29 October 2019, Pune- The correct diagnosis and the chosen treatment by a doctor is the most crucial phases in a person’s successful treatment and recovery and require expertise along with technologically advanced hospital.
A recent case at the Columbia Asia Hospital, Sarjapur Road, Bengaluru highlighted this. A 57-year-old retired professional, Mr. Mohan Rao from Hyderabad visited the hospital after facing disappointments for treatment. Since three years the patient was suffering from symptoms of bleeding in urine and abdominal pain. Not just that, he also had diabetes mellitus, chronic obstructive pulmonary disease, and ischemic heart disease. Due to continued bleeding, the patient had developed Anaemia & heart failure risk. Day by day, his clinical conditions were worsening.
“One issue was that the patient was critical and he was rejected for surgery at other private hospitals for his associated co-morbid conditions. He even resorted for alternative modalities like radiotherapy, and chemotherapy none of which helped him. Additionally, the bleeding started and there was also a bit of cardiac-ailment which is why most doctors didn’t recommend any surgery,” informed Dr. Manohar B, Senior Consultant Urologist and Renal Transplant Surgeon at Columbia Asia Hospital, Sarjapur Road.
The patient also had a tumor in his bladder. From being a small tumor, it had progressed to the whole bladder. With such vast tumor and cardiac condition, most doctors did not recommend surgery for him. This further postponed his treatment and worsened his condition.
Dr. Manohar decided to send a part of the tissue for histopathology examination which revealed that the patient had superficial low grade-transitional cell carcinoma. Looking at the wide spread bladder tumor almost everyone is likely to opt for a radical cystectomy. However, Dr. Manohar chose laser operation as a treatment of choice.
“Most doctors that the patient visited thought the tumor to be after high-grade which is why they suggested him radical cystectomy. But for a major surgery like that, Rao was not fit and hence was not treated,” added the doctor. The misdiagnosis of Rao’s tumour deprived him of the right treatment and increased his health problem.
“For such low-grade tumors, laser fulguration is the treatment of choice. The laser is also better for such vast tumors. Radical cystectomy can be avoided. It was only with the help of laser that I and my team could successfully perform this surgery without any complications,” said Dr. Manohar.
The procedure was performed in spite of the patient being on blood thinners. Even after being on anticoagulants the procedure was uneventful because of the use of laser and could successfully preserve the bladder.
Since it was a minimally invasive surgery, the patient was discharged the same day and relook surgery (cystoscopy) was done after 3 months. The patient has been completely free of tumor post- surgery.
“It was because we had the laser treatment available in our hospital, we could attempt this and it turned out to be a blessing in disguise and beneficial for the patient,” said the doctor highlighting benefits of laser for these urology procedures.
We have very advanced laser treatments available at the hospital which we frequently use so that the morbidity and mortality procedures are less and the patient can be treated better. The advanced diagnostic facilities at Columbia revealed the problem correctly and facilitated the right treatment.