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)

16/02/2026

🚨 What is Pyonephrosis? A Silent, Dangerous Kidney Infection 🚨

I recently treated a very sick patient who came in with sepsis caused by a blocked kidney from a ureteric stone. When the kidney was drained, the fluid inside showed clear signs of severe infection. This condition is called pyonephrosis.

So, what is pyonephrosis?
Pyonephrosis happens when:

A kidney is blocked (most commonly by a stone), and
Infection builds up behind the blockage, and
The infected fluid cannot drain out normally

Because the kidney is “trapped” and under pressure, the infection can spread into the bloodstream, leading to sepsis, which is a life-threatening emergency.

⚠️ Why is this dangerous?

The kidney can be permanently damaged
The infection can spread to the whole body
The patient can become critically ill very quickly
Without urgent treatment, it can be fatal

🚑 How is it treated?
The priority is not just antibiotics. The blocked, infected kidney must be drained urgently.

This is usually done by:
Inserting a ureteric stent or
Placing a drain into the kidney

Only after the infection is controlled do we treat the stone itself.

❗ Important warning signs to watch for:

Fever with chills or shivering
Severe flank or back pain
Painful urination or cloudy urine
Nausea, vomiting, or feeling very unwell

Symptoms of a stone plus fever = EMERGENCY

💡 Take-home message:
Kidney stones are not always “just stones.”
If a stone blocks the kidney and infection sets in, it becomes a medical emergency.
Early treatment can save the kidney and save a life.

13/02/2026

🚨 Don’t Ignore Long-Standing Ureteric Stones, They Can Silently Damage Your Kidney 🚨

Most people think kidney or ureteric stones only cause pain.
But here’s something many don’t realise:

👉 A stone that stays stuck in the ureter for a long time can cause permanent narrowing of the ureter (called a ureteric stricture).

Over time, this can lead to:
• Chronic inflammation and scarring
• 🚧 Narrowing of the ureter (stricture)
• 💧 Hydroureter(swollen ureter)
• 🫗 Hydronephrosis(swollen kidney)
• ⚠️ And eventually, loss of kidney function or kidney failure

The scary part?
❗ This damage often happens slowly and silently, sometimes even after the pain has gone.

Many people assume:

> “The pain is gone, so the stone must be gone.”

Unfortunately, that’s not always true. A stone can stay stuck and quietly block the kidney, causing progressive and sometimes irreversible damage.

🚩 Warning signs may include:
• Recurrent flank pain or discomfort
• Repeated urinary infections
• Worsening kidney function on blood tests
• “Swollen kidney” found on ultrasound or CT scan
• Or sometimes… no symptoms at all

✅ The good news:
If detected early, we can:
• Remove the stone
• Relieve the blockage
• Treat or reconstruct the narrowed segment
• And protect the kidney before permanent damage happens

📌 Take-home message:
✔ Don’t ignore a known ureteric stone
✔ Don’t assume “no pain” means “no problem”
✔ Get proper scans and follow-up
✔ Early treatment can **save your kidney**

Your kidneys are silent workers. By the time they complain, damage may already be advanced.

If you’ve been told you have a ureteric stone and haven’t followed it up, please get it checked. It could save your kidney. 💙

10/02/2026

I’ve decided to join the trend and create a caricature of myself at work 👨‍⚕️🎨

Same role, same commitment to patient care, just illustrated with a bit of fun and creativity.

Sometimes a little humour and personality makes the journey even more enjoyable. Hope you like this lighter side of me and my work!

05/02/2026

What happens when prostate problems are left untreated?

Today I’m sharing a real post-surgery example from a Freyer’s prostatectomy. In this case, two things were removed:
✅ The enlarged prostate tissue that was blocking urine flow
✅ A very large bladder stone that formed because the bladder couldn’t empty properly for a long time

Many men live with symptoms like a weak urine stream, straining, frequent night-time urination, or the feeling that the bladder never fully empties. These are often signs of benign prostate enlargement (BPH). When the blockage is severe and long-standing, urine gets trapped in the bladder, and over time this can lead to infections, bladder damage, and even bladder stones like the one shown here.

A Freyer’s prostatectomy is done for very large prostates when medications are no longer enough. By removing the obstructing part of the prostate, we restore urine flow and help the bladder work properly again. Removing the stone at the same time treats the complication and the cause.

💡 The takeaway:
Don’t ignore ongoing urinary symptoms or “just live with it.” Early checks and treatment can prevent serious problems later on.

