Urinary Stone Disease : Meet Dr Laxman Prabhu

Jun 8, 2010

Dr G G Laxman Prabhu, a consultant Urologist and Prof of Urology, KMC, Mangalore, is popularly known as GG to his friends and acquaintances.   Boredom is the least trait one can expect in the company of this loquacious multi-talented doctor who has varied interests ranging from stamp and coin collection and learning music to his new found passion of trying to restore old Hindustani notations which are on the verge of destruction, apart from his own medical field.  A voracious reader GG is a bundle of knowledge on a variety of topics in addition to his specialized topic of Urology. 

While his other interests may require a separate write up to give the readers a glimpse of his multifarious talents in this interview with daijiworld.com he deals with everything that has got to do with Urinary Stone Disease, which is unfortunately on the rise in the last few decades.  Urinary stone disease is one amongst the many diseases that causes harm to the kidneys inflicting irreversible damage if neglected, says Dr Laxman Prabhu.

Q.  How old is the Urinary Stone Disease which in common parlance people call it as Kidney stones?

A.  This disease is as old as the mankind.  Several ancient scriptures speak about Ashmari Roga (Sanskrit word for stone disease).  Scientists have found evidence of kidney stones in a 7,000-year-old Egyptian mummy. In the Hippocratic oath taken by every doctor, there is a mention of stone surgery which says “I shall not cut for stone but leave it to those proficient in the art”, which tells us that the disease was prevalent  in those days. 

Q.  How common is the disease in our country?

A.  In general urology practice every 6 persons out of 10 (60%) have stone and unfortunately the disease has been witnessing an upward trend with more and more people becoming prone to the disease.  This is also regarded as the disease of the affluent.  We have to understand that the increase in the incidents of stone disease is due to better awareness and availability of proper diagnosis which helps in getting the right statistics and also because more people are becoming susceptible to it.    Interestingly, in India there is a preponderance of stones among people in the northern parts of the country than in the south.  Sometimes certain types of stones are found among people of certain states.  For example in Rajasthan Calcium Oxalate Dihydrate is very common where as in its cousin state Gujarath Calcium Oxlate Monohydrate is the common type of urinary stone. 

There are basically 4  types of stones  of urinary stones  commonly found among most people namely  Calcium Oxalate (calcium stone) which  is the most commonest of the urinary stones followed by Uric  Phosphatic stones, Uric acid stones and infection stones )strevite stones).  Occasionally we also come across Cystine stones which are usually big in size. 

Q.  What causes the formation of stones in human beings?

A.  Whenever a patient asks this question normally doctors advice them not to worry about such minutiae details because it is too complicated to understand. But it is necessary for people to understand the genesis of urinary stones so that they identify the symptoms.  Stone is a mass of precipitated material derived from the urine and are caused due to any of the reasons  namely:

 a. excessive precipitable material appearing in the urine resulting from intake of such material in huge quantities in the form of diet of increased production in the body.

b. Not having adequate water to hold the precipitable material in solution without occurrence of crystallization

c. Reaction of the urine when urine becomes acidic or alkaline which is called pH in scientific terminology.

d. Lack of substances called inhibitors within the body that discourage stone formation, thus creating a conducive atmosphere for stone formation

e. Stagnation of urine in the urinary tract due to anatomic impediments in the urinary tract

f. Epitaxy wherein two crystals of different chemical composition but with similar surfaces tend to cling to each other eventually forming a stone. 

In fact the entire process of stone formation can be compared to a badly managed classroom that comprises mischievous, dullards and boisterous students.  The dullards and boisterous usually cling on to each other.  The mischievous do not allow the rest to concentrate on the lessons.  In the absence of a competent teacher handing these boys becomes impossible (lack of inhibitor substance).  Finally examinations are like blocks that make these students stagnate in the same class.

