For Dr. Murad (name changed), a beloved physician from Iraq, facing a severe urological crisis was made far more daunting by his own medical background. He was suffering from a massive 5 cm kidney stone that caused constant discomfort and threatened his renal function. However, treating the stone was extraordinarily dangerous: Dr. Murad suffered from cardiac arrhythmias and relied on daily blood thinner medications.
In Iraq, local surgeons evaluated his case and concluded that operating under such high-risk cardiac conditions posed too great a threat. Because he could not safely undergo surgery at home, Dr. Murad began searching internationally for a specialized center capable of managing complex, high-risk stone cases.
Through glowing contacts and recommendations from previously treated Iraqi patients, he learned about Dr. Raman Tanwar at Urocentre in India, a renowned specialist who had performed over a thousand successful percutaneous nephrolithotomy procedures.
“When I read about Dr. Raman Tanwar’s biography and the more than a thousand successful operations he had achieved, I felt complete confidence,” Dr. Murad recalls. “I chose him out of a hundred specialists. Despite the risks, I decided to travel to India so I could receive the specialized care I needed.”
Uncovering a 5 cm “Invisible” Stone
Upon arriving at Urocentre, the medical team conducted a thorough, multi-disciplinary evaluation. Diagnostic imaging revealed a surprising clinical challenge: the massive 5 cm stone was completely “invisible” on standard X-rays. A high-resolution CT scan confirmed that the calculus was a large uric acid stone that had branched throughout all the calyces—the internal caves—of his kidney.
Because uric acid stones are radiolucent, they do not show up on conventional X-ray imaging and cannot be shattered using external lithotripsy. Furthermore, his cardiac arrhythmia and reliance on blood thinners presented significant operative hurdles.
To ensure his safety, the team obtained formal cardiology clearance, carefully balancing his cardiac risk while stopping his blood thinners for a few days prior to surgery. Because stopping blood thinners and managing an irregular heartbeat carried strict time limits, the urology team could not afford multiple operations or prolonged surgical sessions. They needed a strategic plan that would achieve 100% stone clearance in a single, highly efficient sitting.
Precision PCNL with Three Keyhole Punctures
The surgical team chose Percutaneous Nephrolithotomy (PCNL) as the definitive path. In a PCNL, a small keyhole entry is created through the back into the kidney, allowing an endoscope to enter directly, visualize the stone, break it into smaller pieces, and extract every fragment.
Because Dr. Murad’s 5 cm stone occupied every single calyx of his kidney, navigating from a single entry point was impossible. To clear all the internal caves without leaving residual fragments behind, the surgical team executed three precise punctures through his back in one sitting.
Navigating through these three targeted pathways, the team methodically fragmented the massive 5 cm uric acid stone and removed every piece. Working with speed and high precision, the surgical team completed the procedure safely, protecting his heart and minimizing operative stress.
“The expertise of Dr. Raman Tanwar and his team was remarkable,” Dr. Murad shares. “He is a truly clever, competent, and approachable doctor who managed every aspect of my care with immense skill. I felt completely well-cared for throughout the entire experience.”
Total Clearance, Full Recovery, and Prevention
The post-operative evaluations confirmed a total success. Comprehensive ultrasound scans and a follow-up CT scan verified 100% complete stone clearance across all kidney calyces before his double-J stent was safely removed.
Dr. Murad experienced a smooth, event-free recovery without any cardiac or bleeding complications. Within a short time, he was standing, feeling great, and preparing to return home to Iraq in excellent health.
To ensure long-term protection, the team analyzed the extracted stone, confirming its uric acid composition. The urology team provided Dr. Murad with a personalized metabolic medication plan designed to regulate his uric acid levels and prevent or delay future stone formation.
Reflecting on his life-saving journey, Dr. Murad expressed deep gratitude for the care he received at Urocentre. “Everything went smoothly without a single problem,” Dr. Murad says with satisfaction. “I call upon God to preserve Dr. Raman Tanwar and his wonderful staff. Traveling to India and leaving completely healthy and stone-free has been a true blessing.”