https://www.linkedin.com/in/arvind-jagwani-160543161?lipi=urn%3Ali%3Apage%3Ad_flagship3_profile_view_base_contact_detail

Dr. Arvind Jagwani Urologist, Subang Jaya (2026)

07/08/2026

🩸 Blood in the Urine (Hematuria): Don't Ignore It! 🚨

Have you ever noticed red, pink, or brown urine? Or perhaps your doctor found blood in your urine during a routine urine test, even though you couldn't see it yourself?

This condition is called hematuria, and while it may sometimes have a harmless cause, it should never be ignored.

What can cause blood in the urine?

🔹 Urinary tract infection (UTI)
🔹 Kidney or ureteric stones
🔹 Enlarged prostate (BPH)
🔹 Vigorous exercise
🔹 Kidney diseases
🔹 Certain medications (such as blood thinners)
🔹 Bladder, kidney, or prostate cancer

When should you seek medical attention?

✅ Blood that you can see in your urine
✅ Blood detected repeatedly on urine tests
✅ Blood in the urine with pain, fever, or burning when passing urine
✅ Blood in the urine with clots
✅ Blood in the urine if you are over 40 years old, especially if you smoke or have smoked in the past

Why is early assessment important?

Sometimes, hematuria is the first and only warning sign of a serious condition, including cancers of the urinary tract. Early diagnosis often means more treatment options and better outcomes.

How is it investigated?

A urologist may recommend:
🩺 A detailed medical assessment
🧪 Urine tests
🩸 Blood tests
🖥️ Ultrasound or CT scan
🔍 Flexible cystoscopy (a small camera to examine the bladder when indicated)

💡 Remember: Even if the bleeding stops on its own, the underlying cause may still be present. Don't assume everything is fine just because the urine has returned to normal.

👨‍⚕️ If you notice blood in your urine, arrange a medical review. Prompt evaluation can provide reassurance when the cause is benign—or detect a condition early when treatment is most effective.

03/08/2026

🤖💙 Retzius-Sparing Robotic-Assisted Radical Prostatectomy🎯

A New Generation of Prostate Cancer Surgery

A diagnosis of prostate cancer can feel overwhelming, but modern technology is transforming the way we treat it. 🌟

One of the most advanced techniques available today is the Retzius-Sparing Robotic-Assisted Radical Prostatectomy (RS-RARP). Using the precision of robotic surgery, this approach removes the prostate while preserving important supporting structures around the bladder whenever appropriate. 🩺🤖

🌟 Why is this technique special?

💧 Earlier return of urinary continence in many suitable patients
🩸 Minimal blood loss during surgery
🔬 Excellent cancer control when performed for appropriately selected patients
🏥 Smaller incisions with less postoperative pain
🚶‍♂️ Faster recovery and a quicker return to daily activities
🎯 High surgical precision with enhanced 3D robotic vision

👨‍⚕️ Is it suitable for everyone?

Not necessarily. Every prostate cancer is unique. The best surgical approach depends on:
📋 Cancer stage and location
📊 MRI and biopsy findings
❤️ Overall health and medical history
🎯 Individual treatment goals

A detailed consultation with a urologist is essential to determine the most appropriate treatment.

💙 As a Consultant Urologist & Robotic Surgeon, my goal is to provide personalised, evidence-based care, helping each patient choose the treatment that offers the best balance between cancer control and quality of life.

📞 If you or a loved one has recently been diagnosed with prostate cancer, don't hesitate to seek advice or obtain a second opinion. Early discussion can make all the difference.

24/07/2026

🤖 Robotic Prostate Surgery – Precision Meets Faster Recovery! 💙

Did you know that robotic-assisted radical prostatectomy (RARP)is one of the most advanced treatments for prostate cancer? 🇲🇾🩺

During the operation, your surgeon carefully removes the prostate using tiny keyhole incisions while controlling robotic instruments with incredible precision. 🎮🤖

✨ What happens during the surgery?
🔹 Tiny keyhole incisions are made 🩹
🔹 The bladder is gently moved aside to reach the prostate 🫧
🔹 The prostate is carefully separated from the surrounding tissues 🎯
🔹 Important nerves that help with urinary control and erections are preserved whenever it is safe to do so 💙
🔹 The prostate is removed, and the bladder is reconnected to the urethra using fine stitches 🪡