Q.  What are the implications of urinary stones and how to detect them?

A. Stones can cause damage to kidneys which is brought about by blocking urinary passage resulting in infection.  A small percentage of stones can cause varying degrees of loss of kidney function which can be sudden when two stones block both the ureters completely or gradually.  aThere are basically two types of stones namely Speaking stones which speak (not literally)   by causing pain and Silent stones which cause silent but maximum damage.   That is why annual check up is a must for those who have a tendency to form stones.  In most cases stones results in pain, some people will feel irritation while urinating, fever and some stones may announce their presence by blood-tinged urine, which in medical term is know as haematuria.

Q How to diagnose the disease and what are the commonly available treatments modalities?

A.  Search is on for a 100% foolproof test but 90% of the cases can be detected by ultrasound which can also be supplemented by X rays and C T scan.  As for the treatment part there are basically 3 types of interventions commonly practiced namely, Surgery, Endoscopy and Shock Wave Lithotripsy.  But it has to be remembered that every case is different and treatment may also differ accordingly, just like the saying which goes “one man’s food is another’s poison”.    

These days with advanced surgical techniques, availability of antimicrobials to combat infections, safe and efficient anesthesia and imaging methods of high resolutions, stone surgery is effective and safe and it has stood the test of time. 

Endoscopic treatment is done through a telescopic instrument which also involves keyhole surgery, is also used to treat urinary stones in many patients.  In this procedure all manipulations are carried out through natural bodily openings or through a small incision or hole which is known as key-hole surgery.  Telescopic instruments are used to break the stone into smaller fragments before their final retrieval. 

Extracorporeal shock wave lithotripsy known by the popular acronym E S W L is the most fascinating technology developed recently in treating urinary stones.  It is a non-operative method of treating stones and the success rate is high with less complications.  In this procedure the stones are broken from outside through shock waves.   The machine can only fragment the stone and it is for the urinary track to expel it totally leaving everything to the mercy of nature after fragmentation. 

Q.   What are the chances of recurrence of urinary stones even after treatment?

A. Even after successful treatment there is a 40% chance of recurrence among people having a tendency to form stones, which in other words means that the disease cannot be eradicated completely.  It tantamount to saying that the logic of ‘prevention is better than cure” does not apply in this case.  Prevention is no doubt better but difficult in this disease.  However certain preventive measures can be adopted to keep the stone disease at check, such as by increasing water intake, cutting down high protein diet, promptly treating infections, correcting any structural abnormalities etc., which can help contain the disease to a certain extent.  These days there are some medicines which are available to curb the tendency of stone formation. 

Q. Is it true that men are more susceptible to stone diseases as compared to women?

A.  It is true men are slightly more prone to the disease as compared to women because certain hormones present in female body offer some kind of protection to them. 

Q.  What is the common misconception people harbor about urinary stones?

A.   Generally people expect even the minutest gravel to come out after the treatment.  This is not required once the big stone is treated.  Normally doctors adopt a three tier approach of patient first, kidney second and stone third.  If the doctor suggests no intervention is needed it is better to leave the stone as it is.   At the same time if removing every piece of gravel is going to harm the kidney, doctors just leave it at that as total destoning is not possible.   People have to understand that even with all the latest gadgets and availability of drugs it is still not possible to clear all the stones in all the patients all the time. Therefore patients should not think otherwise if small gravels recur or remain.

Q.  Are there any alternative treatments available for stone diseases?

A. Alternative treatment called phyto-therapy is available but there is no clear-cut proof of its utility as it is not time tested or is scientifically based.  Recently British Journal of Urology has made a mention of banana stem juice as a possible treatment for the urinary stones. 


Contact Dr Laxman Prabhu:

Cell: 0091 - 9845428532
For Appointments (Clinic) : 0091 - 824-2433506 (After 11.00am, IST)
Email : gglaxman@gmail.com

 

by Florine Roche - Daijiworld Media Network
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Comment on this article

  • Mubeena , Honavar

    Tue, Aug 02 2016

    Hello sir, My son 12 years old went through CT scan doctor said that his left side kidney vein which should be above the kidney has gone from below the kidney and he cant be operated until unless he gets pain. Can you please suggest what is it due to and what precautions need to be taken. Earlier he had blood in urine it ws fresh thn he ws hospitalized and after ultrasound doctor said its kidney stone now in another ultrasound and in CT scan no stone.