If you or someone you care about has persistent urinary symptoms, get them assessed early. It can make a huge difference to comfort, health, and quality of life.

02/02/2026

Understanding Freyer’s Prostatectomy
A surgical option for very large prostate enlargement

As men age, the prostate gland can enlarge, a condition known as benign prostatic hyperplasia (BPH). When the prostate becomes very large, it can severely block urine flow, leading to symptoms such as difficulty passing urine, frequent urination, poor stream, urinary retention, bladder stones, or recurrent infections.

For selected patients with very large prostates, Freyer’s prostatectomy remains a proven and effective surgical treatment.

What is Freyer’s Prostatectomy?

Freyer’s prostatectomy is an open surgical procedure designed to remove the inner enlarged portion of the prostate that is causing blockage.
Importantly, this surgery removes only the obstructing part of the prostate and not the entire gland.

It is typically recommended when:
-The prostate is very large
-Symptoms are severe
-There are complications such as bladder stones, recurrent infections, or long-term urinary retention
-Endoscopic (keyhole) procedures may not be suitable

What happens during the surgery?
During the operation:
-An incision is made in the lower abdomen
-The bladder is opened to access the prostate
-The enlarged inner portion of the prostate is gently removed
-This immediately relieves the blockage to urine flow
-The outer capsule of the prostate is left intact, helping preserve surrounding structures.
-Removal of bladder stones at the same time

In the video being demonstrated, a bladder stone is also removed during the same operation.
-Bladder stones often develop because long-standing prostate blockage prevents the bladder from emptying completely. When Freyer’s prostatectomy is performed:
-The bladder is already open
-Any bladder stones can be safely identified and removed
-This avoids the need for a separate procedure
-Addressing both problems in one surgery helps improve urinary symptoms and reduces the risk of future complications.

Recovery and outcomes

Most patients experience:
-Significant improvement in urine flow
-Better bladder emptying
-Relief from long-standing urinary symptoms

A urinary catheter is usually kept temporarily after surgery to allow healing. Recovery is gradual, with most patients returning to normal daily activities over time.

Why is Freyer’s Prostatectomy still relevant today?
While many modern treatments use minimally invasive techniques, Freyer’s prostatectomy remains an excellent option for:
-Very large prostates
-Complex cases
-Patients with associated bladder stones or severe obstruction

When performed in appropriate patients, it offers durable and reliable results.

31/01/2026

When an Enlarged Prostate Leads to a Giant Bladder Stone

A Silent Complication Many Men Don’t See Coming

Understanding the Prostate and BPH

As men age, the prostate gland naturally enlarges. This condition is known as Benign Prostatic Hyperplasia or BPH.
It is not cancer, and it is extremely common, affecting the majority of men over the age of 50.

The problem arises because the prostate sits just below the bladder and surrounds the urethra. As it enlarges, it can gradually narrow the urine channel, making it harder for urine to flow out freely.

---

How BPH Causes Urine Retention

When urine cannot empty properly, it remains trapped inside the bladder. This is called Chronic urinary retention.

Over time, the bladder becomes:

* Overstretched
* Weak
* Unable to empty completely

This retained urine creates a stagnant environment, which becomes the perfect setting for stone formation.

---

From Retained Urine to Bladder Stones

Urine naturally contains minerals such as calcium, phosphate, and uric acid. When urine sits in the bladder for prolonged periods, these minerals start to crystallize.

With time:

* Tiny crystals form
* Crystals stick together
* Stones slowly enlarge

In men with untreated BPH, these stones can grow silently over years, sometimes reaching remarkable sizes known as Giant bladder stones.

Some stones can grow so large that they occupy most of the bladder.

---

Why Giant Bladder Stones Are Often Missed

One of the most dangerous aspects of this condition is how quietly it develops.

Many men:

* Get used to a weak urine stream
* Assume frequent urination is “normal aging.”
* Ignore straining or incomplete emptying
* Live with symptoms for years without seeking help

By the time symptoms worsen, the bladder stone may already be very large.

---

Symptoms That Should Never Be Ignored

Men with BPH complicated by bladder stones may experience:

* Weak or interrupted urine flow
* Difficulty starting urination
* Frequent urination, especially at night
* Pain or burning during urination
* Blood in the urine
* Recurrent urinary tract infections
* Lower abdominal discomfort

In advanced cases:

* Acute urinary retention
* Severe bladder pain
* Kidney damage

---

How the Diagnosis Is Made

Diagnosis is usually straightforward and painless:

* Ultrasound of the bladder and prostate
* X-ray or CT scan to identify stones
* Urine tests to look for infection or blood
* Prostate assessment by a urologist

Often, patients are shocked when imaging reveals a massive bladder stone that had been growing unnoticed for years.

