Urological disorders are becoming increasingly common due to changing lifestyles and increasing life expectancy, along with a higher rate of diagnosis due to growing awareness among patients.
Conditions affecting kidneys, bladder, prostate and the male reproductive system can adversely impact quality of life if not diagnosed and treated in time. However, advancements in medical technology and minimally invasive procedures have transformed the way urological diseases are being managed today. Dr Varun Mittal, urology consultant, talks to Manav Mander about advancements in urology care.
What are the latest recommendations for early detection and screening of prostate cancer, especially in high-risk groups?
Prostate cancer is one of the most common cancers affecting men worldwide. Early detection remains the cornerstone of successful treatment. Men aged above 50 should discuss prostate cancer screening with their healthcare provider. However, individuals at higher risk, such as those with a family history of the disease or certain genetic predispositions, should consider screening at the age of 45, or even earlier. Screening typically involves a prostate-specific antigen (PSA) blood test and digital rectal examination (DRE). Recent advancements, such as multi-parametric MRI and targeted prostate biopsy, have significantly improved accuracy of diagnostics and reduced unnecessary procedures.
With rising cases of kidney stones, what treatments are most effective today?
The incidence of kidney stones has increased dramatically, largely due to inadequate water intake, change in dietary habits, obesity and sedentary lifestyles. Today, most kidney stones can be treated without major surgical incision. Modern, minimally invasive options include laser-assisted ureteroscopy (URS) for stones in the ureter and kidney, retrograde intrarenal surgery (RIRS) using flexible scopes to treat stones through natural urinary passages, percutaneous nephrolithotomy (PCNL) and mini-PCNL for larger stones, and extracorporeal shock wave lithotripsy (ESWL) for selected patients. The procedures offer shorter hospital stays, less pain and faster recovery compared to traditional surgery.
How do you approach recurring urinary tract infections and bladder dysfunction in patients with lifestyle-related risk factors?
Recurrent urinary tract infections (UTIs) are being increasingly seen in patients with diabetes, obesity, inadequate hydration and sedentary lifestyles. Management of the infection requires identifying and treating the underlying cause, rather than repeatedly prescribing antibiotics. Patients may require detailed urine investigations and imaging studies, assessment for bladder emptying problems, blood sugar control in case of diabetes and lifestyle modifications — including adequate hydration and proper hygiene.
What are the best practices for managing benign prostatic hyperplasia without major surgery?
Benign prostatic hyperplasia (BPH), or enlargement of the prostate gland, affects a lot of ageing men and often leads to urinary symptoms, such as poor flow, frequent urination and incomplete bladder emptying. Management today involves personalised treatment, which includes lifestyle modifications and fluid management, medications that relax the prostate or reduce its size, endoscopic procedures — such as laser prostate surgery and bipolar TURP. The minimally invasive treatments offer excellent outcomes while minimising bleeding, hospitalisation and recovery time.
How is treatment evolving for kidney and bladder cancers?
Advances in cancer treatment have dramatically improved outcomes for patients with kidney and bladder cancers. For kidney tumours, the emphasis has shifted towards nephron-sparing surgery, where the tumour is removed while preserving healthy kidney tissue whenever possible.
In bladder cancer, early-stage tumours can often be treated endoscopically without external incision.
Why does tobacco increase the risk of bladder cancer?
Many people are aware of the link between smoking and lung cancer, but few realise tobacco is one of the strongest risk factors for bladder cancer. Harmful chemicals from tobacco enter the bloodstream and are filtered by the kidneys into the urine. These carcinogens remain in contact with the bladder lining, substantially increasing cancer risks. Studies indicate risk of bladder cancer increases multifold among smokers. Encouraging tobacco cessation is one of the most effective preventive measures in urology.
What has been the impact of robotic tech in urology?
The future of urology is being shaped by robotics, artificial intelligence, precision medicine and advanced imaging technologies. Robot-assisted surgery is transforming complex urological procedures by offering enhanced precision, better visualisation, improved surgical dexterity, reduced blood loss and faster recovery.
In the coming years, we expect greater integration of artificial intelligence for diagnosis, image-guided surgery, personalised treatment and predictive healthcare models. Advances in molecular diagnostics and targeted therapies will further improve outcomes while minimising side effects.
How do diet, hydration, and stress influence urological health, and what preventive measures do you recommend?
Many urological conditions can be prevented or delayed through healthy lifestyle choices. Key recommendations are: drink adequate water, maintain healthy body weight, reduce salt and processed food intake, avoid tobacco, limit alcohol consumption, exercise regularly, and manage diabetes, hypertension and metabolic disorders effectively. People should seek prompt medical attention for urinary symptoms.
Stress management is equally important as chronic stress can worsen urinary symptoms and adversely impact sexual and reproductive health.
