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Prakash Maniam's journey to becoming a urologist began with a painful, yet fateful moment as an undergraduate at The Ohio State University. An aspiring engineer at the time, he was on his way home from class when he suddenly felt a severe pain in his side.
"My brother drove me to the emergency room, where I learned that I had a kidney stone, which was something I'd never heard of before," he recalled. "I passed the stone, but it opened my eyes to medicine, and specifically urology. I shifted gears from engineering to pre-med and went from there."
After earning his medical degree at Ohio State University College of Medicine, Maniam completed general surgery and urology residencies at Case Western Reserve University in Cleveland, Ohio. He then worked in private practice in Augusta, Georgia, and recently relocated to Central Florida with his family.
Today, kidney stones are one of the most prevalent conditions he treats as a board-certified urologist at Medical Specialty Group at Poinciana and Osceola Urology Associates, where he serves patients at Poinciana Medical Center and their sister facility, Osceola Regional Medical Center. He specializes in general urologic care, including treatment for cancers of the urinary tract, prostate diseases, sexual dysfunction and urinary incontinence. He is also a member of the American Urological Association.
Advancements in Care
Maniam enjoys keeping up with advancements in the fast-changing field of urology. One of his favorite aspects of the job is problem-solving, considering both traditional and new techniques to determine what is best for the patient.
"Kidney stone disease is still evolving, and treatments that were the best solution five years ago, aren't anymore," he said. "It's similar with prostate disease, incontinence, and so forth."
In Augusta, Maniam gained experience in robotic surgery to treat prostate cancer and kidney cancer and for urinary reconstruction. Both Poinciana Medical Center and Osceola Regional Medical Center house a surgical robot, which Maniam is trained to use for these procedures.
Another promising technique is using laser, or green light, therapy to treat moderate to severe urinary symptoms caused by an enlarged prostate, or benign prostatic hyperplasia (BPH).
Maniam specializes in photoselective vaporization of the prostate (PVP), using a laser to melt away excess prostate tissue and enlarge the urinary channel. Depending on the size of the prostate, the procedure can take anywhere from one to one-and-a-half hours.
According to the Mayo Clinic, laser surgery offers several advantages over other methods of treating BPH, such as transurethral resection of the prostate and open prostatectomy.
"It lowers the risk of bleeding, shortens or eliminates the hospital stay, speeds up recovery and reduces the need for a catheter," Maniam said. "Patients like it because they can go home the same day. Most importantly, the outcomes have been very good, and improvement is noticeable right away. The goal is to get the patient to where they don't have to worry about basic things like passing urine, and laser therapy allows us to do this easily and more rapidly."
Unmet Needs in Poinciana
These outcomes are rewarding for Maniam, who came to Poinciana after recognizing the opportunity to fill unmet healthcare needs in Osceola and Polk counties. He first heard of Poinciana Medical Center while visiting sister facility Osceola Regional Medical Center, during a trip to the Orlando area to scout out schools for his son, who has special needs.
Since Poinciana Medical Center opened its doors in 2013, the hospital has steadily added new service lines and deepened its bench of specialists.
"I saw a chance to help people who otherwise had to leave the area to get the help they need," Maniam said. "We have an older population in Florida, which is associated with more prostate disease, enlargement and cancer. Being in the Southeast, we see a lot of kidney stones, related to diet and lifestyle, as well as our climate."
Patient education and prevention is a key element of Maniam's practice, particularly because urological issues can sometimes cause patients to feel embarrassed or intimidated. "We emphasize that men should have routine prostate screenings, and patients who have kidney stones should follow up for regular screenings, so we can treat them before it escalates into an emergency."
Involving family members is also critical, Maniam said. "After the patient leaves, these loved ones oversee their care, so they need to be educated about what's going on and the treatment plan we've established. We talk with them about the disease process, what they can look for, and things they can do to prevent a recurrence."
Full Circle
In reflecting on his path from a patient to a physician, Maniam says that empathy helps him deliver better care.
"I remember how it felt to be their shoes, and that's what inspires me every day," he said. "I can take someone who's in severe pain and bring them to a point where they're completely relieved and can go back to their lives again. On the other hand, I treat chronic diseases where I can follow patients for a long time. My goal is to see them as whole individuals rather than only seeing their disease state."
"Using all of the latest tools and technology to treat sometimes complex diseases is rewarding. It's a challenge that really drives me. If it were easy, I'd probably get bored."