---

Treatment Requires Treating Both Problems

Treating the stone alone is not enough.

Effective management must address:

1. Removal of the bladder stone

* Endoscopic stone fragmentation (cystolitholapaxy)
* Open surgery for very large stones

2. Treatment of the enlarged prostate

* Medications for mild cases
* Minimally invasive prostate procedures
* Surgical prostate removal when indicated

If the prostate obstruction is not corrected, stones are likely to recur.

--

The Long-Term Risks of Delayed Treatment

Untreated BPH with bladder stones can lead to:

* Permanent bladder damage
* Recurrent infections
* Chronic catheter dependence
* Kidney failure
* Reduced quality of life

What begins as a “minor urinary issue” can eventually become a major surgical problem.

--

The Take-Home Message for Men

BPH is common.
Bladder stones are preventable.
Giant bladder stones should never happen with timely care.

If you or someone you know experiences persistent urinary symptoms, early evaluation can:

* Prevent complications
* Avoid major surgery
* Preserve bladder and kidney function

Ignoring symptoms does not make them go away; it allows silent damage to progress.

30/01/2026

A personal reflection on trust, resilience, and walking this journey together

Dear Helmi Gimmick, you had already been carrying the weight of a stage 4 kidney cancer diagnosis when you were admitted with severe ongoing blood in the urine. It was an overwhelming and frightening time for you and your family, made even harder by the uncertainty and urgency of the situation. As the bleeding continued, it became clear that immediate action was needed, and my team and I moved quickly to do everything we could to stabilise your condition and keep you safe.

In moments like this, what stays with me most is not the complexity of the surgery, but the trust you and your family placed in us. Being asked to make decisions under such pressure requires courage, and the confidence you showed in my judgment and in the team is something I carry with deep respect and gratitude.

While the surgery itself was complex, that is not what has stayed with me most.

What has stayed with me is the weight of the trust you and your family placed in us.

In emergency situations like this, patients and families are suddenly asked to make decisions under immense emotional pressure. There is fear, uncertainty, and very little time to process what is happening. Yet through all of this, you trusted my judgement, my experience, and the team around me to do what was best for you. That trust is something I do not take lightly, and I remain deeply grateful for it.

As surgeons, we train for years to develop technical skill and clinical judgement. But moments like yours are a reminder that medicine is not just about expertise. It is about responsibility. Every decision carries consequences, and that responsibility is something I carry with great respect and humility.

I am also thankful to the entire healthcare team involved in your care. From the nurses who looked after you day and night, to the anaesthetists, theatre staff, and ward teams who worked calmly and professionally under pressure, your care was truly a team effort.

Since your discharge, our journey has not ended. We have stayed in touch while you continue your recovery at home, sharing updates on your progress, challenges, and milestones. What has been especially inspiring to see is your motivation and positive mindset throughout recovery. Despite everything you have faced, you remain focused, engaged in your care, and determined to keep moving forward. That attitude matters more than many people realise, and it plays an important role in recovery.

Over time, what began as a doctor patient relationship has naturally grown into a friendship built on mutual respect, honesty, and trust. These connections are one of the quiet privileges of being a doctor, and they remind me why I chose this profession.

Your journey also carries an important message for others.

Kidney cancer can be silent for a long time.
Many people have no pain or warning signs and continue with daily life until the disease is advanced. Sometimes, blood in the urine is the first sign. It may be painless, intermittent, or seem insignificant. But it should never be ignored.

Early detection changes everything.
Treatment options are wider
Surgery is often less complex
Outcomes are significantly better

Seeking medical attention early, even for symptoms that seem minor, can truly be life saving.

To you and your family, thank you for your courage, your trust, and your strength. It has been a privilege to care for you and to continue walking this journey together beyond the hospital.

And to everyone reading this, please listen to your body. If you notice blood in your urine or feel that something is not right, do not delay seeing a doctor.

Medicine is built on science and skill, but it is sustained by trust, resilience, continuity, and humanity.

