Urology

The best treatment for a kidney stone depends on its size, location, composition, and whether it is causing obstruction or infection. Small ureteric stones (<5 mm) often pass spontaneously with hydration and an alpha-blocker (tamsulosin). Larger ureteric stones are treated with ureteroscopy (URS) and laser lithotripsy. Kidney stones up to 2 cm are managed with RIRS (flexible ureteroscopy with MOSES 2.0 laser) — a scarless, day-care procedure. Stones >2 cm or staghorn calculi require PCNL. At SRM Prime Hospital, we have Tamil Nadu's MOSES 2.0 laser platform — delivering the most advanced stone fragmentation available, with superior stone clearance rates and minimal patient discomfort.

No. Mild to moderate BPH symptoms are initially managed medically — with alpha-blockers (tamsulosin) to relax the prostate smooth muscle and improve flow, and 5-alpha reductase inhibitors (finasteride) to reduce prostate volume. Combination therapy and mirabegron for overactive bladder symptoms are also used. Surgery is recommended when symptoms are severe (IPSS >20), when medical treatment fails, or when complications develop — such as acute urinary retention, recurrent UTI, bladder stones, or hydronephrosis. At SRM Prime Hospital, we offer MOSES 2.0 HoLEP (the most advanced laser prostate surgery) and bipolar TURP — both highly effective with durable results.

BPH (benign prostatic hyperplasia) is a non-cancerous enlargement of the prostate that causes urinary symptoms — it does not spread or become cancer. Prostate cancer is a malignant tumour of the prostate that can spread to lymph nodes and bone if not treated. The two conditions can coexist. A PSA blood test and digital rectal examination are the initial screening tools — but a definitive diagnosis of prostate cancer requires a prostate biopsy. Elevated PSA can occur in both BPH and prostate cancer — the decision to biopsy is guided by PSA level, PSA density, PSA velocity, and multiparametric MRI (mpMRI) findings.

RIRS (Retrograde Intrarenal Surgery) uses a flexible ureteroscope passed through the natural urinary passage (no skin incision) to reach kidney stones directly and fragment them with a laser (MOSES 2.0 or Holmium) to dust. It is ideal for kidney stones up to 2 cm, hard stones not amenable to ESWL, and patients with anatomical variations. PCNL (Percutaneous Nephrolithotomy) uses a small skin incision to access the kidney directly — it is preferred for large stones (>2 cm), staghorn calculi, and when RIRS would require multiple sessions. The choice depends on stone burden, location, hardness, and patient factors — your urologist will recommend the optimal approach.

Any visible blood in the urine (frank haematuria) should be investigated urgently, even if it occurs only once and resolves spontaneously. It is a cardinal symptom of bladder cancer, kidney tumours, and kidney stones. Significant microscopic haematuria (≥3 red blood cells per high-power field on microscopy) in adults over 40 also warrants evaluation. Investigations include urine cytology, flexible cystoscopy, CT urogram, and PSA. Do not assume painless haematuria is due to a UTI — haematuria in the absence of UTI symptoms should always prompt specialist urological assessment.

Yes. SRM Prime Hospital has a fully functional renal transplant programme led by Prof. Dr. R. Manikandan, who has personally performed over 400 kidney transplants. We perform living-related and living-unrelated donor transplants, as well as cadaveric (deceased donor) transplants through the Tamil Nadu TRANSTAN network. Our programme covers the complete transplant pathway — from pre-transplant evaluation (cross-match, HLA typing, donor and recipient workup) through laparoscopic donor nephrectomy, recipient transplantation, and long-term immunosuppression management.

Yes. Prof. Dr. R. Manikandan is a fellowship-trained robotic uro-oncologist (USA) with over 500 robotic surgeries to his credit. Robotic-assisted procedures available include radical prostatectomy (for prostate cancer), partial nephrectomy (kidney tumour — nephron-sparing), radical nephrectomy (large renal tumours), radical cystectomy with urinary diversion (bladder cancer), and pyeloplasty (UPJ obstruction). Robotic surgery offers superior visualisation, precision, and dexterity in confined pelvic and retroperitoneal spaces — translating into reduced blood loss, nerve sparing, and faster recovery.

MOSES 2.0 (Modulated Optimised Energy System) is the most advanced Holmium laser platform for urological surgery — available at SRM Prime Hospital as Tamil Nadu's first. It delivers laser energy in a modulated, pulse-modulated waveform that significantly reduces retropulsion during stone fragmentation (meaning stones don't bounce away from the laser fibre) and minimises bleeding during HoLEP prostate surgery. For stone patients, MOSES 2.0 means superior stone fragmentation to fine dust (reduced re-treatment rate), shorter operating time, and better stone-free rates at a single session. For BPH patients, it enables safe HoLEP on large prostates (>100 ml) with minimal bleeding, early catheter removal (24–48 hours), and rapid return of normal voiding.