Minimally Invasive Urology Surgery
Reconstructive Urology Surgery
Reconstructive Surgery Procedures
Treatment Of Male Sexual Problems
Transurethral Resection Of The Prostate (Turp) Pro
Transurethral Incision Of The Prostate (Tuip) Proc
Urology Minimally Invasive Surgery
Urinary Incontinence (Ui) Treatment
Kidney Transplant Treatment
Treatment Of Erectile Dysfunction
Blood In Urine (Hematuria) Treatment
Open Prostatectomy Surgery
Hydrocele Treatment (Surgical)
Treatment of H.I.V
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The kidneys make urine, which is a fluid through which wastes from the body including urea are eliminated from the body. There are two kidneys on the right and left side, which make urine, and pass it down to the bladder through tubes known as ureter. The bladder acts as a reservoir of the urine that is formed in the kidneys. It is stored temporarily there before being excreted out of the body through the urethra. The urinary bladder is a highly muscular organ and has a rich connective tissue.
Interstitial cystitis (IC) or painful bladder syndrome (PBS) is a very common condition, which affects females more than males. While the exact etiology is not known, it could be age-related and also lifestyle related. People who are used to controlling the urge to pass urine are highly likely to develop this condition. The simple logic is that there is additional pressure on the bladder from the urine that is contained for longer period of time. As such, the muscular wall stretches and begins to feel stressed.
When this habit continues over a period of time, the bladder wall may become irritated or inflamed or even scarred in severe cases. There is no role of bacteria in this condition, and antibiotics are of no help in managing this condition (though the name cystitis usually indicates infection).
The following symptoms are seen as a result of this constant irritation and inflammation.
- One may suffer from pain and pressure in the bladder as it continues to collect more and more urine.
- This pressure in the bladder also puts pressure on the surrounding tissues in the abdomen including the pelvis, urethra, abdominal organs, uterus, etc.
- Women may experience pain in the vaginal tract including vulva and behind the vagina.
- Men may experience pain in the area of the scrotum, testicles, prostate, and penis.
- There is an increased urge to urinate, which may be as much as 9 to 10 times a day. As the condition progresses, there could be more visits, as many as 40 to 50 visits a day.
- This tendency and urge to urinate increases during nighttime.
- For women, this urge to urinate and other symptoms including pain are worse during menstruation.
- There could be pain during intercourse for both men and women.
- There could be pain even otherwise, which can range from a mild dull ache to a piercing pain.
- At a structural level, this constant pressure leads to pinpoint bleeding (glomerulations) and sometimes even ulcers in the bladder wall.
There is no definitive treatment for IC or PBS. However, bladder distention and instillation are proven methods of increasing bladder capacity, which therefore helps in relieving symptoms.
Lower Urinary tract obstruction refers to a condition of hindrance to urinary flow from bladder outwards. This can occur in all the age groups and affect either sex. The symptoms can be poor urine flow, intermittent flow, straining to pass urine or empty bladder, sense of incomplete emptying of bladder, difficulty in starting urination. Other problems can be increased urine frequency and difficulty to hold on with or without occasional urine leak in clothes. The cause and treatment vary in different age groups.
Few common reasons behind Lower urinary Tract Obstruction:
Congenital urethral stricture and PUV: These defects can be detected either before or after birth and need correction at earliest to avoid long-term complications. It is usually brought to attention by parents who observe abnormal urine flow pattern of their child OR found out during evaluation for repeated urinary tract infections.
Neurogenic bladder: This is caused due to defects of nerves that are responsible for controlling bladder function. This can be due to diseases of brain, spinal cord or peripheral nerves. These defects can occur by birth or later in life. It is very important to take early consult to avoid long-term complications and progression to renal failure.
Urethral stricture: This is narrowing in a long tube that starts from bladder to the external urinary opening. It can be idiopathic, post-traumatic, or due to urethral infections. Usually, a person is able to recognise poor urine flow and bring it to the attention of urologist. Treatment for stricture depends on various factors and range from simple endoscopic surgery to open surgeries.
