expert surgeons, compassionate nursing staff, and supportive medical social workers, is committed to providing personalized care. We also offer financial assistance to patients in need, ensuring that everyone has access to quality healthcare. 

Features

  • Advanced Surgical Capabilities: Open, laparoscopic, and endoscopic procedures, integrated with robotic and laser technologies. 
  • Comprehensive Diagnostic Services: Extensive laboratory and imaging services under one roof. 
  • Specialized Departments: Support from Pathology, Microbiology, Biochemistry, Toxicology, Immunology, Genetics, Radiology, Nuclear Medicine, and many more. 
  • Holistic Patient Care: Dedicated nursing services, patient movement support, medical social workers, and extensive public relations and secretarial staff. 
  • Financial Assistance: Support for patients facing financial constraints through collaborations with governmental and non-governmental funding agencies. 

Facilities

  • Modern Operating Theatres: Equipped with the latest surgical tools and technologies. 
  • Advanced Imaging Centres: Comprehensive radiology services including MRI, CT, and ultrasound. 
  • Well-Equipped Laboratories: State-of-the-art facilities for pathology, microbiology, biochemistry, and more. 
  • Robust Support Services: Anaesthesia and Intensive Care, Infectious Diseases, Nephrology, Physical Medicine, Plastic and Reconstructive Surgery, Endocrinology, Neuro-Sciences, Radiation and Medical Oncology, and many more. 
  • Dedicated Patient Care Areas: Comfortable inpatient wards, specialized units for paediatrics, geriatrics, gynaecology, and pain and palliative care. 
  • Comprehensive Rehabilitation Services: Physical medicine and rehabilitation services to support patient recovery. 

Our Philosophy

Our philosophy is rooted in providing compassionate, holistic, and high-quality healthcare. We believe in integrating advanced medical technologies with a patient-centered approach, ensuring that every individual receives personalized and comprehensive care. Inspired by the selfless dedication of Shri Mata Amritanandamayi Devi, we are committed to serving our community with love, respect, and empathy. Our goal is to heal, support, and uplift our patients, ensuring their well-being and enhancing their quality of life. 

Services Offered

Endourology 

We perform endoscopic treatments for stones and diseases affecting the kidney, ureter, bladder, prostate, and urethra using natural body openings, thereby circumventing the discomfort often associated with open surgeries. 

Laparoscopic Urology  

Minimally invasive keyhole surgery is employed to remove and reconstruct urinary organs, minimizing postoperative pain and reducing lengthy bed rest associated with open surgery. Procedures such as nephrectomy, radical and partial nephrectomy, stone extraction, correction of hydronephrosis due to PUJ obstruction, and ureteral re-implantation are routinely performed. Our experience includes over 800 laparoscopic live donor nephrectomies and more than 400 laparoscopic adrenalectomies, marking one of the largest Indian experiences. Additionally, we regularly conduct laparoscopic radical prostatectomy for organ-confined prostatic cancer, positioning us among the select centres in India offering this specialized procedure. 

Urological Oncology  

The Department of Urology houses a dedicated division specializing in urological malignancies, addressing cancers affecting the kidney, bladder, prostate, ureters, adrenals, testis, and penis. Our unique venture includes a subspecialty clinic in Uro-oncology, a pioneering initiative in India. For cases requiring multimodality treatment, our institution offers seamless collaboration among medical oncologists, radiation oncologists, advanced radiology, pathology, and nuclear medicine departments, all under one roof. We provide facilities for brachytherapy, conformal radiotherapy, Intensity-Modulated Radiation Therapy (IMRT), and therapeutic nuclear medicine procedures. Our multidisciplinary team, comprising Uro-oncologists, radiation oncologists, medical oncologists, and Uro-pathologists, collectively assess cases and devise comprehensive management plans at the Tumour Board. Follow-up and further management adhere to current protocols, ensuring optimal patient care. 

Kidney Cancer  

Mainstay treatments for kidney cancer include laparoscopic and open radical nephrectomies. For locally extensive kidney cancers necessitating intricate procedures like IVC exploration, we offer both open and laparoscopic partial nephrectomies (nephron sparing surgeries). Additionally, we routinely administer immunotherapy for advanced renal cancers. These interventions represent a comprehensive approach to kidney cancer management, ensuring tailored treatment options for each patient's unique circumstances. 

Prostate Cancer  

The diagnosis of prostate cancer has significantly advanced with TRUS-guided multicore biopsy, while staging benefits from bone scans, PSMA PET CT scans, 1.5 and 3 Tesla MRI, improving early detection and outcomes. At our facility, laparoscopic prostatectomy, conformal radiotherapy, IMRT (Image modulated radiotherapy), and brachytherapy are standard procedures, ensuring comprehensive treatment options for patients. These advancements enable tailored approaches to prostate cancer management, optimizing both efficacy and patient outcomes. 

Bladder Cancer  

The preferred treatment for advanced bladder cancer is radical cystectomy with orthotopic neobladder reconstruction, considered the gold standard. This procedure involves removing the diseased bladder and reconstructing it with a section of the intestine during the same operation, enabling patients to urinate naturally. This approach significantly enhances the quality of life by eliminating the need for a urine collection pouch and associated social discomfort. In select cases, bladder preservation is achieved through chemo-radiation following endoscopic tumour resection. 

Testicular Cancer  

Treatment for testicular cancer typically starts with the surgical removal of the affected testicle (orchiectomy), followed by tailored therapies based on the cancer's stage and type. Retroperitoneal lymph node dissection (RPLND) is often considered, especially if there's a risk of cancer spreading to the abdominal lymph nodes. At Amrita Hospital, we offer RPLND using open or robot-assisted laparoscopic methods. This approach aims to remove lymph nodes in the retroperitoneum, halting cancer spread. Chemotherapy or radiation therapy may be recommended for more aggressive forms. Regular follow-ups are vital for monitoring and managing recurrence. Comprehensive care includes emotional support and counselling to aid patients through their journey. 

Adrenal Tumours  

Keyhole surgery has supplanted open adrenalectomy due to improved visualization and accelerated recovery. At Amrita Hospital, we boast the largest collection of laparoscopic adrenalectomies in India. Additionally, retroperitoneoscopic adrenalectomy, a procedure performed at only a few select centres worldwide, is exclusively offered at our facility. 

Penile Cancer  

In cases of penile carcinoma, the standard treatment typically involves partial or total penectomy along with radical lymph node dissection. Recent advancements in treatments have significantly decreased the associated morbidity. Collaborating with the plastic surgery team enables the reconstruction of the penis using a forearm flap, greatly enhancing the comfort and quality of life for affected individuals. Furthermore, the option of penile implants allows them to resume a normal sexual life. 

