Dr Ali Shandar Durrani Urology clinic

27/10/2025

How should men get tested for infertility?

It goes beyond a basic check. Dr. Durrani emphasizes a multi-step approach: Semen Analysis, followed by Hormone Profiling (FSH, LH, Testosterone), and targeted imaging like Scrotal Ultrasound to diagnose varicocele or anatomical issues. Accurate diagnosis requires comprehensive data.

📍 Doctor Details:
Dr. Ali Shandar Durrani
Consultant Urologist | Kidney Transplant Surgeon | Male Sexual Health Specialist
Expert in: PCNL, RIRS, URS, TURP, TURBT & Kidney Transplant Surgery
📍 Available in Lahore & Gujranwala
📞 For Appointment: 0317-4249279

23/10/2025

23/10/2025

Struggling to conceive your second child?

Secondary infertility is common, but treatable. Dr. Ali Shandar Durrani, Urologist & Male Fertility Specialist, explains the potential male factors. We investigate issues such as subclinical varicocele progression, hormonal shifts post-first child, and occult infections affecting sperm parameters. Early and precise Semen Analysis and Hormone Profiling are key to accurate diagnosis. Don't wait to seek professional help.

Points:
Subclinical varicocele progression.
Hormonal shifts post-first child.
Occult infections affecting sperm parameters.
Early and precise Semen Analysis and Hormone Profiling are key.

📍 Doctor Details:
Dr. Ali Shandar Durrani
Consultant Urologist | Kidney Transplant Surgeon | Male Sexual Health Specialist
Expert in: PCNL, RIRS, URS, TURP, TURBT & Kidney Transplant Surgery
📍 Available in Lahore & Gujranwala
📞 For Appointment: 0317-4249279

22/10/2025

Why Choose Microscopic Varicocelectomy?

1. Superior Visualization and Preservation:
The procedure uses a high-powered surgical microscope to magnify the structures in the spermatic cord (the tube containing the veins and artery) up to 25 times.

Identifies All Veins:
The magnification allows the surgeon to see and ligate even the smallest abnormal veins that contribute to the varicocele, ensuring a more complete repair.

Spermatic Artery Preservation:
Crucially, the surgeon can clearly identify and preserve the tiny spermatic artery (which supplies blood to the testicle). This is essential for the health of the testicle and helps maintain testosterone production.

Lymphatic Channel Preservation:
The procedure allows for the identification and preservation of the lymphatic channels, which significantly reduces the risk of post-operative hydrocele (a fluid collection around the testicle), a common complication in non-microscopic techniques.

2. Higher Success and Better Outcomes
Because of the precise nature of the surgery:
Lowest Recurrence Rate: Microscopic varicocelectomy has a very low rate of recurrence (the varicocele returning), typically less than 1-2%, because all problematic veins are addressed.

Maximum Fertility Improvement: Studies show this technique results in the highest rates of improvement in sperm count and motility for men suffering from infertility due to varicocele.

3. Reduced Complications and Recovery
The procedure is minimally invasive, usually performed through a small incision in the groin.

Faster Recovery:
Patients can often return to normal activities within a few days.

📍 Doctor Details:
Dr. Ali Shandar Durrani
Consultant Urologist | Kidney Transplant Surgeon | Male Sexual Health Specialist
Expert in: PCNL, RIRS, URS, TURP, TURBT & Kidney Transplant Surgery
📍 Available in Lahore & Gujranwala
📞 For Appointment: 0317-4249279

21/10/2025

How Varicocele Affects Fertility:
A varicocele is an enlargement of the veins inside the scrotum (a varicose vein), and it impairs fertility primarily through two mechanisms.

Increased Scrotal Temperature:
The pooled, stagnant blood in the enlarged veins raises the temperature around the testicles. The testicles need to be slightly coole. than the rest of the body for optimal sperm production. This increased heat damages the cells responsible for creating and maturing sperm.

