Pune: Doctors at Sassoon General Hospital (SGH) have successfully performed a rare life-saving laser surgery on an eight-month-old boy suffering from a serious urinary tract obstruction. The baby was born with a birth defect that later developed into renal failure, said hospital officials on Wednesday.
According to the officials, the baby, a resident of Beed, was admitted to the hospital on June 29 with complaints of fever, difficulty in passing urine, dribbling micturition (involuntary loss of urine immediately after finishing urination) and pyuria (presence of a large number of white blood cells, also known as pus cells, in the urine).
According to SGH doctors, the child was diagnosed with a kidney problem early on, but the family delayed seeking treatment. By the time he was brought to Sassoon for admission, the infant had already developed early renal failure, urinary infection and hypertension.
Following initial management of infection, detailed investigations at the hospital revealed an obstructing membrane within the urethra - a condition known as posterior urethral valve (PUV). This obstruction had led to severe back pressure on the kidneys, vesico-ureteric reflux (urine abnormally flowing in the reverse direction) on the left side, and poor functioning of one kidney.
After stabilising the patient, on 28 July, a team led by Dr Dasmit Singh Khokar and Dr Minakshi Nalbale-Bhosale, head of Paediatric Surgery, conducted a laser fulguration (a medical procedure that uses laser energy to destroy abnormal tissue) of the posterior urethral valve (a rare birth defect in boys that involves extra tissue in the urethra, blocking urine flow from the bladder) to remove the obstruction from the valve located within the urethra (the tube that carries urine from the bladder out of the body).
{{/usCountry}}After stabilising the patient, on 28 July, a team led by Dr Dasmit Singh Khokar and Dr Minakshi Nalbale-Bhosale, head of Paediatric Surgery, conducted a laser fulguration (a medical procedure that uses laser energy to destroy abnormal tissue) of the posterior urethral valve (a rare birth defect in boys that involves extra tissue in the urethra, blocking urine flow from the bladder) to remove the obstruction from the valve located within the urethra (the tube that carries urine from the bladder out of the body).
{{/usCountry}}Post surgery, which took between 30-40 minutes, the baby is doing well and will be discharged soon, stated a statement released on Wednesday by the hospital authorities.
Speaking to HT, Dr Minakshi Nalbale-Bhosale said, “With the addition of Holmium Laser, our capabilities have increased manifold. We can now treat children with complex urological conditions like posterior urethral valves, ureterocele and urinary stones endoscopically without taking an incision.”
The machine, Holmium Laser (Litho EVO), was recently donated by Rotary Club of Pune Heritage to the Paediatric Surgery Department at Sassoon Hospital. The machine cost 25 lakhs.
On the success rate of this procedure in general, she said a 5-10 year survival rate after the surgery is 80-90%, but few of these babies (10-20%) tend to develop end-stage renal failure requiring renal transplantation during adolescence or adult life. Hence, every attempt must be made to treat/clear/remove the obstruction in urethra early in the most efficient way to prevent/delay renal failure and requirement of renal transplant, she added.
Dr Eknath Pawar, Dean of B.J. Medical College (BJMC) and SGH said, “Doctors from the newly established Paediatric Surgery Department at Sassoon are regularly performing complex and critical surgeries on children successfully. The hospital administration is trying to provide better quality infrastructure to them. The addition of the laser machine is serving as a useful adjunct to their armamentarium.”