Bladder neck obstruction: Bladder neck is a network or a group of muscles that connect the bladder to the urethra. The muscles tighten to hold urine in the bladder, and relax as they release it through the urethra. Urinary tract obstruction occurs when there are abnormalities blocking the bladder neck that restricts its opening during urination.
BPH: This occurs due to enlarged prostate obstruction urine flow out of bladder. Prostate enlargement is mostly age-related and rarely due to prostatic tumors. Urinary stones. This can be usually recognized by sudden obstruction to urine flow in person who was voiding normally. These episodes might be recurrent due to movement of stone in between bladder and urethra.
Bladder tumors: The are mostly characterized by blood in urine. Sometimes there might be blood clots that obstruct the urine flow. Phimosis: Usually occurring post-puberty, it is referred to as the inability to retract the glans (the sensitive structure at the end of the penis). It is a condition in which the distal foreskin, which was previously retractable, is unable to retract anymore.
Phimosis: Phimosis is another major reason behind urinary tract obstructions.
Bladder cancer is characterized by irregular growth of abnormal tissue (tumor) on the lining of the bladder. This type of cancer may spread to the surrounding tissues or other body parts as well.
What are the causes?
Bladder cancer can be caused by environment-related factors and smoking. In fact, smoking tobacco is one of the major causes of bladder cancer around the world. The chemicals present in tobacco can irritate the bladder lining which ultimately leads to bladder cancer. It may also be caused by continuous exposure to chemicals such as dyes or leather dust and radiation. These chemicals tend to cause unusual changes in the cells of the bladder lining and causes cancer in the bladder.
It can also be caused by modifications in the dna in the cells of the bladder which may impair the functioning of the cells in the body. This can cause mutations in the bladder resulting in cancer.
What are the symptoms?
1. Presence of blood in the urine, often painless
2. Feeling of pain while passing urine
3. Back pain
4. Excessive urination
5. Infections in the urinary tract
6. Lower leg swelling
7. Pain in the bones, especially in the pelvic area
8. Weight loss
Treatments for bladder cancer depend on the stage of the cancer. The various treatment choices are:
Surgery - In some cases, these cancers are surgically removed by a surgeon. A type of surgery used is transurethral resection of bladder tumor (turbt) where the cancer cells are destroyed with laser by passing a thin fiber into the bladder.
Chemotherapy - In this method, medications are used to target and destroy cancer cells.
Radiation therapy - Radiation therapy uses rays such as x-ray or uv rays to destroy cancer cells in the body
Immunotherapy - This treatment boosts the immune system of the body so that it attacks the cancerous cells in the bladder.
What you should know about Urinary Incontinence.
Urinary incontinence is the inability to hold urine in the bladder because of loss of control of the bladder. The severity may range from temporary to chronic, depending on the cause of this disease. Urinary incontinence is more common in women than men and can be categorized into three types.
Types and symptoms of urinary incontinence
Stress incontinence: This incontinence may occur while participating in any physical activity such as a sudden cough, laugh, sneezing or exercising. The stress here refers to the sudden physical pressure that a person experiences, leading him/her to urinate involuntarily.
Urge incontinence: A sudden, involuntary contraction of the muscular wall of the bladder causes an urgency to urinate. This urgency can be formed by a sudden change in position or sex.
Overflow incontinence: This is more common in men with prostate gland problems, damaged bladder or blocked urethra. The person has an urge to urinate frequently but in small amounts.
Causes of urinary incontinence
There are a number of causes of urinary incontinence ranging from aging to cancer and physical damage to the neurological disorder.
1. Aging: With age, the bladder muscle weakens and the chances of incontinence increases.
Damage: Since the pelvic muscles support the bladder any damage to it (surgery or any procedure to remove the uterus) can lead to urinary incontinence.