----------------------------------------------------------------

Refleksi peribadi tentang kepercayaan, ketabahan, dan perjalanan yang kita lalui bersama

Sahabatku Helmi Gimmick, anda telah lama memikul beban diagnosis kanser buah pinggang tahap 4 apabila anda dimasukkan ke wad akibat pendarahan darah dalam air kencing yang berterusan. Ia merupakan satu tempoh yang sangat mencabar dan menakutkan untuk anda dan keluarga, ditambah p**a dengan ketidaktentuan serta keadaan yang mendesak. Apabila pendarahan berterusan, jelas bahawa tindakan segera diperlukan, dan pasukan saya serta saya sendiri bertindak pantas untuk melakukan segala yang perlu bagi menstabilkan keadaan dan memastikan keselamatan anda.

Dalam situasi seperti ini, apa yang paling kekal dalam ingatan saya bukanlah kerumitan pembedahan, tetapi kepercayaan yang anda dan keluarga berikan kepada kami. Membuat keputusan dalam keadaan tertekan memerlukan keberanian, dan keyakinan yang anda tunjukkan terhadap pertimbangan saya serta pasukan perubatan adalah sesuatu yang saya hargai dengan penuh rasa hormat dan terima kasih.

Sebagai seorang pakar bedah, kami menjalani latihan bertahun lamanya untuk membina kemahiran teknikal dan pertimbangan klinikal. Namun pengalaman seperti ini mengingatkan saya bahawa perubatan bukan sekadar kepakaran. Ia adalah tentang tanggungjawab. Setiap keputusan mempunyai kesannya, dan tanggungjawab itu sentiasa saya pikul dengan penuh rasa rendah diri dan hormat.

Saya juga amat berterima kasih kepada seluruh pasukan penjagaan kesihatan yang terlibat dalam rawatan anda. Daripada jururawat yang menjaga anda siang dan malam, kepada pakar bius, kakitangan dewan bedah, dan pasukan wad yang bekerja dengan tenang dan profesional dalam keadaan tertekan, penjagaan anda benar benar merupakan usaha berpasukan.

Selepas anda dibenarkan p**ang, perjalanan kita tidak berakhir di situ. Kami terus berhubung ketika anda menjalani pemulihan di rumah, berkongsi perkembangan, cabaran, dan pencapaian kecil sepanjang proses ini. Apa yang paling menginspirasikan saya ialah motivasi dan sikap positif yang anda tunjukkan sepanjang pemulihan. Walaupun berdepan dengan pelbagai dugaan, anda kekal fokus, terlibat aktif dalam penjagaan diri, dan bertekad untuk terus melangkah ke hadapan. Sikap ini sangat bermakna dan memainkan peranan penting dalam proses pemulihan.

Seiring dengan masa, hubungan yang bermula sebagai hubungan doktor dan pesakit telah berkembang secara semula jadi menjadi satu persahabatan yang berasaskan saling hormat, kejujuran, dan kepercayaan. Hubungan seperti ini adalah antara keistimewaan yang jarang disedari dalam profesion perubatan, dan ia mengingatkan saya mengapa saya memilih bidang ini.

Perjalanan anda juga membawa satu mesej penting untuk orang lain.

Kanser buah pinggang boleh berlaku secara senyap untuk jangka masa yang lama.
Ramai orang tidak mengalami kesakitan atau tanda amaran dan meneruskan kehidupan seperti biasa sehingga penyakit berada di tahap lanjut. Kadangkala, darah dalam air kencing adalah tanda pertama. Ia mungkin tidak sakit, berlaku sekali sekala, atau kelihatan tidak serius. Namun ia tidak boleh diabaikan.

Pengesanan awal mengubah segalanya.
Pilihan rawatan adalah lebih luas
Pembedahan selalunya kurang kompleks
Hasil rawatan adalah jauh lebih baik

Mendapatkan rawatan awal, walaupun untuk gejala yang kelihatan kecil, boleh menyelamatkan nyawa.

Kepada anda dan keluarga, terima kasih atas keberanian, kepercayaan, dan kekuatan yang ditunjukkan. Ia merupakan satu penghormatan untuk menjaga anda dan untuk terus berjalan bersama dalam perjalanan ini, walaupun selepas keluar dari hospital.

Dan kepada semua yang membaca, dengarlah tubuh badan anda. Jika anda melihat darah dalam air kencing atau merasakan sesuatu yang tidak kena, jangan berlengah untuk berjumpa doktor.

Perubatan dibina atas sains dan kemahiran, tetapi ia diperkukuhkan oleh kepercayaan, ketabahan, kesinambungan penjagaan, dan nilai kemanusiaan.

All pictures and videos posted with his consent and approval

28/01/2026

Bladder Cancer Awareness

Post 12:

The Key Take-Home Message on Bladder Cancer

Bladder cancer is a condition that can be treated, especially when it is detected early.

