Dr Pras Sivam FRACS (Urol)
Urologist, Uro-Oncologist and Robotic Surgeon
Dr. Sivam grew up in Melbourne and attended Haileybury College, where he graduated as Dux of the School in 1998. He then went on to study at the University of Melbourne Medical School, where he was accepted with the top tertiary entrance rank of 99.95. After completing his postgraduate surgical training in Victoria, he was offered a Fellowship in Urologic Oncology at Memorial Sloan-Kettering Cancer Center in New York. This gave him the opportunity to receive specialized training from world-renowned experts in his field.
Dr. Sivam offers a range of general urologic services, with a focus on the latest surgical techniques for treating urological cancers. Click here to learn more about his background, qualifications, and services.
Melbourne Urologist Robotic Prostatectomy Prostate Cancer
Please click below for detailed descriptions of common operations, including robotic prostatectomy, prostate biopsy, stone surgery, TURP and surgery for kidney, bladder and testis cancer.
The "Hood Technique"
Dr Pras utilises the “Hood Technique” for robotic radical prostatectomy (1). This approach combines elements of both the traditional “anterior” and newer “Retzius-sparing” techniques to enable early return of continence without compromising surgical margin rates.
Early continence recovery
In a recent audit of the last 50 cases using the Hood Technique, we found that 37% of our patients achieved continence (0 pads or 1 security pad) within 2 weeks of surgery, and 57% within 3 months. Few studies have looked at continence this early after surgery, however one large systematic review reported 3-month continence rates ranging from 25% to 90% (2).
Excellent cancer control
In a recent audit of the last 50 cases using the Hood Technique, we achieved superior cancer control rates with a negative margin rate of 100% for organ-confined cancer (stage pT2) and 82% for locally-advanced cancer (stage pT3). For comparison, in one large systematic review the average negative margin rate was 91% for pT2 and 63% for pT3 cancers (3).
(1) Wagaskar et al. European Urology, Volume 80, Issue 2, August 2021, Pages 213-221.
(2) Ficarra et al. European Urology, Volume 62 Issue 3, September 2012, Pages 405-417.
(3) Novara et al. European Urology, Volume 62 Issue 3, September 2012, Pages 382-404.
GP Education Webinar on Male Urinary Symptoms with a focus on BPH
This is a video of a webinar Dr Pras gave to Melbourne GPs through his work at the Australian Prostate Centre. The goal of this presentation was to provide a framework for GPs to assess and manage men with urinary symptoms, and to also identify those factors that would warrant early referral to a urologist.
GP Education Webinar on Testicular Cancer and Benign Scrotal Conditions
Here’s a link to a recent GP webinar providing an overview of testicular cancer and other benign and malignant scrotal conditions. The webinar was part of Dr Pras’ work through the Australian Prostate Centre. The learning goals of this presentation were to help GPs better diagnose and manage patients presenting with scrotal problems, and to identify the red flags for testicular cancer in patients presenting with testis pain or a mass. Dr Pras has spearheaded the testis cancer program at the Northern Hospital, and has performed six retroperitoneal lymph node dissections in the two years since its inception.
In the news – Alban Gee Award
Dr. Pras was recently honoured with the prestigious 2022 Alban Gee Award at the Annual Meeting of the Urological Society of Australia and New Zealand, which took place at the Gold Coast Convention Centre. This award has been presented annually since 1987 to recognize the best poster by a USANZ member at the Annual Scientific Meeting.
Dr. Pras’s winning poster, titled “Factors impacting clinician reluctance to defer prostate biopsy in men with a negative multiparametric MRI,” addressed the issue of doctors who remain reluctant to defer prostate biopsy in men with negative MRI findings. His research has shed light on an important issue in the field of urology and has garnered recognition from his peers.