Laparoscopic Surgeries in Uro-oncology  

Laparoscopic surgery has revolutionized the approach to surgical procedures in Uro-oncology. Many formerly open surgeries, such as radical nephrectomy, nephroureterectomy, radical prostatectomy, and radical cystectomy, are now increasingly performed with minimal morbidity and facilitate a quicker return to work. 

Multi-Disciplinary Tumour Board (MDTB) 

Decisions on the treatment of urological cancers are made during board meetings attended by Medical Oncologists, Radiation Oncologists, Surgical Oncologists, Radiologists, Pathologists, and Urologists. These meetings are conducted without any cost to the patient, ensuring they receive the most comprehensive and optimal care available. 

Paediatric Urology  

We offer specialized expertise in surgically addressing congenital urinary tract defects, utilizing both open surgery and laparoscopy techniques at Amrita Hospital. Common conditions such as hypospadias, vesico ureteric reflux, hydronephrosis, stone disease, and urethral valves are routinely corrected here. Our neonatal anaesthesia and ICU support services are of exceptional quality. Amrita Hospital stands out as the sole centre in South India with an active paediatric laparoscopic urology program. We provide comprehensive transitional care for children with ongoing congenital urological issues as they grow. Additionally, we perform renal transplantation surgeries for children and regularly conduct upper and lower endourologic procedures. 

Renal Transplantation 

Renal transplantation procedures are conducted regularly, typically once or twice a week, supported by a specialized transplant ICU. Donor nephrectomies are predominantly performed laparoscopically. When deemed appropriate, renal transplantation is also extended to children. Amrita Hospital actively participates in a cadaveric multiorgan retrieval and transplantation initiative in collaboration with SORT (Society for Organ Retrieval and Transplantation), a voluntary NGO based in Kerala. 

Female Urology and Neuro-urology 

We specialize in treating women experiencing urinary incontinence and managing urinary issues in patients with neurological conditions or injuries. Our centre is equipped with "Laborie" urodynamic equipment, which significantly assists in effectively managing these patients. We provide expertise in various procedures including rectus sheath pubovaginal sling operations, TVT (Tension-free Vaginal Tape), TOT (Trans-Obturator Tape), as well as augmentation cystoplasty and continent urinary diversion procedures. Robotic or laparoscopic sacrocolpopexy procedures are performed as needed. Additionally, we undertake infrequent procedures such as urethrolysis and the removal of synthetic slings.  

Andrology 

Regularly, we conduct assessment techniques for erectile dysfunction, such as penile doppler, pharmacocavernosometry and pharmacocavernosography, alongside performing procedures like penile prosthetic implantation surgery. Additionally, we offer artificial urinary sphincter (AMS 800) insertion for severe male urinary incontinence. 

Sex Reassignment Surgery 

Also known as Gender Confirmation Surgery or Gender-Affirming Surgery, comprises a series of medical procedures undertaken by transgender and non-binary individuals to align their physical appearance and sexual characteristics with their gender identity. Led by our skilled Plastic and Reconstructive Surgery team, we address the urological aspects of this intricate process, ensuring comprehensive care and support throughout the journey. 

General Urology 

We routinely treat kidney stones, ureteral stones, bladder stones, and common urethral diseases like strictures, as well as conditions of the prostate such as cancer and enlargement. Advanced treatment options for urinary tract stones, including those in the kidney, are readily available. Our facility is equipped with the latest "Dornier Sigma" ESWL machine, ensuring highly effective stone fragmentation without the need for surgery. 

Diagnostic Tests and Procedures

Laparoscopic Urology 

  • The department is recognized as one of the apex centres in laparoscopic urology. Both laparoscopic and retroperitoneoscopic surgeries including: 
  • Laparoscopic and retroperitoneoscopic adrenalectomy 
  • Laparoscopic and retroperitoneoscopic nephrectomy and radical nephrectomy, laparoscopic nephron sparing surgeries. 
  • Laparoscopic pyeloplasty 
  • Laparoscopic radical prostatectomy 
  • Laparoscopic donor nephrectomy 

Endo Urology 

  • Ureteroscopy 
  • Flexible ureteroscopy and laser lithotripsy 
  • Transurethral Resection of the Prostate TURP 
  • Transurethral Resection of Bladder Tumour TURBT 
  • Antegrade and retrograde Endopyelotomy 

Robotic Assisted Laparoscopic Surgery 

  • Radical prostatectomy and other prostate surgeries 
  • Radical cystectomy and other bladder surgeries 
  • Retroperitoneal lymphadenectomy 
  • Adrenal surgeries 
  • Partial Nephrectomy 
  • Pyeloplasty 
  • Ureteric reimplantation 
  • Sacrocolpopexy 
  • Radical inguinal lymphadenectomy 
  • Vesico-vaginal fistula repair 

Uro-oncology 

  • Prostate Cancer 
    • Open, laparoscopic and robotic assisted radical prostatectomy 
    • Intensity Modulated Radiation Therapy (IMRT) and Conformal Radiotherapy 
    • Hormonal treatment 
    • Chemotherapy 
    • Radio isotope treatment 
  • Kidney Tumours 
    • Radical nephrectomy: open and laparoscopic 
    • Nephron sparing surgeries: open and laparoscopic. 
    • Radiofrequency Ablation (RFA) 
    • Immunotherapy 
  • Testicular Tumours 
    • Inguinal orchiectomy 
    • Retroperitoneal lymph node dissection 
    • Chemotherapy and radiotherapy 
  • Bladder Cancer 
    • Radical cystectomy and conduit 
    • Orthotopic neobladder 
    • Bladder preservation 
  • Penile Cancer 
    • Penectomy and penile reconstruction 
    • Video-assisted and open inguinal lymphadenectomy 

Reconstructive Urology  

  • Vesico-Ureteric Reflux: STING therapy, laparoscopic and open ureteric reimplantation. 
  • Urethral stricture: Perineal urethroplasty, Buccal mucosal graft urethroplasty, Trans pubic urethroplasty. 
  • Pelvi ureteric obstruction: Laparoscopic and open pyeloplasty Endopyelotomy. 

