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Ramesh HospitalsRamesh Hospitals

Dr Mayank Mohan Agrawal

Speciality / Department
Senior consultant and head, Urologist
Qualification
MBBS, MS – Maulana azad medical college, New Delhi, India
MCh (urol) – Post Graduate Institute of Medical Education and Research, Chandigarh, India
additional :
DNB – National board of examinations, New Delhi
MRCS – Royal College of Surgeons of Edinburgh
fellowships –
Varoon Mahajan Memorial Foundation fellowship – Memorial Sloan Kettering Cancer Center, New York, USA
Indian American Urological Association fellowship
University of California, Los Angeles, USA
Wakeforest University Baptist Medical Center, Winston Salem, USA
Areas of interest
Advanced urological laparoscopy, Uro-oncology, Uro-gynecology, Neuro-urology and urodynamics, Endourology, urethral reconstruction
Work experience
2014-2017 : Consultant & head of urology, NMC specialty hospital, Abu Dhabi
2013-2014 : Specialist urology, NMC specialty hospital, Abu Dhabi
2011-2013 : Associate professor of urology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
2005-2013 : Assistant professor of urology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
Highlights
Clinical –
Developed (with MCh residents and colleagues) –
1. a novel continent cutaneous urinary diversion technique (eponymed PGIMER pouch)
2. validated indian population-specific uroflow nomograms for men and women (eponymed PGIMER nomograms)
3. validated concept of flow volume index for interpretation of uroflowmetry (similar to concept of body mass index)
Research –
Supervised MS and MCh residents scientific-research theses over 8 years. Published over 70 research papers in national and international scientific journals. Contributed chapters in International books (including Smith’s endourology), published book on urodynamics. Associate editor of indexed journal (Indian Journal of Urology, BMC urology, Current bladder dysfunction reports)
Success stories
  • Introduced various advanced laparoscopic urological procedures in the department of Urology, PGIMER, Chandigarh, India (namely – radical nephrectomy, partial nephrectomy, pyeloplasty, ureteral reimplantation, ureterocalicostomy, radical prostatectomy / cystoprostatectomy, pelvic lymph node dissection, uterovesical & vesicovaginal fistula repair, and so on) and several of these in NMC specialty hospital, Abu Dhabi, UAE
  • Introduced various techniques for urinary incontinence (midurethral slings – TVT, TVT-O, Monarc, Sparc, custom-made slings, Burch Colposuspension, Pubovaginal fascial slings, Botox injection, sacral neuromodulation) and pelvic organ prolapse (vaginal sacrospinal ligament fixation, complete pelvic reconstruction – anatomical / mesh, vaginal paravaginal cystocoele repair, open / laparoscopic mesh sacro-colpopexy, and anterior uterocervicopexy,) to PGIMER, Chandigarh and then to NMC specialty hospital, Abu Dhabi
  • Introduced advanced urodynamic testing (including dynamic urethral profilometry and separated video-urodynamics) to both the institutions and writing manual of urodynamics
  • developed and regularized miniPCNL and RIRS (even for large stones) at NMC specialty hospital, Abu Dhabi
Articles published

Uro-oncology:

  1. Factors affecting BMD in patients of carcinoma prostate, before and after orchidectomy. Cancer 2005; 103(10): 2042-2052
  2. A cohort study investigating patient expectations and satisfaction outcomes in men undergoing robotic assisted radical prostatectomy. Int Urol Nephrol 2011; 43(2): 405-415
  3. Primary renal inflammatory malignant fibrous histiocytoma: A diagnostic challenge. Int J Urol 2006; 13 (7): 1000-1002. doi:10.1111/j.1442-2042.2006.01458
  4. Nutritional Supplementation in Cancer Patients. DSC J Surg 2003; 3 (1): 110-114
  5. Need for measurement of bone mineral density in patients of prostate cancer before and after orchidectomy: Role of Quantitative Computer Tomography. JAPI 2007; 55: 486-490
  6. Lactose intolerance in prostate cancer patients: Incidence and associated factors. Scand J Gastroenterol 2008 Mar; 43(3): 270-6
  7. Impact of newer unidirectional and bidirectional barbed suture on vesicourethral anastomosis during robot-assisted radical prostatectomy and its comparison with Polyglecaprone-25 suture: An initial experience. Int Urol Nephrol 2012; 44(1): 125-132
  8. Preliminary short-term outcomes of a modified double-T ileal continent cutaneous urinary diversion using Yang-Monti tube implantation through serosa-lined extramural tunnel: the PGIMER pouch. Urology 2012 79(4): 943-949
  9. Surgicel® granuloma: Unusual cause of ‘recurrent’ mass lesion following laparoscopic nephron-sparing surgery of renal cell carcinoma. Urology 2010 Aug; 76(2):334-5.