Impaired Blood Flow & Toxin Build-up:
The poor drainage of blood can lead to a buildup of waste products or toxins around the testicle, which further harms the sperm-producing cells.

Impact on Sperm:
This damage results in lower sperm quality, often characterized by:
Low Sperm Count .
Poor Sperm Motility.
Abnormal Sperm Morphology.

Because of these effects, a man with a varicocele may struggle to conceive a child naturally. Treatment (varicocelectomy) is often recommended to improve these sperm parameters and enhance the chance of successful conception.

📍 Doctor Details:
Dr. Ali Shandar Durrani
Consultant Urologist | Kidney Transplant Surgeon | Male Sexual Health Specialist
Expert in: PCNL, RIRS, URS, TURP, TURBT & Kidney Transplant Surgery
📍 Available in Lahore & Gujranwala
📞 For Appointment: 0317-4249279

20/10/2025

Varicocele and Male Sexual Health

A varicocele is an enlargement of the veins within the loose bag of skin holding the testicles (the scrotum). It's essentially a "varicose vein" in the scrotum.

Heat Damage to Testis:
Varicoceles cause blood to pool around the testicles, which increases the temperature in the scrotum. This elevated temperature is harmful to the testicle tissue.

Testosterone Production Damage:
The testicles are the primary site for testosterone production. The persistent heat and impaired blood flow caused by the varicocele can damage the Leydig cells, which are responsible for producing testosterone.

Low Testosterone (Low-T): This damage leads to lower-than-normal testosterone levels. Low testosterone can cause a range of symptoms, which the patient might describe as mardana kamzori (male weakness or low vigor), including:

Erectile Dysfunction (ED):
Difficulty achieving or maintaining an erection.

Low Libido (Sex Drive):
A reduced interest in sex.

Fatigue and Low Energy:
General lack of stamina and weakness.

Mood Changes:
Depression and irritability.

While varicoceles are most famously associated with male infertility (due to damaging sperm production), the effect on testosterone is a direct link to other aspects of male sexual health and vigor.

📍 Doctor Details:
Dr. Ali Shandar Durrani
Consultant Urologist | Kidney Transplant Surgeon | Male Sexual Health Specialist
Expert in: PCNL, RIRS, URS, TURP, TURBT & Kidney Transplant Surgery
📍 Available in Lahore & Gujranwala
📞 For Appointment: 0317-4249279

18/10/2025

Kidney Transplantation & Varicocelectomy
The day began with a Kidney Transplantation case. Following the transplant, you performed a Right-Sided Varicocelectomy.

Case Details:
The patient presented specifically for fertility-related issues.

Procedure:
Right-Sided Varicocelectomy (A procedure to correct an enlarged vein in the scrotum, often done to improve male fertility).

2. Laparoscopic Management of Undescended Testis
The second case involved a young male patient with a history of an undescended testis (cryptorchidism).

Patient History:
The young man stated that he had never felt his right testis in the scrotum since childhood. He requested a check-up.

Diagnosis:
An MRI was performed, which revealed that the right testis, which was not palpable in the scrotum, had begun to descend from the intra-pelvic region and was likely in the inguinal canal or a high scrotal position (the term "intrapelvic part" suggests its initial location was within the abdomen/pelvis).

Surgical Plan & Rationale:
You discussed the case with the patient, who gave consent for the best course of action.

Crucial Counseling Point:
You informed the patient that an undescended testis (testis remaining in the abdomen/groin) has a significantly higher risk of becoming cancerous (Testicular Cancer).

Conclusion:
Therefore, to mitigate the cancer risk, it was necessary to either bring the testis down to its proper position in the scrotum (orchidopexy) or, if not viable or if the risk was too high, remove it (orchiectomy).

Procedure:
You were in the process of performing a Laparoscopic procedure (likely a laparoscopic orchidopexy or exploration) to manage this undescended testis.