Female urology 

  • Rectus sheath/Tensor fascia lata pubovaginal sling 
  • TVT (Tension-free Vaginal Tape) 
  • TOT (Transobturator Tape) 
  • Reconstructive surgery for Vesicovaginal fistula (VVF)  
  • Uretero-vaginal fistula (UVF) 
  • Laparoscopic/robotic/open sacrocolpopexy 
  • Anterior colporrhaphy 

Andrology  

  • Pharmacocavernosography and cavernosometry 
  • Penile prosthesis implantation 
  • Penile vascular reconstruction 
  • Surgeries for Peyronie’s Disease 
  • Epididymal and Testicular sperm aspiration for in-vitro fertilisation 
  • Microscopic varicocelectomy 

Paediatric Urology  

  • Paediatric pyeloplasty: Lap/open 
  • Paediatric adrenalectomy: Lap/open 
  • PUV fulguration 
  • Ureteric reimplantation: (Laparoscopic/open) and STING surgery 
  • Hypospadias repair 

Treatments

Endourology 

  • Endoscopic treatments for stones and diseases of the kidney, ureter, bladder, prostate, and urethra 

Laparoscopic Urology 

  • Nephrectomy (kidney removal) 
  • Radical and partial nephrectomy 
  • Stone extraction 
  • Correction of hydronephrosis due to PUJ obstruction 
  • Ureteral re-implantation 
  • Laparoscopic live donor nephrectomies 
  • Laparoscopic adrenalectomies 
  • Laparoscopic radical prostatectomy for organ-confined prostatic cancer 

Urological Oncology 

  • Multimodality treatment for urological cancers 
  • Brachytherapy 
  • Conformal radiotherapy 
  • Intensity-Modulated Radiation Therapy (IMRT) 
  • Therapeutic nuclear medicine procedures 

Kidney Cancer 

  • Laparoscopic and open radical nephrectomies 
  • IVC exploration for locally extensive kidney cancers 
  • Open and laparoscopic partial nephrectomies (nephron sparing surgeries) 
  • Immunotherapy for advanced renal cancers 

Prostate Cancer 

  • TRUS-guided multicore biopsy 
  • Bone scans, PSMA PET CT scans, 1.5 and 3 Tesla MRI for staging 
  • Laparoscopic prostatectomy 
  • Conformal radiotherapy 
  • IMRT (Image Modulated Radiotherapy) 
  • Brachytherapy 

Bladder Cancer 

  • Radical cystectomy with orthotopic neobladder reconstruction 
  • Chemo-radiation following endoscopic tumour resection for bladder preservation 

Testicular Cancer 

  • Surgical removal of the testicle (orchiectomy) 
  • Retroperitoneal lymph node dissection (RPLND) 
  • Chemotherapy or radiation therapy 
  • Open or robot-assisted laparoscopic RPLND 

Adrenal Tumors 

  • Keyhole surgery (laparoscopic adrenalectomy) 
  • Retroperitoneoscopic adrenalectomy 

Penile Cancer 

  • Partial or total penectomy 
  • Radical lymph node dissection 
  • Penile reconstruction using a forearm flap 
  • Penile implants 

Pediatric Urology 

  • Surgical correction of congenital urinary tract defects (e.g., hypospadias, vesicoureteric reflux) 
  • Neonatal anesthesia and ICU support 
  • Paediatric laparoscopic urology 
  • Renal transplantation for children 
  • Upper and lower endourologic procedures 

Renal Transplantation 

  • Regular renal transplantation procedures 
  • Laparoscopic donor nephrectomies 
  • Cadaveric multiorgan retrieval and transplantation initiative in collaboration with SORT 

Female Urology and Neuro-Urology 

  • Treatment of urinary incontinence 
  • Management of urinary issues in patients with neurological conditions 
  • Rectus sheath pubovaginal sling operations 
  • TVT (Tension-free Vaginal Tape) 
  • TOT (Trans-Obturator Tape) 
  • Augmentation cystoplasty and continent urinary diversion procedures 
  • Robotic or laparoscopic sacrocolpopexy 
  • Urethrolysis and removal of synthetic slings 

Andrology 

  • Penile doppler, pharmacocavernosometry, and pharmacocavernosography 
  • Penile prosthetic implantation surgery 
  • Artificial urinary sphincter (AMS 800) insertion for severe male urinary incontinence 

Sex Reassignment Surgery 

  • Urological aspects of gender confirmation surgery 

General Urology 

  • Treatment of kidney, ureteral, and bladder stones 
  • Management of common urethral diseases (e.g., strictures) 
  • Treatment of prostate conditions (e.g., cancer, enlargement) 
  • Advanced treatment options for urinary tract stones using "Dornier Sigma" ESWL machine 

Achievements

  • Kerala’s first Centre to perform keyhole surgery to harvest right kidney for transplantation. 
  • Kerala’s first Centre to conduct retroperitoneoscopic kidney and adrenal surgeries and lymphadenectomies including harvesting kidneys on either side for transplantation. 
  • Ureteral, urethral and prostatic stents (Memokath, Allium) inserted for the first time in Kerala. 
  • Kerala’s first pelvic dysfunction clinic. 
  • Kerala’s first Robot-assisted retroperitoneoscopic lymph node dissection for testicular malignancy. 
  • We have conducted nearly 900 renal transplantations and 800 robotic surgeries including robotic renal transplantation. 
  • First in Kerala to offer BMG (Buccal mucosal graft) urethroplasty for women for treating female urethral stricture (narrowing of the urethra) 
  • Forty-five Urologists, 7 physician assistants are trained in this department. Many of them are leading Urologists and Physician Assistants in various parts of the country and abroad, several of whom are taken up Faculty positions in teaching centres. 

Doctors

Dr. K. V. Sanjeevan
Clinical Professor and Head
MS, MCh (Urology)
Dr. Appu Thomas
Emeritus Professor
MS, MCh (Urology)
Dr. Georgie Mathew
Clinical Professor
MS, MCh (Urology)
Dr. Kannan R Nair
Clinical Professor
MS, DNB, MRCS, MCh, FRCS
Dr. Rohan Rajendran
Clinical Assistant Professor
MS, MCh, DNB
Dr. Ginil Kumar P
Clinical Professor-Urooncologist and Robotic Surgeon
MS (Gen Surgery), M Ch (Urology), DNB (Urology), MNAMS (Urology)
Dr. Midhun Mohan
Clinical Assistant Professor
MS, MCh

Overview

The Urology Department at Amrita Hospital provides top-notch facilities for diagnosing and treating male genitourinary and female urinary diseases across all age ranges. Our team consists of highly skilled and experienced urologists and resident surgeons who are available round-the-clock. We boast the latest cutting-edge technology and equipment to ensure the best possible care. Our faculty specializes in various subspecialties within the field. 