  • Raben, 6JVbmjQnG

    Tue, Jul 14 2015

    Thanks Rick,We try to accommodate our users wsehis. I'm glad that you will be able to tell his story.After talking with you on the phone it became quite apparent that his story should not be forgotten. There are thousands of other people with stories just as awesome as his and at GraveDATA we will see to it that The Story Behind the Stone is recorded for future generations.Rob Teed

  • Neelanjali, Bangalore

    Thu, Jan 15 2015

    sir thank u for suggesting us about our future as i was interested in musicotherapy and i had a wrong notion that there is no scope for it in future but u changed my mind and now i have fixed my mind for doing it and your words are truly inspirational thank you so much sir

  • Ramesh Nayak, Mangalore

    Tue, Jan 06 2015

    V. Good Doctor. He treated me in 2009-10. Takes care of the patient and not running after money. God bless him.

  • prabu, rayalaseema

    Sat, Oct 15 2011

    See kindney stones are all normal....drink beer everyday it will come out!!

  • Kusuma , Nellore/Kodyadka

    Fri, Nov 05 2010

    He is hreat doctor, Very caring and always of helping nature I love this DOctor for his professional care. hes the gretaest all of Urologists not in Managlore but in whole of wouth india I feel

  • K Mahesh kamath, Bangalore

    Mon, Aug 09 2010

    Glad to hear about both my friends.Please see me on face book.

  • sadashiv, puttur

    Mon, Jun 28 2010

    Sir.. I am having 19 mm kidney stone in the middle ureter. How can I go for treatment.Plz suggest

  • preethi pinto, mangalore/abudhabi

    Sat, Jun 12 2010

    Its great to read the article & view your snaps Dr.Laxman Prabhu. it reminded my olden days that is 11yrs back i was assisting Dr prabhu in operation theatre in Athena Hospital. I was working as a staff nurse. He is gem of a person & a excellent doctor.

  • ADNAN, BHATKAL/ DUBAI

    Sat, Jun 12 2010

    Thanks to Dr.Prabhu who carried out my key hole surgery successfully.He is the best available doctor in the town at present.

  • Joyce Sequeira, Mangalore

    Sat, Jun 12 2010

    Nice article. Really Dr. Laxman Prabhu is an excellent Urologist I have ever come across. His friendly nature makes his patients comfortable in his presence. I had this experience two years back when I had a surgery and was lucky enough to be treated by him. I wish good luck and God's blessings on him. Keep up the good work and all the best dear doctor.

  • Imtiyaz Ahamed, Shiruru

    Sat, Jun 12 2010

    Dr.Luxman Prabhu, really great personality. A huge responsible job in this age is really respectful. Gives satisfactory advices while treatment and very strict in operation theatre. Wow a really Gentleman Doctor. I pry that May Almighty Allah give him a longest life so that we all can take more help from this great doctor.

  • harish shenoy, mangalore/ajman

    Fri, Jun 11 2010

    DR.GGLP IS THE BEST UROLOGIST I HAVE SEEN ,&ONE OF THE BEST DOCTORS IN KMC MANGALORE.
    HARISH EX LAB TECHNICIAN UMC.

  • Helen Lobo, Kemmannu -Qatar

    Fri, Jun 11 2010

    thanks Dr GG, nice to read this article, 15 yrs ago i work with U as a nursing student in urology out patient clinic in manipal KMCH ,u r a Dr along with good teacher, God bless u live long.....

  • rajesh, mangalore/dubai

    Fri, Jun 11 2010

    Dr.Laxman prabhu is a fantastic human being with a great sense of humor..i worked with him in university medical centre operation theatre.when he enters theatre whole atmosphere will become lively..he is very spontanious..i still remember some of his jokes..and as a professional i dnt have to explain anything..his name and fame speaks evrything.

  • Agnel Pinto, Mangalore/ Dubai

    Thu, Jun 10 2010

    Dr. Laxman Prabhu will never get you bored. I got operated by him just last month. He can talk on different topics. I remember he went on talking all through the procedure. He does not make you feel you are a patient. Good we have doctors like him in M'lore. Thank you Doctor!!!