🌟 Benefits of robotic surgery may include:
✅ Smaller incisions
✅ Less pain after surgery 😊
✅ Reduced blood loss 🩸
✅ Faster recovery 🏃‍♂️
✅ Shorter hospital stay 🏥
✅ Excellent cancer control in appropriately selected patients 🎯

Every patient is unique, and the surgical approach is tailored to achieve the best balance between complete cancer removal, urinary continence, and preservation of quality of life. ❤️

👨‍⚕️ If you've been diagnosed with prostate cancer and would like to learn whether robotic surgery is suitable for you, speak to a urologist to discuss your options.

🤖
💙
🩺
✨
👨
💪

17/07/2026

🤖🩺 Bladder Drop in RARP 🚀

One of the first key steps in a Robotic-Assisted Radical Prostatectomy (RARP) is the bladder drop. 🔽💧

During this step, the bladder is gently mobilised away from the abdominal wall, opening the Space of Retzius and revealing the prostate hidden beneath. 🔍✨

Why is this important? 🤔

✅ Improves exposure of the prostate
✅ Identifies important anatomical landmarks 🗺️
✅ Facilitates precise robotic dissection 🎯🤖
✅ Sets the stage for a safe and efficient operation 🏥

With the robotic system's 3D high-definition vision 👀🔬 and advanced instrument control 🎮, surgeons can perform this step with exceptional precision.

💡 A smooth bladder drop = a strong foundation for a successful robotic prostatectomy! 🚀🩺❤️

16/07/2026

🤖🎯 Robotic-Assisted Radical Prostatectomy (RARP): A Modern Approach to Prostate Cancer Surgery 🩺💙

🌟 What is Robotic-Assisted Radical Prostatectomy?

Prostate cancer is one of the most common cancers affecting men worldwide. 👨‍⚕️

For many patients with localized prostate cancer, surgery remains one of the most effective treatment options. Today, thanks to advances in technology, this surgery can be performed using the highly sophisticated Da Vinci® Robotic Surgical System 🤖✨.

A Robotic-Assisted Radical Prostatectomy (RARP) involves the complete removal of the prostate gland and seminal vesicles through several tiny keyhole incisions. The robotic system is fully controlled by the surgeon and does not operate independently.

Think of it as the surgeon's hands — but with enhanced precision, flexibility, and vision! 🎮👨‍⚕️

---

🤖 How Does Robotic Surgery Work?

During the procedure:

🔹 Small incisions are made in the abdomen.

🔹 Tiny robotic instruments and a high-definition 3D camera are inserted.

🔹 The surgeon sits comfortably at a console and controls every movement.

🔹 The prostate gland is carefully removed.

🔹 The bladder is reconnected to the urethra.

🔹 A urinary catheter is temporarily placed to allow healing.

The robotic system provides:

🔍 Magnified 3D Vision

🎯 Tremor Filtration

✋ Enhanced Dexterity

📈 Greater Surgical Precision

---

🌈 Benefits of Robotic Prostate Surgery

Patients often experience several advantages compared to traditional open surgery:

✅ Smaller scars

✅ Less blood loss 🩸⬇️

✅ Reduced postoperative pain 😊

✅ Lower transfusion rates

✅ Shorter hospital stay 🏥

✅ Faster return to normal activities 🚶‍♂️

✅ Enhanced visualization of delicate structures

✅ Improved precision during nerve-sparing surgery

---

❤️ Preserving Quality of Life

One of the major goals of robotic surgery is preserving important structures surrounding the prostate.

🚻 Urinary Continence

The robotic system allows meticulous dissection around the urinary sphincter.

This may help:

💧 Faster return of urinary control

💧 Better long-term continence outcomes

💧 Improved quality of life

---

❤️ Erectile Function

Running beside the prostate are delicate nerves responsible for erections.

When cancer characteristics permit, surgeons may perform:

💙 Unilateral Nerve Sparing

💙 Bilateral Nerve Sparing

💙 Maximum Safe Preservation of Erectile Function

Every patient is unique, and cancer control always remains the highest priority. 🎯

---

🦠 Is It Effective Against Cancer?

Absolutely! ✅

Robotic-assisted radical prostatectomy offers excellent cancer control outcomes for appropriately selected patients.