  • Uro-oncology (cancers of the urinary tract) 
  • Congenital Urological disorders (Children, Adolescents and Adults) 
  • Urinary stone diseases (Kidney, Ureteral and Bladder stones) 
  • Prostate and Urethral stricture related Urination Problems 
  • Urologic trauma and reconstruction  
  • Female Urology (Female Pelvic Medicine and Reconstructive Surgery) 
  • Neuro-Urology (Urinary problems in Nervous Disorders) 
  • Male sexual and reproductive health (Andrology) 
  • Renal (kidney) transplantation 
  • Gender-Reassignment Surgery 

Facilities

Out Patient Procedures

The outpatient department has facilities to take care of all office urology procedures. It is supported by trained staff including two staff nurses, blood draw facilities, full-fledged procedure rooms, dedicated X-ray machines, ultrasound equipment, etc.

Uro Radiology 

Ultra sound machine: The department has its own B-K ultrasound machine apart from the facility available in Radiology to do ultra sound guided procedures like TRUSS guided prostate biopsy, percutaneous nephrostomy, ultrasound-guided aspirations, etc. It has a dedicated TRUSS probe for an accurate prostate biopsy to diagnose prostate cancer. The department has a separate radiology suite for doing procedures like MCU (micturating cystourethrogram) and RGU (retrograde urethrogram). It is supported by a radiology department with all modern equipment including:

  • CT: MD CT ( Seimens sensation 64) , Seimens CT scan
  • MRI: GE HD xT, Magnotom symphony classic
  • Most modern invasive radiology suite
  • Ultra sound section having 4 ultra sound machine
  • A mobile USG and X ray unit
  • Image guided radiofrequency ablation equipment
  • Seimens double head Gamma camera: Used for all procedures including diagnostic services like bone scan, DTPA scan, DMSA scan, MAG3 and therapeutic procedures in carcinoma prostate.

Uro Dynamics

Two uroflow meters and Labourie Janus urodynamics machines are used for assessing the urine flow and evaluating neurogenic bladder

Flexible Cystoscopy

Two Karl Storz flexible cystoscopes are used in the evaluation of hematuria to rule out bladder malignancies and in the follow up of bladder cancer to diagnose early recurrence. They help to avoid anaesthesia during routine cystoscopy as the procedure is painless.

Extracorporeal Shock Wave Lithotripsy (ESPWL)

A Dornier compact sigma lithotripter is used for extra corporeal lithotripsy

Achievements

  • Kerala’s first Centre to start Retroperitoneoscopic kidney surgery
  • Kerala’s first pelvic dysfunction clinic.
  • Kerala’s first Robot-assisted Retroperitoneoscopic lymph node dissection for testicular malignancy.
  • First in Kerala to offer BMG (Buccal mucosal graft) urethroplasty for women for treating female urethral stricture (narrowing of the urethra) in 2022

Services Offered

Endourology

Endoscopic treatment of stones and diseases of the kidney, ureter, bladder, prostate and urethra is performed through natural openings in the body avoiding the pain associated with open operations.

Laparoscopic Urology 

Key – hole surgery to remove and reconstruct urinary organs avoiding pain and long bed rest associated with open surgery. Nephrectomy, radical and partial nephrectomy, stone extraction, correction of hydronephrosis due to PUJ obstruction and re-implantation of the ureters are performed. More than 200 laparoscopic live donor nephrectomies and over 130 (the largest Indian experience) laparoscopic adrenalectomies have been successfully performed. We are one of the few centres in India who perform laparoscopic radical prostatectomy regularly for organ confined prostatic cancer.

Urological Oncology 

The Department of Urology has a separate division for urological malignancies. The cancers of kidney, bladder, prostate, ureters, adrenals, testis and penis are taken care by this section. A subspecialty clinic in Uro-oncology is a unique venture in India. In cases where multimodality treatment is required, our institution has medical oncologists, radiation oncologists, state-of-the-art radiology, pathology and nuclear medicine departments, all under one roof. There are facilities for brachytherapy, conformal radiotherapy, Intensity-Modulated Radiation Therapy (IMRT) and therapeutic nuclear medicine procedures. The Uro-oncologists, radiation oncologists, medical oncologists and Uro-pathologists discuss the cases and make combined decisions on the management of all the cases at the Tumour Board. Follow up and further management are done as per the current protocols.

Kidney Cancer 

Surgeries like laparoscopic and open radical nephrectomies are the mainstay of treatment in kidney cancer. Complicated surgeries that require IVC exploration in locally extensive kidney cancers, open and laparoscopic partial nephrectomies (nephron sparing surgeries), and immunotherapy for advanced renal cancers are regularly done.

Prostate Cancer 

Diagnosis of prostate cancer by TRUSS-guided multicore biopsy, and staging by bone scan, PET CT, 1.5 Tesla MRI, MD CT have greatly improved the detection of early disease and improved the outcome. Laparoscopic prostatectomy, conformal radiotherapy, IMRT (Image modulated radiotherapy) and brachytherapy all are routinely performed here.

Bladder Cancer 

The gold standard for the treatment of advanced bladder cancer is radical cystectomy with orthotopic neobladder reconstruction. After removal of the diseased bladder, the bladder is reconstructed with a loop of intestine in the same sitting so that the patient is able to pass urine naturally. The quality of life is greatly improved as the patient is free from using a pouch to collect urine and the resultant social embarrassments. In a certain subset of patients, bladder preservation is done with the help of chemo radiation after endoscopic resection of the tumour.

Testicualr Cancer 

The gold standard for the treatment of advanced bladder cancer is radical cystectomy with orthotopic neobladder reconstruction. After removal of the diseased bladder, the bladder is reconstructed with a loop of intestine in the same sitting so that the patient is able to pass urine naturally. The quality of life is greatly improved as the patient is free from using a pouch to collect urine and the resultant social embarrassments. In a certain subset of patients, bladder preservation is done with the help of chemo radiation after endoscopic resection of the tumor.

Adrenal Tumors 

Key hole surgery has replaced open adrenelectomy as there is better visualisation and enhances early recovery. We have the largest series of laparoscopic adrenalectomies in India . Retroperitoneoscopic adrenelectomy is done only in a handful of centres in the world with Amrita Hospital being one.

Penile Cancer 

Partial or total penectomy and radical lymph node dissection is the standard treatment in carcinoma of penis. Recent advances in the treatments have reduced the treatment morbidity considerably. With the help of plastic surgery team, penis can be reconstructed with forearm flap which makes the life of these unfortunate people comfortable. They can have a normal sexual life with the help of penile implants.

Laparoscopic Surgeries in Uro-oncology 

The laparoscopic surgery has changed the surgical concept in Uro-oncology. Most of the open surgeries like radical nephrectomy, nephroureterectomy, radical prostectomy and radical cystectomy are now done more and more with minimum morbidity and early return to work.