Blood in the urine is never normal. Even a single episode should always be checked, whether or not there is pain.

Early symptoms are often visible. Paying attention to changes in your urine and seeking medical advice early can make a life-changing difference.

Bladder cancer care does not end with treatment. Regular follow-up is essential and allows early detection of recurrence, when treatment is simpler and more effective.

Even when major surgery is required, many patients continue to live active, independent, and fulfilling lives. With modern treatment, education, and support, quality of life can be very good.

Awareness leads to early action. Early action saves lives.

If you notice blood in your urine or persistent urinary symptoms, do not ignore them. See a doctor early.

Your health is worth checking.

26/01/2026

Post 11:

Why Long-Term Follow-Up Matters After Bladder Cancer

• Follow-up is lifelong
Regular check-ups are needed even when you feel well.

• Bladder cancer can recur
Recurrence can happen months or years after treatment.

• Early detection matters
Finding recurrence early allows simpler and more effective treatment.

• Follow-up provides reassurance
Normal results give peace of mind and confidence.

• Anxiety is normal
Feeling nervous before follow-up visits is common and understandable.

• Do not skip appointments
Missing follow-up can delay diagnosis and lead to more complex treatment.

• Proactive care
Follow-up helps maintain long-term control and good quality of life.

Staying engaged in follow-up is one of the most important parts of bladder cancer care.

23/01/2026

Bladder Cancer Awareness

Post 11: Life After Bladder Cancer Treatment

• Recovery takes time
It is normal to feel tired at first. Energy and strength gradually return.

• Regular follow-up is important
Appointments help monitor recovery and detect problems early.

• Returning to daily life
Most patients can return to work, travel, exercise, and social activities.

• Emotional well-being matters
Feeling anxious after treatment is common. Support from healthcare teams, family, and friends helps.

• Healthy lifestyle choices
Stopping smoking, staying active, eating well, and drinking enough fluids support recovery.

• Life after bladder removal
With education and support, patients adapt well and remain independent.

• Positive outlook
Many patients live full, active lives after bladder cancer treatment.

Recovery does not happen overnight, and that is okay. Feeling tired, uncertain, or anxious at times is normal. With time, support, and follow-up, most people regain strength and confidence.

Life after bladder cancer is not about constant restriction. Many patients return to work, enjoy time with family, travel, exercise, and continue living active, meaningful lives.

Regular follow-up appointments are there to protect you, not to worry you. Healthy habits, staying engaged in daily life, and open communication with your healthcare team all play an important role in long-term wellbeing.

You are not alone on this journey. With the right care and support, life after bladder cancer can be full and fulfilling.

21/01/2026

Post 10

Ileal Conduit After Bladder Removal (Cystectomy)

• Why it is needed
After bladder removal, the body needs a new way to pass urine.

• What an ileal conduit is
A short piece of small intestine is used to create a channel for urine.

• How urine drains
Urine flows from the kidneys through this channel and exits through a small opening on the abdomen called a stoma.

• Urine bag
Urine drains continuously into a secure, discreet external bag attached to the skin.

• Living with an ileal conduit
Modern bags are odour proof and comfortable. Patients can walk, exercise, travel, work, and sleep normally.

• Support and training
Stoma care nurses teach patients how to care for the stoma and change the bag confidently.

• Quality of life
Most patients adapt well and return to active, independent lives.

• Important message
An ileal conduit is a safe and reliable solution after bladder removal.

With education and support, life after cystectomy can be full and meaningful.

15/01/2026

Post 9:

Cystectomy: When Bladder Removal Is the Best Treatment

• When cystectomy is needed
Recommended when bladder cancer has grown into the muscle or is aggressive and likely to spread.

• What a cystectomy is
Surgery to remove the bladder to treat bladder cancer.

• Why it is done
To remove all cancer and give the best chance of cure and long-term control.

• Careful decision making
The recommendation is based on scans, tissue results, and overall health.

• Major surgery with preparation
Patients are fully assessed before surgery and cared for by an experienced medical team.

• Recovery and support
Recovery takes time, with careful pain control and gradual return to activity.

• Life after cystectomy
Many patients return to normal daily activities and enjoy a good quality of life.

• Important message
Cystectomy is a life-saving treatment, not a failure.

With proper care, support, and follow-up, patients do very well after cystectomy.

Dr. Arvind Jagwani Urologist

16/02/2026

13/02/2026

10/02/2026

05/02/2026

02/02/2026

31/01/2026

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