Benefits include:

🎯 Complete removal of the cancerous prostate

🎯 Accurate pathological assessment

🎯 Determination of tumour stage

🎯 Assessment of surgical margins

🎯 Long-term PSA monitoring

Following successful surgery, PSA levels should become extremely low or undetectable. 📉

---

👨‍⚕️ Who May Benefit From Robotic Prostatectomy?

Patients diagnosed with:

✔ Localized prostate cancer

✔ Selected locally advanced prostate cancer

✔ Good overall health

✔ Life expectancy greater than 10 years

The final treatment recommendation depends on:

📊 PSA Levels

🧬 Biopsy Results

🖥 MRI Findings

🔬 PSMA PET Scan Results

🩺 Overall Health Status

---

⚠️ Are There Any Risks?

As with any major surgery, risks can occur.

Potential complications include:

⚠️ Urinary leakage

⚠️ Erectile dysfunction

⚠️ Bleeding

⚠️ Infection

⚠️ Blood clots

⚠️ Bladder neck scarring

⚠️ Rare injury to nearby organs

Fortunately, serious complications are uncommon when surgery is performed by experienced robotic surgeons. 👨‍⚕️🤖

---

🌟 The Future of Prostate Cancer Surgery

Robotic-assisted surgery represents one of the most significant advances in modern urology. By combining surgical expertise with cutting-edge technology, patients can benefit from excellent cancer control while maximizing recovery and quality of life. 💙✨

Early detection remains crucial. Men over 50 years old or earlier if there is a family history of prostate cancer should discuss PSA screening with their healthcare provider. 🩺

---

👨‍⚕️ Dr Arvind Jagwani
Consultant Urologist & Robotic Surgeon 🤖

🔹 Prostate Cancer
🔹 Robotic Surgery
🔹 Kidney Cancer
🔹 Bladder Cancer
🔹 Kidney Stones
🔹 Enlarged Prostate (BPH)

📍 Helping patients achieve the best possible outcomes through advanced minimally invasive and robotic surgical techniques.

🤖💙🎯

13/07/2026

A Rare Cancer Successfully Treated: Understanding Urachal Adenocarcinoma 🩺✨

🌟 A Recent Challenging Case

Recently, I had the opportunity to treat a young gentleman diagnosed with a very rare form of cancer known as Urachal Adenocarcinoma.

This uncommon condition required careful investigation, meticulous surgical planning, and definitive treatment. The patient successfully underwent an open laparotomy with partial cystectomy, where the tumour was completely removed along with the affected portion of the bladder. 💪🏥

---

🤔 What Is the Urachus?

Before birth, a structure called the urachus connects the developing bladder to the umbilical cord.

👶 During fetal development, this channel helps drain urine from the fetus.

Normally, it closes and disappears before birth.

However, in some individuals, remnants of this structure remain throughout life. In extremely rare cases, these remnants can develop into cancer known as Urachal Adenocarcinoma.

📊 Urachal cancers account for less than 1% of all bladder cancers.

---

⚠️ Symptoms of Urachal Cancer

Many patients may not notice symptoms until the disease has grown significantly.

Common symptoms include:

🩸 Blood in the urine (Haematuria)

🚻 Frequent urination

😣 Pain during urination

🤕 Lower abdominal discomfort

🔵 Mucus in the urine

📉 Unexplained weight loss

😴 Fatigue

Because these symptoms can mimic common urinary conditions, diagnosis is often delayed.

---

🔍 How Is It Diagnosed?

Accurate diagnosis usually involves multiple investigations:

🩺 Clinical assessment

🧪 Urine testing

📸 Ultrasound

💻 CT Scan

🧲 MRI Scan

🔬 Cystoscopy (camera examination of the bladder)

🧬 Histopathological examination of tissue samples

In this patient's case, imaging studies revealed a suspicious mass arising from the dome of the bladder, raising concern for a urachal tumour.

---

🧬 What Did The Pathology Show?

Following surgical removal, the specimen was sent for detailed pathological examination.

🔬 Histopathology confirmed:

➡️ Urachal Adenocarcinoma

➡️ Malignant gland-forming tumour

➡️ Originating from urachal remnants

➡️ Surgical margins assessed to ensure complete removal

Pathological assessment plays a crucial role in determining prognosis and guiding future treatment.