Paediatric Urology 

Expertise for the surgical reconstruction of congenital defects of the urinary tract either by open surgery or laparoscopy is available. Hypospadias, vesico ureteric reflux, hydronephrosis, stone disease, urethral valves, etc. are routinely corrected at Amrita Hospital. The neonatal anaesthesia and ICU support facilities are excellent. We are the only centre in South India who has an active paediatric laparoscopic urology program.

Renal Transplantation and Access Surgery

Renal transplantation is routinely performed once or twice a week with a dedicated transplant ICU. Laparoscopic kidney retrieval, vascular access and fistula creation are also done routinely. The hospital is involved in cadaveric multiorgan retrieval and transplantation program in association with SORT (Society for Organ Retrieval and Transplantation), a voluntary NGO in Kerala.

Female Urology and Neuro-urology

Treatment of women with incontinence of urine and management of urinary problems in patients with neurological disease or injury is practiced as a sub-specialty. “Life tech Janus IV” urodynamic equipment available at the center correctly aids in managing these unfortunate patients. Expertise for sling operations, TVT (TransVaginal Tape), TOT (TransObturator Tape), SPARC (SupraPubic Arc sling) and augmentation and continent urinary diversion procedures are available.

Andrology

Evaluation methods for erectile dysfunction including pharmacocavernosometry, pharmacocavernosography and procedures like penile implantation surgery are done regularly.

General Urology

Stones in the kidney, ureter, bladder, common diseases of the urethra (stricture), prostate (cancer, enlargement) and bladder are routinely treated. All the advanced treatment options for stones in the kidney and other parts of the urinary tract are available. The latest “Dornier Compact Delta” ESWL machine is available for the most effective crushing of stones without surgery.

Ancillary Services

Advanced urological imaging, pathology, microbiology, nuclear medicine, anaesthesia, cardiology, nephrology, oncology and paediatric services contribute to complete team approach to our patients.

Procedures performed

  • Laparoscopic Urology

The department is recognized as one of the apex centres in laparoscopic urology. Both laparoscopic and retroperitoneoscopic surgeries including:

  • Laparoscopic and retroperitoneoscopic adrenalectomy
  • Laparoscopic and retroperitoneoscopic nephrectomy and radical nephrectomy, laparoscopic nephron sparing surgeries
  • Laparoscopic pyeloplasty
  • Laparoscopic radical prostatectomy
  • Laparoscopic donor nephrectomy
  • Endo Urology
    • Ureteroscopy
    • Flexible ureteroscopy and laser lithotripsy
    • Transurethral Resection of the Prostate TURP
    • Transurethral Resection of Bladder Tumour TURBT
    • Endopyelotomy and retrograde endopyelotomy
  • Onco Urology
Prostate Cancer
  • Open and laparoscopic radical prostatectomy
  • Intensity Modulated Radiation Therapy (IMRT) and Conformal Radiotherapy
  • Hormonal treatment
  • Chemotherapy
  • Radio isotope treatment
Kidney Tumours
  • Radical nephrectomy: open and laparoscopic
  • Nephron sparing surgeries: open and laparoscopic
  • Radiofrequency Ablation (RFA)
  • Immunotherapy
Testicular Tumors
  • Inguinal orchiectomy
  • Retroperitoneal lymph node dissection
  • Chemotherapy and radiotherapy
Bladder Cancer
  • Radical cystectomy and conduit
  • Orthotopic neobladder
  • Bladder preservation
Penile Cancer
  • Penectomy and penile reconstruction
  • Reconstructive Urology 
    • Vescico ureteric reflux : STING therapy, laparoscopic and open ureteric reimplanation.
    • Urethral stricture : Perineal urethroplasty, Buccal mucosal graft urethroplasty, Transpubic urethroplasty.
    • Pelvi uretric obstruction : Laparoscopic and open pyeloplasty Endopyelotomy.
    • Female urology : TVT (TransVaginal Tape), TOT (TransObturator Tape), SPARC (SupraPubic Arc sling)  surgery, Reconstructive surgery for Vesicovaginal fistula (VVF) and Urovaginal fistula (UVF).
  • Andrology 
    • Pharmaco cavernosography and cavernosometry
    • Penile prosthesis implantation
    • Penile vascular reconstruction
    • Surgeries for Peyronie’s Disease
  • Paediatric Urology 
    • Paediatric pyeloplasty: Lap/open
    • Paediatric adrenalectomy: Lap/open
    • PUV fulgration
    • Ureteric reimplanation: ( Lap/open) and STING surgery
    • Hypospadias repair

Diseases Treated

  • Kidney stones 
  • Ureteral stones 
  • Bladder stones 
  • Prostate cancer 
  • Enlarged prostate (Benign Prostatic Hyperplasia) 
  • Urethral strictures 
  • Kidney cancer 
  • Bladder cancer 
  • Prostate cancer 
  • Testicular cancer 
  • Penile cancer 
  • Adrenal tumors 
  • Urinary tract infections 
  • Urinary incontinence 
  • Neurogenic bladder 
  • Congenital urological disorders (e.g., hypospadias, vesicoureteral reflux, urethral valves) 
  • Urological trauma and reconstruction needs 
  • Female pelvic medicine and reconstructive surgery conditions 
  • Male sexual and reproductive health issues (e.g., erectile dysfunction, Peyronie's disease) 
  • Urinary problems associated with nervous disorders (Neuro-urology) 
  • Pediatric urological conditions 
  • Renal transplantation needs 
  • Gender reassignment surgery needs 

Specialities

Uro-oncology 

Expertise in treating cancers of the urinary tract. 

Congenital Urological Disorders

  • Specialized care for children, adolescents, and adults with congenital urological conditions. 

Urinary Stone Diseases 

  • Advanced treatment for kidney, ureteral, and bladder stones. 

Prostate and Urethral Stricture Related Urination Problems 

  • Comprehensive management of urination issues due to prostate and urethral strictures. 

Urologic Trauma and Reconstruction 

  • Specialized care for patients with urologic injuries and the need for reconstructive surgery. 

Female Urology

  • Expertise in female pelvic medicine and reconstructive surgery. 

Neuro-Urology 

  • Treatment of urinary problems related to nervous disorders. 

Male Sexual and Reproductive Health (Andrology)

  • Comprehensive care for male sexual and reproductive health issues. 

Renal (Kidney) Transplantation 

  • Advanced renal transplantation services. 

Gender-Reassignment Surgery 

  • Specialized surgery and care for gender-reassignment procedures. 

What We Offer

At Amrita Hospital, Kochi, we provide a wide array of advanced healthcare services. Our surgical capabilities cover a broad spectrum, including open, laparoscopic, and endoscopic procedures for both upper and lower urinary tract conditions.  