  10. Plasma Chromogranin A: Clinical Implications in Patients with Castrate Resistant Prostate Cancer receiving Docetaxel Chemotherapy. Cancer Biomarkers 2011; 8(2): 81-87
  11. Rare case of renal cell carcinoma with double inferior vena cava with vena caval thrombus. Int Urol Nephrol 2009; 41: 185-188.
  12. Non-interventional management of obstructive acute renal-failure in hormone-naïve prostate cancer. Can J Urol 2007; 14(3): 3580-3582
  13. Pheochromocytoma of urinary bladder. Ind J Nephrol. 2011; 21: 198–200
  14. Short-term functional and urodynamic outcome of w-ileal orthotopic neobladder with serosa-lined tunneled uretero-ileal anastomosis. LUTS 2013 12 MAR 2013. DOI: 10.1111/luts.12014
    Endourology and Urolithiasis:
  15. Risk factors and preventive strategies in urolithiasis. Bulletin PGIMER 2006; 40(1): 10-15
  16. Endourological management of forgotten encrusted ureteral stents: Can Ureteroscopic lithotripsy is avoided? Surg Laparosc Endosc Percutan Tech 2009; 19(1): 72-77.
  17. Comparison of pneumatic versus Laser lithotripsy for endoscopic management of ureteric calculi. Urol Int 2009; 82: 341–345
  18. Comparison of HOLEP and TURP in terms of efficacy in the early postoperative period and the perioperative morbidity. Urol Int 2009; 82(2):130-5
  19. Tamsulosin facilitates clearance of stone fragments and reduces pain after Shockwave Lithotripsy for renal calculi: Results from an open-label randomized study. Urology 2008; 72: 1006-1011
  20. Percutaneous Cyanoacrylate Glue Injection into the Renal Pseudoaneurysm to Control Intractable Hematuria after Percutaneous Nephrolithotomy. Cardiovascular and Interventional Radiology 2009; 32: 767-77
  21. Is there an adjunctive role of tamsulosin to extracorporeal shockwave lithotripsy for upper ureteric stones: results of an open label randomized non-placebo controlled study – Urology 2009; 74(5): 989-992
  22. Equipment: Set up, preoperative and post procedure handouts. In: Smith AD, Badlani G, Preminger G, Kavoussi LR, et al (eds), Smith’s Endourology, Wiley Blackwell, 2010; pp-1468-1480. DOI: 10.1002/9781444345148.ch122
  23. Preventive fluid and dietary therapy for urolithiasis: An appraisal of strength, controversies and lacunae of current literature. Ind J Urol 2011; 27: 308-316
  24. Serum leptin: a marker of prostate cancer irrespective of obesity. Cancer Biomarkers 2010 Jan 1;7(1):11-5
  25. Prevention. In: Nayak C, Siddiqui VA, Mehra P, et al (eds.), Urolithiasis (disease monograph-5), Central Council for research in Homoeopathy, Delhi, India, pp – 59-76
  26. Status of Oxidative Stress in Patients with Renal Cell Carcinoma. J Urol 2012 Apr;187(4):1172-6
  27. Dynamic computed tomography and Doppler findings in different subtypes of renal cell carcinoma with their histopathological correlation. J cancer res ther 2014; 10:552-557
  28. unexplained occurrence of multiple de novo pseudoaneurysms in patients with chronic kidney disease undergoing angio-embolisation for bleeding following percutaneous renal intervention: Are we dealing with infection or vasculitis Ind J Urol 2013: 29: 129-132
  29. Role of Tamsulosin, Tadalafil, and Silodosin as the Medical Expulsive Therapy in Lower Ureteric Stone: A Randomized Trial (a Pilot Study). Accepted: September 16, 2014; DOI: http://dx.doi.org/10.1016/j.urology.2014.09.022
    Laparoscopy (some covered in uro-oncology):
  30. Surgical management of renal cystic disease. Curr Urol Rep 2010; 12(1): 3-10.
  31. Laparoscopic management of atypical ureteropelvic junction obstruction: alternative and simple techniques for complex situations. Urologia internationalism 2008; 81: 87-93. DOI – 10.1159/000137647
  32. Laparoscopic ureterocalicostomy for salvage of giant hydronephrotic kidney: an initial experience. Urology 2007; 70 (3): 590.e7–590.e10. Doi: 10.1016/ j.urology.2007. 06. 1088
  33. A novel technique of intracorporeal excisional tailoring of mega ureter before laparoscopic ureteral reimplantation. Urology 2010; 75(1): 96-99
    Voiding Dysfunction and Urodynamics:
  34. Management of neurogenic bladder: The current status. In: Progress in Clinical Neurosciences, vol 19, ed. Sharma BS, Mishra UK, Creative printers, New Delhi, 2004: 226-260
  35. Effect of Lumbar-Epidural Administration of Tramadol on Lower Urinary Tract Function. Neurourol Urodyn 2008; 27(1):65-70
  36. Neurogenic voiding dysfunction: the basics and beyond. In: Review in Neurology. 2006. pp 242-272 (eds. S Prabhakar and Arun B Tally)
  37. Editorial comment (Agarwal MM, Mavuduru R): Eandi JA, Tanaka ST, Hellenthal NJ, O’Connor RC, Stone AR. Self-Reported Urinary Continence Outcomes for Repeat Midurethral Synthetic Sling Placement. Int Br J Urol 2008; 34 (3): 336-344.