---

🏥 The Surgical Treatment

The gold standard treatment for localized urachal adenocarcinoma is surgery.

For this patient, we performed:

✅ Exploratory Laparotomy

✅ En Bloc Tumour Excision

✅ Partial Cystectomy

✅ Removal of Urachal Tract

✅ Umbilical Resection when indicated

The primary goal is complete removal of the tumour with clear margins while preserving as much normal bladder function as possible.

⚕️ Surgery remains the most important treatment offering the best chance of long-term cure.

---

❤️ Recovery After Surgery

Most patients can expect:

🚶 Early mobilisation

💧 Temporary urinary catheter

🏥 Hospital stay for recovery and monitoring

📅 Regular follow-up appointments

📸 Surveillance imaging

🧪 Blood and urine investigations

Long-term monitoring remains important because urachal cancers can occasionally recur.

---

🌈 Why Early Detection Matters

Like many cancers, outcomes are significantly improved when detected early.

If you experience:

🩸 Blood in urine

🚻 Persistent urinary symptoms

🤕 Unexplained lower abdominal pain

📉 Unexplained weight loss

Please seek medical evaluation promptly.

Early diagnosis can save lives. ❤️

04/07/2026

🩺💙 Urachal Adenocarcinoma: A Rare Cancer That Can Hide in Plain Sight! 🎗️🧬

📍 What is the Urachus?

Before birth, a small tube called the urachus connects the baby's bladder to the umbilical cord 👶. Normally, this tube closes and becomes a fibrous band after birth.

However, in some individuals, remnants of the urachus remain behind. While most remain harmless, these remnants can occasionally develop infections, cysts, or in very rare cases, cancer known as Urachal Adenocarcinoma 🚨.

---

🎗️ What is Urachal Adenocarcinoma?

Urachal Adenocarcinoma is a rare type of cancer arising from the urachal remnant, typically located between the bladder dome and the belly button (umbilicus) 📍.

🔬 It accounts for:

* Less than 1% of all bladder cancers
* Approximately 0.01% of adult cancers
* Usually diagnosed between 40–70 years of age

Because it develops outside the main bladder lining, symptoms may be absent until the disease has grown significantly ⚠️.

---

🚩 Common Symptoms

Many patients initially experience subtle symptoms:

🩸 Blood in the urine (Haematuria) – most common symptom
🚽 Frequent urination
😖 Pain or discomfort above the bladder
🔵 Mucus in the urine (Mucinuria)
🤕 Lower abdominal pain
⚖️ Unexplained weight loss
🤒 Recurrent urinary tract infections

Unfortunately, symptoms often appear late, which can delay diagnosis ⏳.

---

🔍 How is it Diagnosed?

A thorough evaluation is important:

✅ Urine analysis
✅ Urine cytology
✅ Ultrasound scan
✅ CT Urogram or MRI scan 🖥️
✅ Flexible cystoscopy 🔦
✅ Tissue biopsy for confirmation 🔬

CT scans often reveal a mass arising from the bladder dome extending toward the umbilicus, sometimes with characteristic calcifications 🦴.

---

🏥 Treatment Options

The mainstay of treatment is surgery 🔪.

Surgical Management

👨‍⚕️ Partial cystectomy (removal of part of the bladder)

➕ Removal of:

* The entire urachal tract
* Umbilicus (belly button)
* Surrounding tissues when necessary

This procedure is often called:

🎯 En-bloc resection of the urachus, umbilicus and bladder dome**

Modern approaches may include:

🤖 Robotic-assisted surgery
🔍 Laparoscopic surgery
🏥 Open surgery for advanced cases

---

💊 Is Chemotherapy Needed?

Some patients may require:

💉 Chemotherapy
🎯 Targeted therapy
🧬 Molecular-guided treatment

This is particularly considered when:

⚠️ Cancer has spread to lymph nodes
⚠️ Metastatic disease is present
⚠️ Recurrence occurs after surgery

Treatment plans are individualized by a multidisciplinary cancer team 👨‍⚕️👩‍⚕️.