📍 Doctor Details:
Dr. Ali Shandar Durrani
Consultant Urologist | Kidney Transplant Surgeon | Male Sexual Health Specialist
Expert in: PCNL, RIRS, URS, TURP, TURBT & Kidney Transplant Surgery
📍 Available in Lahore & Gujranwala
📞 For Appointment: 0317-4249279

13/10/2025

What is Urinary Tract Infection (UTI)? Causes, Symptoms & Treatment

Urinary Tract Infection (UTI) is a common infection that affects any part of the urinary system — including the kidneys, ureters, bladder, and urethra. It occurs when bacteria enter the urinary tract and start multiplying, leading to inflammation and discomfort.
UTIs are more common in women, but men can also develop them, especially with prostate enlargement or kidney stones.

⚠️ Common Symptoms of UTI:
Burning sensation during urination
Frequent urge to urinate, even with little urine output
Pain or pressure in the lower abdomen or back
Cloudy, dark, or foul-smelling urine
Blood in urine (Hematuria)
Fever and chills – if infection reaches the kidneys
Weakness or general feeling of illness

💊 Treatment Options:
UTIs are usually treated based on the cause and severity of infection:
Antibiotic Therapy – prescribed after urine tests to target the bacteria.
Pain Relief Medications – to reduce burning and discomfort.
Hydration Therapy – drink plenty of water to flush out bacteria.
Treatment of Underlying Causes – such as removing kidney stones, treating prostate issues, or managing diabetes.

⚠️ Untreated UTIs can lead to serious complications like kidney infections (Pyelonephritis) or sepsis — so timely medical attention is essential.

💧 Prevention Tips:
Drink 8–10 glasses of water daily
Do not hold urine for long periods
Maintain personal hygiene
Urinate after sexual activity
Avoid using harsh soaps or sprays in the genital area
Manage blood sugar levels if diabetic

📍 Doctor Details:
Dr. Ali Shandar Durrani
Consultant Urologist | Kidney Transplant Surgeon | Male Sexual Health Specialist
Expert in: PCNL, RIRS, URS, TURP, TURBT & Kidney Transplant Surgery
📍 Available in Lahore & Gujranwala
📞 For Appointment: 0317-4249279

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10/10/2025

What is Prostate Cancer? Its Symptoms and Treatment

Prostate cancer is a type of cancer that develops in the prostate gland, a small walnut-sized gland found in men, responsible for producing the fluid that nourishes and transports sperm. It’s one of the most common cancers in men, especially after the age of 50.

⚠️ Symptoms of Prostate Cancer:

In its early stages, prostate cancer often shows no clear symptoms, which is why regular checkups are important. As it grows, you may notice:

Difficulty in urination – weak flow or trouble starting/stopping urination
Frequent urination, especially at night
Pain or burning while urinating
Blood in urine or semen
Erectile dysfunction (difficulty maintaining erection)
Pain in lower back, hips, or thighs (in advanced stages)

💊 Treatment Options:
Treatment depends on the stage of cancer, age, and overall health of the patient. The main treatment options include:

Active Surveillance / Observation:
For slow-growing prostate cancers that are not causing symptoms.

Surgery (Radical Prostatectomy):
The removal of the prostate gland, often done laparoscopically or robotically for faster recovery.

Radiation Therapy:
High-energy rays used to destroy cancer cells.

Hormone Therapy:
Reduces testosterone levels that help prostate cancer grow.

Chemotherapy / Immunotherapy:
Used in advanced cases where cancer has spread beyond the prostate.

📍 Doctor Details:
Dr. Ali Shandar Durrani
Consultant Urologist | Kidney Transplant Surgeon | Male Sexual Health Speciali
📍 Available in Lahore & Gujranwala
📞 For Appointment: 0317-4249279

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09/10/2025

Laser treatment for kidney stones — known as RIRS (Retrograde Intrarenal Surgery) or Laser Lithotripsy — is one of the most advanced and safest methods to remove stones. It uses a flexible camera and laser fiber to break the stones into tiny pieces without any cuts or stitches.