  38. Uroflowmetry in healthy women: development and validation of flow – volume and corrected flow – age nomograms. Neurourol Urodyanm 2009; 28(8): 1003-9
  39. Effect of lumbar epidural administration of neostigmine on lower urinary tract function. Neurourol Urodynam 2010; 29(3): 443-448
  40. Which voiding position is associated with lowest flow rates in healthy adult men? Role of natural voiding position. Neurourol Urodynam 2010; 29(3): 413-417
  41. Incidental ureteral catheterization with cystometry catheter during videourodynamics: a prompt diagnosis. Urology 2011 Jan;77(1): 71-2
  42. Are urine flow-volume nomograms developed on Caucasian men optimally applicable for Indian men? Need for appraisal of flow-volume relations in local population. Ind J Urol 2010 26(3): 338-344
  43. Agarwal MM. Re: Letter to the Editor re: Uroflowmetry in healthy women: development and validation of flow – volume and corrected flow – age nomograms. Neurourol Urodynam 2010 (accepted)
  44. Urodynamic profile of diabetic patients with lower urinary tract symptoms: Association of diabetic cystopathy with Autonomic & Peripheral Neuropathy. Urology 2010 Dec 30. [Epub ahead of print)
  45. Agarwal MM, Badlani G. editorial comment: The “inside-out” trans-obturator tension-free vaginal tape (tvt-o) for the management of occult stress urinary incontinence in women undergoing pelvic organ prolapse repair”. Urology. 2010 Dec; 76(6):1358-61. Urology. 2010 Dec;76 (6):1362-3
  46. Is There a Role for Micturitional Urethral Pressure Profilometry in the Evaluation of Voiding Dysfunction in the 21st Century? Curr Bladder dysfunction reports 2011; 6(4): 193-197
  47. Editorial comment: Agarwal MM. Thinking out-of-the-box (of GAG) in interstitial cystitis. Re: A Second Multi-Center, Randomized, Double-Blind, Parallel Group Evaluation of the Effectiveness and Safety of Intravesical Sodium Chondroitin Sulfate Compared to Inactive Vehicle Control in Subjects with Interstitial Cystitis/ Bladder Pain Syndrome. Urology 2012; 79: 1224
  48. Urodynamics: Indications, Technique, and Fluoroscopy. In: Badlani G (Ed), Minimally Invasive Therapy for Urinary Incontinence and Pelvic Organ Prolapse Current Clinical Urology Springer: New York, 2014, pp 15-32. DOI 10.1007/978-1-4939-0008-4_2
  49. Gabapentenoids in pain management in urological chronic pelvic pain syndrome: gabapentin or pregabalin, Neurourol Urodynam 2017 feb 10 doi: 10.1002/nau.23225. Epub ahead of print
  50. Is Sacrocolpopexy Adequate for Cervico-uterine Prolapse in Patients with Classical Bladder Exstrophy- J Obs Gyn Ind 2014; 64: 83-84
  51. Voiding dysfunction after repair of giant trigonal vesicovaginal or urethrovesicovaginal fistulae: a need for long-term follow up. Ind J Urol 2012; 28: 405-408
  52. Comparison of low dose ketamine to midazolam for sedation during paediatric urodynamic study. Paediatr Anaesth. 2013; 23: 415-21
  53. Agarwal MM. Manual of Urodynamics. Jaypee brothers. 2014
  54. Is sacro-colpopexy adequate for cervico-uterine prolapse in patients with classical bladder exstrophy? J Obs Gyn Soc Ind 2012 (accepted)
  55. Rationalization of interpretation of Uroflowmetry for a non-Caucasian (Indian) population: conceptual development and validation of volume-normalized flow rate index. Neurourol Urodynam 2014; 33: 135-41
  56. Micturitional urethral pressure profilometry for the diagnosis, grading, and localization of bladder outlet obstruction in adult men: a comparison with pressure-flow study. Urology 2014; 83: 550-555
    Miscellaneous:
  57. Spontaneous bladder rupture: diagnostic and treatment dilemma? A review of literature. Urotoday Int J 2009 Apr; 2(2). doi:10.3834/uij.1944-5784.2009.04.04
  58. Is S-shaped kidney always a fusion anomaly? Radiological diagnosis of a new anatomical variant of a single kidney. Ind J Urol 2009; 25(4): 541-542
  59. Unususal cause of failure of end-to-end anastomotic urethroplasty for traumatic obliterative bulbar urethral stricture. Urology 2010 Oct 22. [Epub ahead of print]