---

📈 Prognosis

Outcomes depend largely on:

✅ Stage at diagnosis
✅ Completeness of surgical removal
✅ Presence of metastasis
✅ Tumor grade

Early detection and complete surgical excision offer the best chance for long-term control and survival 🌟.

---

🛡️ Can It Be Prevented?

There is currently no proven way to prevent urachal adenocarcinoma.

However, medical attention should be sought if you experience:

🩸 Blood in urine
🚽 Persistent urinary symptoms
😖 Lower abdominal discomfort
🔵 Mucus in urine

Early evaluation can help identify serious underlying conditions sooner ⏰.

---

💙 Key Take-Home Message

Although Urachal Adenocarcinoma is rare, it remains an important diagnosis because it often presents silently and may only become apparent at an advanced stage.

🚨 Blood in the urine should never be ignored.

🔬 Modern imaging, cystoscopy, and pathological assessment play a crucial role in diagnosis, while surgery remains the cornerstone of treatment.

👨‍⚕️ Early consultation with a urologist can make a significant difference in outcomes.

29/06/2026

🩺✨ URACHAL REMNANT – A HIDDEN CONDITION FROM BEFORE BIRTH! ✨🩺

Did you know that before we are born, there is a small tube connecting the baby's bladder to the umbilical cord (belly button)? 🤰👶

This tube is called the urachus.

Normally, it closes completely before birth and becomes a fibrous band called the median umbilical ligament. However, in some people, parts of this tube remain open, resulting in what we call a Urachal Remnant ⚠️

━━━━━━━━━━━━━━━━━━━

🔍 What Types of Urachal Remnants Can Occur?

There are several forms:

1️⃣ Patent Urachus
➡️ Entire channel remains open
➡️ Urine may leak from the belly button 💧

2️⃣ Urachal Cyst
➡️ Middle portion remains open
➡️ Fluid collects within the cyst 🫧

3️⃣ Umbilical-Urachal Sinus
➡️ Opening near the belly button
➡️ Persistent discharge from the umbilicus 🤕

4️⃣ Vesicourachal Diverticulum
➡️ Opening remains near the bladder
➡️ Can cause urinary symptoms 🚻

━━━━━━━━━━━━━━━━━━━

⚠️ What Problems Can a Urachal Remnant Cause?

🦠 Infection
The most common complication.

Symptoms may include:
✅ Belly button discharge
✅ Redness around the umbilicus
✅ Fever 🤒
✅ Lower abdominal pain
✅ Pus discharge

━━━━━━━━━━━━━━━━━━━

🪨 Stone Formation

Long-standing remnants may accumulate debris and form stones.

Symptoms:
⚡ Pain
⚡ Recurrent infection
⚡ Blood-stained discharge

━━━━━━━━━━━━━━━━━━━

🧫 Abscess Formation

An infected urachal cyst can develop into an abscess.

Signs include:
🔥 Severe abdominal pain
🔥 Fever
🔥 Swelling below the belly button

This often requires antibiotics and drainage.

━━━━━━━━━━━━━━━━━━━

🩸 Blood in the Urine (Haematuria)

Some patients may experience:
🔴 Visible blood in urine
🔴 Irritative urinary symptoms
🔴 Recurrent urinary tract infections

━━━━━━━━━━━━━━━━━━━

🎗️ Urachal Cancer – Rare but Important

Although uncommon, urachal remnants can sometimes develop into cancer.

The most common type is:

🔬 Urachal Adenocarcinoma

Warning signs:
⚠️ Blood in urine
⚠️ Mucus in urine
⚠️ Recurrent urinary infections
⚠️ Lower abdominal mass
⚠️ Unexplained weight loss

Because urachal cancer is often detected late, early assessment is important. 🚨

━━━━━━━━━━━━━━━━━━━

🔎 How Is It Diagnosed?

Your urologist may recommend:

📋 Physical examination
🩻 Ultrasound
💻 CT Scan
🧲 MRI Scan
🔭 Cystoscopy (camera examination of the bladder)

━━━━━━━━━━━━━━━━━━━

⚕️ Treatment Options

Treatment depends on the type of remnant and symptoms.

🩺 Observation (for selected asymptomatic cases)

💊 Antibiotics (for infection)

🔪 Surgical Removal
✔️ Laparoscopic surgery
✔️ Robotic surgery 🤖
✔️ Open surgery in selected cases

Complete removal helps prevent:
✅ Recurrent infections
✅ Abscess formation
✅ Future malignant transformation

━━━━━━━━━━━━━━━━━━━

💡 When Should You See a Urologist?