However, like any medical procedure, there can be minor and temporary side effects, which usually go away on their own within a few days.

Here are some possible effects:

Mild Burning or Discomfort While Urinating:
🔹 Common for 1–2 days after the procedure.
🔹 Caused by temporary irritation of the urinary tract.

Slight Blood in Urine:
🔹 Pinkish urine for 24–48 hours is normal and usually resolves with hydration.

Back or Flank Pain:
🔹 Can occur if a DJ stent is placed after surgery; it improves once the stent is removed.

Frequent Urge to Urinate:
🔹 A temporary side effect of the stent or mild inflammation after the procedure.

Rare Complications:
🔹 Infection or fever (very rare and preventable with antibiotics).

✅ Overall:
Laser treatment is minimally invasive, highly effective, and has a very fast recovery time — usually patients can go home the same or next day.

📍 Doctor Details:

Dr. Ali Shandar Durrani
Consultant Urologist | Kidney Transplant Surgeon | Male Sexual Health Specialist
Expert in RIRS, PCNL, URS, TURP, TURBT & Kidney Transplant Surgery
📍 Masood Hospital, Lahore — Tue to Thu (3 PM – 5 PM)
📍 Farooq Hospital, Iqbal Town — Tue to Thu (5 PM – 7 PM)
📍 Central Hospital, Gujranwala — Mon & Fri (4 PM – 7 PM)
📞 For Appointment: 0317-4249279

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08/10/2025

When both kidneys have stones, deciding which kidney to treat first depends on several important medical factors. The goal is always to protect kidney function and prevent complications.

Here’s how doctors usually decide:

The More Affected Kidney:
🔹 The kidney with severe obstruction, infection, or larger stones is usually treated first.
🔹 This helps relieve pressure and prevent permanent damage.

Kidney Function:
🔹 If one kidney is functioning poorly, doctors may treat that one first to try to preserve as much function as possible.
🔹 In some cases, the healthier kidney is operated on first to secure safe urine drainage.

Presence of Infection or Swelling:
🔹 If infection or swelling is present, that kidney is prioritized to avoid serious complications like sepsis.

Stone Location:
🔹 If one kidney’s stones are easier to access (via RIRS, PCNL, or URS), the procedure may start there first.

After recovery from the first procedure, the second kidney is operated on—usually after 2–4 weeks, depending on recovery and condition.

📍 Doctor Details:

Dr. Ali Shandar Durrani
Consultant Urologist | Kidney Transplant Surgeon | Male Sexual Health Specialist
Expert in: PCNL, RIRS, URS, TURP, TURBT & Kidney Transplant Surgery
📍 Available in Lahore & Gujranwala
📞 For Appointment: 0317-4249279

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07/10/2025

The type of surgery for varicocele depends on the severity of symptoms, grade of varicocele, and fertility goals of the patient. The main goal of surgery is to block or tie the abnormal veins so that blood can flow through healthy veins instead.

Here are the most common surgical options:

Microsurgical Varicocelectomy:
🔹 Considered the gold standard treatment.
🔹 Performed through a small incision using a surgical microscope.
🔹 Offers highest success rate and lowest recurrence.

Laparoscopic Varicocelectomy:
🔹 Minimally invasive, done through small keyhole incisions.
🔹 Useful for bilateral (both sides) varicocele.

Percutaneous Embolization:
🔹 A non-surgical procedure done by a radiologist.
🔹 A coil or chemical is inserted into the vein to block it.
🔹 Quick recovery, but not suitable for all cases.

The choice of surgery should always be made after consultation with a urologist, depending on patient’s condition, symptoms, and fertility plans.

📍 Doctor Details:

Dr. Ali Shandar Durrani
Consultant Urologist | Kidney Transplant Surgeon | Male Sexual Health Specialist
Expert in: PCNL, RIRS, URS, TURP, TURBT & Kidney Transplant Surgery
📍 Available in Lahore & Gujranwala
📞 For Appointment: 0317-4249279
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