  • Gladys Laura Mudarth, Mangalore/Canada

    Thu, Jun 10 2010

    Ten years back when I was settling in Mangalore I was told not to,in a place where Doctors and Lawyers are doing well. People I have met in the train who come from Goa in the North to Trivandrum in the South for Doc Laxman Prabhu. I hope to meet him in September. I am supposed to have met him 5
    years back. In March I just missed him. Hope God keeps me safe from Volcanic ash travel and mangalore plane crash.

  • Rammohan, Puttur

    Wed, Jun 09 2010

    Nice to read the article, as many may not know personality of the multifaceted doctor,unless one comes into contact with him. His handling patients with problems is excellent

  • grace pinto,

    Wed, Jun 09 2010

    Sometimes all one needs is a chat with this doctor and you return fully cured!!

  • Dr.Ananth pai, udupi, abudhabi

    Wed, Jun 09 2010

    Hi GG,my association with you as a colleague doctor, friend and relative will be for ever. You are a wonderful human being, exceptional doctor.Very informative article. God bless you and family. Shall see you in August

  • Kusuma Kumari, Nellore/Kodyadka

    Wed, Jun 09 2010

    Dr Laxman Prabhu is a very good honest enthusiastic doctor who is also very skilled and prorfesional

  • Aadil Khan, Kasaragod/Saudi Arabia

    Wed, Jun 09 2010

    Dr. Prabhu, a part from being an emininet physcian, is also a good narrator about the patient's desease in details. His consalation words give great relief to the worried patient when he or she visits him. I had an opportunity too to consult him and he is an undisupted uroligist in the town. God bless him.

  • Concepta Fernandes Alva, Mangalore

    Wed, Jun 09 2010

    Concepta Fernandes Alva
    Dr. G.G. Laxman Prabhu is a wonderful person, great orator,prolific author, music enthusiast apart from being a succesful urologist. I have had the pleasure of interviewing, recording and broadcasting him for several years at All India Radio, Mangalore on varied topics. We at AIR would look forward to GG's visit for that fresh breath if air & humour. Thank you Daiji for featuring a cherished friend. Good job Florine.
    Concepta Fernandes, Programme utive, AIR, Mangalore.

  • Dheeraj, Mangalore

    Wed, Jun 09 2010

    It’s really true that Dr.G.G.Laxman Prabhu is one of the best Urologists in Mangalore. He treats all his patients with lots of love and care. He has treated me and given me a new life.
    Thank you doctor and wish you 1000 years of good life.

  • Bhat, Mangalore

    Tue, Jun 08 2010

    Herbal medicine provided by a gentleman in Narasipura in Shimoga district has worked for many for kidney stones.

  • mohan bhat b, Field Street,Mangalore

    Tue, Jun 08 2010

    A doctor par excellence. A good summaritan.Humble and good human being. I stay just opposite to his house at Field Street,Mayamaya Temple Rooad,Mangalore

  • Ramesh Baliga, Mangalore/Mangalore

    Tue, Jun 08 2010

    Dr.Prabhu has treated me...sir you are simply wonderful.. i take this opportunity to thank you for treating me and making me healthy within a very short time.

  • Edwin JF DSouza, Mangalore, Highlands

    Tue, Jun 08 2010

    A very good Doctor, Counsellor, friend, philatelist,humorist Rotarian and more than everything else - a good human being. Bless you GG
    -Rtn.Edwin JF, RC Mangalore

  • Arjun, India

    Tue, Jun 08 2010

    Serving banana stem juice and eating banana stem slightly cooked helps in breaking down kidney stone is a common knowledge..there hasn't been a scientific study on these. Good to know that the British journal of urology made a mention of it. There are many traditional healing knowledge that when explored by scientific world can help cure many diseases faced by mankind!

  • helen dsa, mangalore/uk

    Tue, Jun 08 2010

    mr.laxman prabhu, is well known to me,i have worked with him as a nurse for six years. he is the one who taught me the basics of urology.today i am here,i dont have to write more about that.mr.prabhu is a very very famous urologist in mangalore city. if u just get down in mangalore and ask any person they would show u his clinic ,because mangaloreans are very helpful,trustworthy people.good luck to u.