We integrate cutting-edge robotic and laser technologies to enhance precision and patient outcomes. Our facility houses nearly all diagnostic laboratory and imaging services, supported by specialized departments such as Pathology, Microbiology, Biochemistry, Toxicology, Immunology, Genetics, Radiology, Nuclear Medicine, and more. Our comprehensive approach ensures that every patient receives holistic and specialized care under one roof. 

Why Choose Us

Our state-of-the-art infrastructure and advanced technological capabilities enable us to deliver outstanding medical services. Our team of dedicated professionals, including expert surgeons, compassionate nursing staff, and supportive medical social workers, is committed to providing personalized care. We also offer financial assistance to patients in need, ensuring that everyone has access to quality healthcare. 

Features

  • Advanced Surgical Capabilities: Open, laparoscopic, and endoscopic procedures, integrated with robotic and laser technologies. 
  • Comprehensive Diagnostic Services: Extensive laboratory and imaging services under one roof. 
  • Specialized Departments: Support from Pathology, Microbiology, Biochemistry, Toxicology, Immunology, Genetics, Radiology, Nuclear Medicine, and many more. 
  • Holistic Patient Care: Dedicated nursing services, patient movement support, medical social workers, and extensive public relations and secretarial staff. 
  • Financial Assistance: Support for patients facing financial constraints through collaborations with governmental and non-governmental funding agencies. 

Facilities

  • Modern Operating Theatres: Equipped with the latest surgical tools and technologies. 
  • Advanced Imaging Centres: Comprehensive radiology services including MRI, CT, and ultrasound. 
  • Well-Equipped Laboratories: State-of-the-art facilities for pathology, microbiology, biochemistry, and more. 
  • Robust Support Services: Anaesthesia and Intensive Care, Infectious Diseases, Nephrology, Physical Medicine, Plastic and Reconstructive Surgery, Endocrinology, Neuro-Sciences, Radiation and Medical Oncology, and many more. 
  • Dedicated Patient Care Areas: Comfortable inpatient wards, specialized units for paediatrics, geriatrics, gynaecology, and pain and palliative care. 
  • Comprehensive Rehabilitation Services: Physical medicine and rehabilitation services to support patient recovery. 

Our Philosophy

Our philosophy is rooted in providing compassionate, holistic, and high-quality healthcare. We believe in integrating advanced medical technologies with a patient-centered approach, ensuring that every individual receives personalized and comprehensive care. Inspired by the selfless dedication of Shri Mata Amritanandamayi Devi, we are committed to serving our community with love, respect, and empathy. Our goal is to heal, support, and uplift our patients, ensuring their well-being and enhancing their quality of life. 

Services Offered

Endourology 

We perform endoscopic treatments for stones and diseases affecting the kidney, ureter, bladder, prostate, and urethra using natural body openings, thereby circumventing the discomfort often associated with open surgeries. 

Laparoscopic Urology  

Minimally invasive keyhole surgery is employed to remove and reconstruct urinary organs, minimizing postoperative pain and reducing lengthy bed rest associated with open surgery. Procedures such as nephrectomy, radical and partial nephrectomy, stone extraction, correction of hydronephrosis due to PUJ obstruction, and ureteral re-implantation are routinely performed. Our experience includes over 800 laparoscopic live donor nephrectomies and more than 400 laparoscopic adrenalectomies, marking one of the largest Indian experiences. Additionally, we regularly conduct laparoscopic radical prostatectomy for organ-confined prostatic cancer, positioning us among the select centres in India offering this specialized procedure. 

Urological Oncology  

The Department of Urology houses a dedicated division specializing in urological malignancies, addressing cancers affecting the kidney, bladder, prostate, ureters, adrenals, testis, and penis. Our unique venture includes a subspecialty clinic in Uro-oncology, a pioneering initiative in India. For cases requiring multimodality treatment, our institution offers seamless collaboration among medical oncologists, radiation oncologists, advanced radiology, pathology, and nuclear medicine departments, all under one roof. We provide facilities for brachytherapy, conformal radiotherapy, Intensity-Modulated Radiation Therapy (IMRT), and therapeutic nuclear medicine procedures. Our multidisciplinary team, comprising Uro-oncologists, radiation oncologists, medical oncologists, and Uro-pathologists, collectively assess cases and devise comprehensive management plans at the Tumour Board. Follow-up and further management adhere to current protocols, ensuring optimal patient care. 

Kidney Cancer  

Mainstay treatments for kidney cancer include laparoscopic and open radical nephrectomies. For locally extensive kidney cancers necessitating intricate procedures like IVC exploration, we offer both open and laparoscopic partial nephrectomies (nephron sparing surgeries). Additionally, we routinely administer immunotherapy for advanced renal cancers. These interventions represent a comprehensive approach to kidney cancer management, ensuring tailored treatment options for each patient's unique circumstances. 

Prostate Cancer  

The diagnosis of prostate cancer has significantly advanced with TRUS-guided multicore biopsy, while staging benefits from bone scans, PSMA PET CT scans, 1.5 and 3 Tesla MRI, improving early detection and outcomes. At our facility, laparoscopic prostatectomy, conformal radiotherapy, IMRT (Image modulated radiotherapy), and brachytherapy are standard procedures, ensuring comprehensive treatment options for patients. These advancements enable tailored approaches to prostate cancer management, optimizing both efficacy and patient outcomes. 

Bladder Cancer  

The preferred treatment for advanced bladder cancer is radical cystectomy with orthotopic neobladder reconstruction, considered the gold standard. This procedure involves removing the diseased bladder and reconstructing it with a section of the intestine during the same operation, enabling patients to urinate naturally. This approach significantly enhances the quality of life by eliminating the need for a urine collection pouch and associated social discomfort. In select cases, bladder preservation is achieved through chemo-radiation following endoscopic tumour resection. 

Testicular Cancer  

Treatment for testicular cancer typically starts with the surgical removal of the affected testicle (orchiectomy), followed by tailored therapies based on the cancer's stage and type. Retroperitoneal lymph node dissection (RPLND) is often considered, especially if there's a risk of cancer spreading to the abdominal lymph nodes. At Amrita Hospital, we offer RPLND using open or robot-assisted laparoscopic methods. This approach aims to remove lymph nodes in the retroperitoneum, halting cancer spread. Chemotherapy or radiation therapy may be recommended for more aggressive forms. Regular follow-ups are vital for monitoring and managing recurrence. Comprehensive care includes emotional support and counselling to aid patients through their journey. 

