Ludhiana, February 23
Dr Sanjay Kulkarni, Professor of Urology at BJ Medical College and a renowned reconstructive urologist at Pune, feels that all technically advanced treatments are required more by the poor who cannot afford long recovery periods associated with major surgeries.
But unfortunately in India, the infrastructure required for setting up such facilities are very expensive and laproscopic surgeries are not being performed on the poor to the extent these should .
Dr Kulkarni was in the city to attend a three-day conference on laproscopic surgery. One of the leading urologists of India, Dr Kulkarni performs about 100 urethrotomy endoscopic procedures and 10 surgeries of bladder a year.
Talking to Ludhiana
Tribune, he said that an incident changed his perspective on the treatment. "I performed a surgery on 75- year- old cancer patient. That was one of my initial surgeries. The patient's family had to sell their house . Unfortunately, the patient died 10 days post surgery. His wife abused me for making them homeless and penniless, as she did not have the money to support her young grand daughters".
Dr Kulkarni said that urologists world over were trying to achieve success in the field of radical cystomy to treat prostate cancer.
The expert further added that India had the best surgeons in the world and they had vast experience in treating a number of variety of diseases. "The only drawback is that Indian institutes lack at the infrastructure level. There is a need of joint effort by doctors, institutes, government and systems to project the medical calibre of our people internationally", he said.
Dr Kulkarni gave a guest lecture on 'Urethral injury and treatment' at Christian Medical College and Hospital here yesterday.
He said that urethral injury following road traffic accidents was the common cause for urethral stricture -a disease causing narrowing of urethra. Infection and instrumentation were other causes of urethral stricture.
The stricture, if short ,could be effectively treated by endoscopic procedures. These strictures could recur and could be managed by open operation where the scar tissue was excised and normal segments of the urethra stitched together.
If the urethral stricture was long, several reconstructive procedures were available to fashion out a new urethra to replace the diseased one, said Dr Kulkarni.
During his interaction with the faculty and medical students at CMCH, Dr Kulkarni highlighted the use of bowel segments for reconstruction of urinary bladder after removal of the bladder for locally advanced cancer of urinary bladder.
After surgical removal of the bladder, 45 cm of the small bowel was used to fashion out a new bladder and this was connected to the urethra and the ureter coming from the kidney.
The patients who received the neo-bladder were usually happy with the surgical results. The neo-bladder enabled patients with bladder cancer to live without an external urine collection bag.