  60. Medical therapy in urolithiasis. BJU Int. 2011 Feb; 107(3):356-68. doi: 10.1111/j.1464-410X.2010.09802.x. Epub 2011 Jan 18
  61. Renal hematoma: An unusual cause of acute abdomen and fetal demise in severe Pre-Eclampsia. Ind J Med Sc 2011; 65: 456-459
  62. Retrograde Urethrogram or a Venogram – Be Careful Next Time. Ind J Surg 2012; 76: 411-412
  63. Phosphodiesterase inhibitors for lower urinary tract symptoms consistent with benign prostatic hyperplasia. PROTOCOL. Cochrane Prostatic Diseases and Urologic Cancers Group 2012
  64. Isolated bilateral renal mucormycosis masquerading as renal abscess in an immunocompetent individual: a lesson learnt. Case Reports in Urology 2014 Article ID 304380, http://dx.doi.org/10.1155/2014/304380
  65. Fracture-penis: a radiological or clinical diagnosis? Our experience & literature review. Can J Urol 2009 Apr;16(2):4568-75
  66. Medical management of benign prostatic hyperplasia. Drugs Bulletin 2006; 30(4): 31-54
  67. Penile gangrene in diabetes mellitus with renal failure: A poor prognostic sign of systemic vascular calciphylaxis. Ind J Urol 2007; 23: 208-210
  68. Acute pyelonephritis with renal vein and inferior vena cava thrombosis in a case of hyperhomocysteinemia. Int Urol Nephrol 2009; 41(1): 185-188.
Awards
  1. Delhi University Gold Medal for being the Best student in Ist MBBS, Delhi University, 1993-1994.
  2. Smt Shakuntala Sethi award for being the Best student in Ist MBBS, Delhi University, 1993-1994.
  3. Dr Hukum Chand Gold Medal for being the Best Student in Anatomy, Delhi University, 1993-1994.
  4. Late Prof Vishwamitter Charnalia Endowment award for being the Best Student in Anatomy, Delhi University, 1993-1994.
  5. Delhi administration first Prize in Anatomy, Delhi University, 1994.
  6. Best Poster award in annual conference of North-Zone Chapter of Urologic Society of India 2003.
  7. II prize in laparoscopy session in 4th Basic Surgical Training course, the Royal College of Surgeons of Edinburgh, held in New Delhi in September’2004.
  8. Hargobind Singh Memorial Travel Fellowship for the year 2006-7 by North Zone Chapter of Urological Society of India (AIIMS, Delhi – Robotic Surgery; Kasturba Hospital for Women and Children, Chennai – Urogynecology).
  9. Dr H S Bhat Gold medal in superspeciality DNB, Genitourinary Surgery, December 2005, awarded by the National Board of Examination.
  10. Best poster prize for “A study of correlation of cystometric findings with presence of autonomic neuropathy in patients with diabetes mellitus presenting with lower urinary tract symptoms.” 9th Asian Congress of Urology, New Delhi, India.
  11. Chandigarh Best Video prize for “A novel intracorporeal laparoscopic technique of ureteral tailoring for ureteroneocystostomy”, USICON 2009, Jan 09, Indore.
  12. Clinical Observer fellowship at Memorial Sloan Kettering Cancer Center, New York (Scholarship awarded by Varoon Mahajan Memorial Foundation, New York), Oct-Dec’ 2009. (Uro-oncology – Robotic Oncology, pelvic reconstruction, voiding dysfunction)
  13. Clinical Observer Fellowship at departments of Urology at University of California Los Angeles, Wake Forest University at North Carolina (Scholarship awarded by Indian American Urological Association), May-July’2010. (Robotic Urology, Urogynecology, Voiding Dysfunction)
  14. Best research paper for Indian Journal of Urology 2010 entitled “Are urine flow-volume nomograms developed on Caucasian men optimally applicable for Indian men? Need for appraisal of flow-volume relations in local population.”
  15. Brij Kishore Patna prize paper for surgical innovation “Preliminary clinical and urodynamic outcomes of modified T-pouch continent cutaneous urinary diversion: the PGIMER pouch” awarded during USICON 2012, Bengaluru.
Hobbies
Karate, sketching, watching nature, spending time with family
Languages fluent
Hindi, English