Adrenal Tumours  

Keyhole surgery has supplanted open adrenalectomy due to improved visualization and accelerated recovery. At Amrita Hospital, we boast the largest collection of laparoscopic adrenalectomies in India. Additionally, retroperitoneoscopic adrenalectomy, a procedure performed at only a few select centres worldwide, is exclusively offered at our facility. 

Penile Cancer  

In cases of penile carcinoma, the standard treatment typically involves partial or total penectomy along with radical lymph node dissection. Recent advancements in treatments have significantly decreased the associated morbidity. Collaborating with the plastic surgery team enables the reconstruction of the penis using a forearm flap, greatly enhancing the comfort and quality of life for affected individuals. Furthermore, the option of penile implants allows them to resume a normal sexual life. 

Laparoscopic Surgeries in Uro-oncology  

Laparoscopic surgery has revolutionized the approach to surgical procedures in Uro-oncology. Many formerly open surgeries, such as radical nephrectomy, nephroureterectomy, radical prostatectomy, and radical cystectomy, are now increasingly performed with minimal morbidity and facilitate a quicker return to work. 

Multi-Disciplinary Tumour Board (MDTB) 

Decisions on the treatment of urological cancers are made during board meetings attended by Medical Oncologists, Radiation Oncologists, Surgical Oncologists, Radiologists, Pathologists, and Urologists. These meetings are conducted without any cost to the patient, ensuring they receive the most comprehensive and optimal care available. 

Paediatric Urology  

We offer specialized expertise in surgically addressing congenital urinary tract defects, utilizing both open surgery and laparoscopy techniques at Amrita Hospital. Common conditions such as hypospadias, vesico ureteric reflux, hydronephrosis, stone disease, and urethral valves are routinely corrected here. Our neonatal anaesthesia and ICU support services are of exceptional quality. Amrita Hospital stands out as the sole centre in South India with an active paediatric laparoscopic urology program. We provide comprehensive transitional care for children with ongoing congenital urological issues as they grow. Additionally, we perform renal transplantation surgeries for children and regularly conduct upper and lower endourologic procedures. 

Renal Transplantation 

Renal transplantation procedures are conducted regularly, typically once or twice a week, supported by a specialized transplant ICU. Donor nephrectomies are predominantly performed laparoscopically. When deemed appropriate, renal transplantation is also extended to children. Amrita Hospital actively participates in a cadaveric multiorgan retrieval and transplantation initiative in collaboration with SORT (Society for Organ Retrieval and Transplantation), a voluntary NGO based in Kerala. 

Female Urology and Neuro-urology 

We specialize in treating women experiencing urinary incontinence and managing urinary issues in patients with neurological conditions or injuries. Our centre is equipped with "Laborie" urodynamic equipment, which significantly assists in effectively managing these patients. We provide expertise in various procedures including rectus sheath pubovaginal sling operations, TVT (Tension-free Vaginal Tape), TOT (Trans-Obturator Tape), as well as augmentation cystoplasty and continent urinary diversion procedures. Robotic or laparoscopic sacrocolpopexy procedures are performed as needed. Additionally, we undertake infrequent procedures such as urethrolysis and the removal of synthetic slings.  

Andrology 

Regularly, we conduct assessment techniques for erectile dysfunction, such as penile doppler, pharmacocavernosometry and pharmacocavernosography, alongside performing procedures like penile prosthetic implantation surgery. Additionally, we offer artificial urinary sphincter (AMS 800) insertion for severe male urinary incontinence. 

Sex Reassignment Surgery 

Also known as Gender Confirmation Surgery or Gender-Affirming Surgery, comprises a series of medical procedures undertaken by transgender and non-binary individuals to align their physical appearance and sexual characteristics with their gender identity. Led by our skilled Plastic and Reconstructive Surgery team, we address the urological aspects of this intricate process, ensuring comprehensive care and support throughout the journey. 

General Urology 

We routinely treat kidney stones, ureteral stones, bladder stones, and common urethral diseases like strictures, as well as conditions of the prostate such as cancer and enlargement. Advanced treatment options for urinary tract stones, including those in the kidney, are readily available. Our facility is equipped with the latest "Dornier Sigma" ESWL machine, ensuring highly effective stone fragmentation without the need for surgery. 

Diagnostic Tests and Procedures

Laparoscopic Urology 

  • The department is recognized as one of the apex centres in laparoscopic urology. Both laparoscopic and retroperitoneoscopic surgeries including: 
  • Laparoscopic and retroperitoneoscopic adrenalectomy 
  • Laparoscopic and retroperitoneoscopic nephrectomy and radical nephrectomy, laparoscopic nephron sparing surgeries. 
  • Laparoscopic pyeloplasty 
  • Laparoscopic radical prostatectomy 
  • Laparoscopic donor nephrectomy 

Endo Urology 

  • Ureteroscopy 
  • Flexible ureteroscopy and laser lithotripsy 
  • Transurethral Resection of the Prostate TURP 
  • Transurethral Resection of Bladder Tumour TURBT 
  • Antegrade and retrograde Endopyelotomy 

Robotic Assisted Laparoscopic Surgery 

  • Radical prostatectomy and other prostate surgeries 
  • Radical cystectomy and other bladder surgeries 
  • Retroperitoneal lymphadenectomy 
  • Adrenal surgeries 
  • Partial Nephrectomy 
  • Pyeloplasty 
  • Ureteric reimplantation 
  • Sacrocolpopexy 
  • Radical inguinal lymphadenectomy 
  • Vesico-vaginal fistula repair 

Uro-oncology 

  • Prostate Cancer 
    • Open, laparoscopic and robotic assisted radical prostatectomy 
    • Intensity Modulated Radiation Therapy (IMRT) and Conformal Radiotherapy 
    • Hormonal treatment 
    • Chemotherapy 
    • Radio isotope treatment 
  • Kidney Tumours 
    • Radical nephrectomy: open and laparoscopic 
    • Nephron sparing surgeries: open and laparoscopic. 
    • Radiofrequency Ablation (RFA) 
    • Immunotherapy 
  • Testicular Tumours 
    • Inguinal orchiectomy 
    • Retroperitoneal lymph node dissection 
    • Chemotherapy and radiotherapy 
  • Bladder Cancer 
    • Radical cystectomy and conduit 
    • Orthotopic neobladder 
    • Bladder preservation 
  • Penile Cancer 
    • Penectomy and penile reconstruction 
    • Video-assisted and open inguinal lymphadenectomy 

Reconstructive Urology  

  • Vesico-Ureteric Reflux: STING therapy, laparoscopic and open ureteric reimplantation. 
  • Urethral stricture: Perineal urethroplasty, Buccal mucosal graft urethroplasty, Trans pubic urethroplasty. 
  • Pelvi ureteric obstruction: Laparoscopic and open pyeloplasty Endopyelotomy. 