  • DR Ajay Ramachandran, Mangalore /Surathkal/Birmingham ,UK

    Tue, Jun 08 2010

    I have known Laxman Prabhu from KMC days at Mangalore and Manipal although I have now not met him for several years. As an Anaesthetist at KMC MANIPAL I had the opportunity to work with him with both of us at different ends of the patient but I can never forget his down to earth attitude and the way he used to talk on various topics and used to keep us all in good humour. A session with GG made my day. I enjoyed reading his article and mind you...he looks exactly the same after 17 years! Hoping to meet him during my next KUDLA trip.Ashok Pandit and Laxman Prabhu were both at Manipal during my time there and it was a pleasure working with them.

  • Gurudath, Mangalore/Mumbai

    Tue, Jun 08 2010

    Hi GG glad to read this article. I am proud of you.

    Gurudath

  • syed younus, bhatkal/dubai

    Tue, Jun 08 2010

    thanks to Dr prabhu who carried out my kidney operation successfully in june 2002,

  • yjnaneshwara rao, mangalore

    Tue, Jun 08 2010

    Dr.Laxman Prabhu is one of the best Urologist in the town.His way of interaction with the patient and analysing the problem is really excellent.In my opinion there are only few such Doctors who makes the patient feel free from any tension about the disease with his advice and guidance.I wish him all the sucess in his future endeavours.

  • leny d costa, mangalore

    Tue, Jun 08 2010

    thanks to dr.G.G.Laxman prabhu for his simple and good expanination,He is a person simple,humble, gentle, caring, helpful and good knowledge doctor.
    i ever come across.almighty god always bless him

  • Hanik, Mangalore

    Tue, Jun 08 2010

    He is more a social worker than a doctor, an active rotarian. God bless!

  • Thomas Valder, Bahrain

    Tue, Jun 08 2010

    Dr. Prabhu is a wonderful doctor. I had a Kidney problem & Dr. Ashok Pandit (another gem of a doctor in Mangala Kidney Foundation) alongwith Dr. Prabhu had very successfully did nephrectomy & now I am living a very normal life. Thanks Dr. Ashok Pandit, Dr. Laxman Prabhu & Dr. Ganpat as well. Long live these wonderful Doctors. Thanks 'Daiji' for unearthing gem of Mangalore for public knowledge.

  • viola, mangalore/kuwait

    Tue, Jun 08 2010

    yes Dr.Laxman Prabhu is one of the best urologist .......and a person who cheers everyone even in his busy schedule .......wishing him sucess in all his endeavours ...

  • Kavitha, Mangalore

    Tue, Jun 08 2010

    Dr.G.G.Laxman Prabhu is one of the best Urologist . A person with a simple get up but with infinite knowledge and above all treats his patients with lots of love and affection..... Long live Doctor....

  • harsha, mangalore

    Tue, Jun 08 2010

    Dr G G Lakshman Prabhu is not only the best Doctor in town, he belongs to the rare tribe of doctors who empathise with their patients. He is an asset to KMC. He has a good stamp collection

  • hakeem, Abu Dhabi

    Tue, Jun 08 2010

    Dr.GG clinic near Athena Hospital mangalore.

  • ABdul Samad, MNG/DXB

    Tue, Jun 08 2010

    Dr G G Laxman Prabhu is one of the best Urologist in the town.

  • Ahmed, Mangalore/Saudi

    Tue, Jun 08 2010

    Nice to see the article.I would like to visit his place. I am patient too.If someone known the place where he locate please guide me.
    Thanks daiji.

  • seby, Goa

    Tue, Jun 08 2010

    Thankes to Dr. L prabhu for the wounderful explanation as i did go under a key hole procegers and regarding the banana stem was known along back & lots of other commen leaves are also available

  • Pradeep Shenoy, Mangalore/San Francisco

    Mon, Jun 07 2010

    Hello GG,

    Good to see you after nearly 30 years and read your article.

    Your classmate at CHS & CJC - Pradeep


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