If you experience:

🔴 Persistent belly button discharge
🔴 Recurrent infections around the umbilicus
🔴 Blood in urine
🔴 Lower abdominal swelling
🔴 Recurrent urinary tract infections

It is worth getting evaluated by a urologist.

━━━━━━━━━━━━━━━━━━━

👨‍⚕️ Take Home Message

A urachal remnant is a congenital condition that many people may not know they have. While some remain harmless throughout life, others can lead to infection, stones, abscesses, urinary symptoms, or even rare cancers. Early diagnosis and appropriate treatment can prevent long-term complications. 🌟

23/06/2026

👶🔬 Fowler-Stephens Stage 2 Orchidopexy – Bringing the Te**is Home 🔬👶

After successful completion of the first stage, the second stage of the Fowler-Stephens procedure is performed approximately 6 months later, allowing new collateral blood vessels to develop and support the te**is. 💙

🎥 Key Steps of the Procedure

🔹 Laparoscopic access is established to identify the intra-abdominal te**is.

🔹 The te**is and surrounding tissues are carefully mobilized, preserving the blood supply arising from the vas deferens and collateral vessels.

🔹 Extensive dissection is performed to obtain maximum length, ensuring a tension-free descent into the sc***um.

🔹 A pathway is created to bring the te**is into the sc***um safely.

🔹 The te**is is delivered into a newly created dartos pouch within the sc***um.

🔹 The te**is is secured in its natural position to prevent re-ascent.

✨ The Goal
✅ Position the te**is within the sc***um
✅ Preserve testicular viability
✅ Optimize future hormonal function
✅ Improve fertility potential
✅ Facilitate long-term examination and surveillance

🩺 In this case, I performed the procedure using a minimally invasive laparoscopic approach, allowing precise dissection, excellent visualization, minimal scarring, and a quicker recovery.

Every successful orchidopexy represents more than just moving a te**is, it is an investment in a child's future reproductive and hormonal health. 🌟

👨‍⚕️ Early treatment of undescended te**es remains crucial for achieving the best long-term outcomes.

21/06/2026

👶🔬 Fowler-Stephens Stage 1 Orchidopexy – Preserving Fertility, One Step at a Time 🔬👶

Not all undescended te**es can be brought down into the sc***um in a single operation. When a te**is is located high within the abdomen, a Fowler-Stephens procedure may be required to safely relocate it while maximizing its long-term function. 💙

🩺 What is Fowler-Stephens Stage 1?

The aim of the first stage is to encourage the development of alternative blood supply to the te**is before moving it to the sc***um during a second operation.

🔹 Step 1: Diagnostic laparoscopy is performed to identify the position of the te**is.
🔹 Step 2: The te**is is carefully assessed for size, appearance, and mobility.
🔹 Step 3: The testicular vessels are identified and meticulously dissected.
🔹 Step 4: The testicular artery and vein are clipped and divided, while preserving the vas deferens and its accompanying blood supply.
🔹 Step 5: The te**is is left in its original position to allow collateral circulation to develop over the next several months.

⏳ After approximately 6 months, a Stage 2 Fowler-Stephens orchidopexy is performed to bring the te**is down into the sc***um using its newly established blood supply.

✨ Why perform the procedure in two stages?
✅ Improves the chances of testicular survival
✅ Reduces tension on the spermatic cord
✅ Maximizes future hormonal function
✅ Preserves fertility potential whenever possible

👨‍⚕️ In my practice, I perform the procedure using a minimally invasive laparoscopic approach, allowing excellent visualization, precise dissection, smaller scars, and faster recovery.

Early diagnosis and treatment of undescended te**es are important to optimize future fertility and reduce long-term complications.

The video below shows me pointing out the vas deference and vessels. Not in this video is where i proceed to clip the artery hoping to rely of supply from the artery to vas and cremasteric artery.

Dr. Arvind Jagwani Urologist

07/08/2026

03/08/2026

24/07/2026

17/07/2026

16/07/2026

13/07/2026

04/07/2026

29/06/2026

23/06/2026

21/06/2026

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