Female urology 

  • Rectus sheath/Tensor fascia lata pubovaginal sling 
  • TVT (Tension-free Vaginal Tape) 
  • TOT (Transobturator Tape) 
  • Reconstructive surgery for Vesicovaginal fistula (VVF)  
  • Uretero-vaginal fistula (UVF) 
  • Laparoscopic/robotic/open sacrocolpopexy 
  • Anterior colporrhaphy 

Andrology  

  • Pharmacocavernosography and cavernosometry 
  • Penile prosthesis implantation 
  • Penile vascular reconstruction 
  • Surgeries for Peyronie’s Disease 
  • Epididymal and Testicular sperm aspiration for in-vitro fertilisation 
  • Microscopic varicocelectomy 

Paediatric Urology  

  • Paediatric pyeloplasty: Lap/open 
  • Paediatric adrenalectomy: Lap/open 
  • PUV fulguration 
  • Ureteric reimplantation: (Laparoscopic/open) and STING surgery 
  • Hypospadias repair 

Treatments

Endourology 

  • Endoscopic treatments for stones and diseases of the kidney, ureter, bladder, prostate, and urethra 

Laparoscopic Urology 

  • Nephrectomy (kidney removal) 
  • Radical and partial nephrectomy 
  • Stone extraction 
  • Correction of hydronephrosis due to PUJ obstruction 
  • Ureteral re-implantation 
  • Laparoscopic live donor nephrectomies 
  • Laparoscopic adrenalectomies 
  • Laparoscopic radical prostatectomy for organ-confined prostatic cancer 

Urological Oncology 

  • Multimodality treatment for urological cancers 
  • Brachytherapy 
  • Conformal radiotherapy 
  • Intensity-Modulated Radiation Therapy (IMRT) 
  • Therapeutic nuclear medicine procedures 

Kidney Cancer 

  • Laparoscopic and open radical nephrectomies 
  • IVC exploration for locally extensive kidney cancers 
  • Open and laparoscopic partial nephrectomies (nephron sparing surgeries) 
  • Immunotherapy for advanced renal cancers 

Prostate Cancer 

  • TRUS-guided multicore biopsy 
  • Bone scans, PSMA PET CT scans, 1.5 and 3 Tesla MRI for staging 
  • Laparoscopic prostatectomy 
  • Conformal radiotherapy 
  • IMRT (Image Modulated Radiotherapy) 
  • Brachytherapy 

Bladder Cancer 

  • Radical cystectomy with orthotopic neobladder reconstruction 
  • Chemo-radiation following endoscopic tumour resection for bladder preservation 

Testicular Cancer 

  • Surgical removal of the testicle (orchiectomy) 
  • Retroperitoneal lymph node dissection (RPLND) 
  • Chemotherapy or radiation therapy 
  • Open or robot-assisted laparoscopic RPLND 

Adrenal Tumors 

  • Keyhole surgery (laparoscopic adrenalectomy) 
  • Retroperitoneoscopic adrenalectomy 

Penile Cancer 

  • Partial or total penectomy 
  • Radical lymph node dissection 
  • Penile reconstruction using a forearm flap 
  • Penile implants 

Pediatric Urology 

  • Surgical correction of congenital urinary tract defects (e.g., hypospadias, vesicoureteric reflux) 
  • Neonatal anesthesia and ICU support 
  • Paediatric laparoscopic urology 
  • Renal transplantation for children 
  • Upper and lower endourologic procedures 

Renal Transplantation 

  • Regular renal transplantation procedures 
  • Laparoscopic donor nephrectomies 
  • Cadaveric multiorgan retrieval and transplantation initiative in collaboration with SORT 

Female Urology and Neuro-Urology 

  • Treatment of urinary incontinence 
  • Management of urinary issues in patients with neurological conditions 
  • Rectus sheath pubovaginal sling operations 
  • TVT (Tension-free Vaginal Tape) 
  • TOT (Trans-Obturator Tape) 
  • Augmentation cystoplasty and continent urinary diversion procedures 
  • Robotic or laparoscopic sacrocolpopexy 
  • Urethrolysis and removal of synthetic slings 

Andrology 

  • Penile doppler, pharmacocavernosometry, and pharmacocavernosography 
  • Penile prosthetic implantation surgery 
  • Artificial urinary sphincter (AMS 800) insertion for severe male urinary incontinence 

Sex Reassignment Surgery 

  • Urological aspects of gender confirmation surgery 

General Urology 

  • Treatment of kidney, ureteral, and bladder stones 
  • Management of common urethral diseases (e.g., strictures) 
  • Treatment of prostate conditions (e.g., cancer, enlargement) 
  • Advanced treatment options for urinary tract stones using "Dornier Sigma" ESWL machine 

Achievements

  • Kerala’s first Centre to perform keyhole surgery to harvest right kidney for transplantation. 
  • Kerala’s first Centre to conduct retroperitoneoscopic kidney and adrenal surgeries and lymphadenectomies including harvesting kidneys on either side for transplantation. 
  • Ureteral, urethral and prostatic stents (Memokath, Allium) inserted for the first time in Kerala. 
  • Kerala’s first pelvic dysfunction clinic. 
  • Kerala’s first Robot-assisted retroperitoneoscopic lymph node dissection for testicular malignancy. 
  • We have conducted nearly 900 renal transplantations and 800 robotic surgeries including robotic renal transplantation. 
  • First in Kerala to offer BMG (Buccal mucosal graft) urethroplasty for women for treating female urethral stricture (narrowing of the urethra) 
  • Forty-five Urologists, 7 physician assistants are trained in this department. Many of them are leading Urologists and Physician Assistants in various parts of the country and abroad, several of whom are taken up Faculty positions in teaching centres. 

Doctors

Dr. K. V. Sanjeevan
Clinical Professor and Head
MS, MCh (Urology)
Dr. Appu Thomas
Emeritus Professor
MS, MCh (Urology)
Dr. Georgie Mathew
Clinical Professor
MS, MCh (Urology)
Dr. Kannan R Nair
Clinical Professor
MS, DNB, MRCS, MCh, FRCS
Dr. Rohan Rajendran
Clinical Assistant Professor
MS, MCh, DNB
Dr. Ginil Kumar P
Clinical Professor-Urooncologist and Robotic Surgeon
MS (Gen Surgery), M Ch (Urology), DNB (Urology), MNAMS (Urology)
Dr. Midhun Mohan
Clinical Assistant Professor
MS, MCh