2. Enlarged prostate: Enlargement of the prostate gland in older men may give rise to this condition.
3. Cancer: Urinary incontinence may be associated with untreated prostate cancer, which is a side effect of treatments for it.
4. Menopause: Estrogen is a hormone that keeps the lining of bladder and urethra healthy. After menopause the production of estrogen is decreased, increasing the chances of urinary incontinence.
Prevention: Urinary incontinence is not preventable but some steps can be taken to reduce the risk of it. Maintaining a healthy lifestyle, avoiding smoking, practicing pelvic floor exercises, avoiding caffeine and acidic foods and eating more fiber to prevent constipation can help decreasing the risk of it.
The prostate gland in males surrounds the urethra, through which urine and sperm are passed out of the body. Its function is to secrete a fluid, which provides nourishment to the sperm. It is about the shape of a walnut and is present between the pubic bone and the rectum.
As a man crosses 40, the prostate gland begins to increase in size due to an increase in the number of cells. This is known as hyperplasia. The condition is usually benign and therefore the name benign prostate hyperplasia (BPH). As it continues to grow, there is an increased pressure on the urethra. Therefore, there can be problems with urination. The bladder, being a muscular organ, compensates to some extent and so the problems with urination are mostly managed. If left untreated, this can continue to be a major problem and the bladder may not be able to compensate. In men who are 60-plus, BPH is very common.
Signs and symptoms
- One of the initial symptoms of BPH is when the urine stream begins to grow weak.
- There could also be a reduced speed of passing urine.
- Men with BPH never have a feeling of complete emptying of the bladder.
- On the other hand, there is also a constant difficulty in initiating a urine stream. There could be intermittent breaks in the urine stream.
- The person may feel the need to strain to initiate the stream and to ensure complete emptying.
- There could be dribbling of urine after passing urine.
- The duration between two bathroom visits can constantly reduce, with the constant urge to urinate.
- There is a constant urge to visit the bathroom, which is more common in the night. One of the most annoying features of BPH is the walking up at night to urinate, but with an inability to initiate a stream and an inability to completely empty the bladder, it leaves the person very irritated and frustrated.
- There could be blood in the urine. In fact, blood in the urine accompanied by fever, chills, nausea and vomiting are indications of an emergency.
- There could be blockage of urine completely, if the enlargement is quite severe.
If you are having any of these symptoms, then the doctor will first test for an enlarged prostate through a digital rectal exam. Then a test is done to check a chemical called prostate specific antigen. Increased levels of this chemical is almost always indicative of BPH. In addition, X-rays and scanning may be used to confirm diagnosis.
Though medications are available, confirmatory treatment is through surgical removal. The procedure needs a inimum of 2 to 3 days. If you wish to discuss about any specific problem, you can consult a urologist and ask a free question.
If you are experiencing pain in urination along with a burning sensation, a health condition known as dysuria is indicated. This condition is usually common in women and men alike. However, older men are more prone to face this problem. Pain during urination may occur because of various reasons. The most common causes are as follows:
- Urinary tract infections (UTIs) are a common cause of painful urination. Infections may occur in any part of your urinary tract, such as in the kidneys, bladder, and the ureters. These infections occur due to bacteria, which gets into the urinary tract via the urethra. There are several factors, which increase your chances of being affected by UTI. They include diabetes, an enlarged prostate, old age, pregnancy, and kidney stones. UTI is signified by other symptoms such as fever, bloody urines, flank pain, stronger smelling urine, and an increased urge for urination.
- At times, painful urination may also be associated with vaginal infections in women, like yeast infection. Vaginal discharge and foul odor are indicated in the case of vaginal infections.
- Painful urination is also caused because of certain sexually transmitted infections (STIs) such as gonorrhea, genital herpes and Chlamydia.
Inflammation and irritation
There are several problems, which can cause inflammation of your urinary tract and genital region. This further results in painful urination. Inflammation and irritations also occur because of other factors such as urinary tract stones, vaginal changes associated with menopause, certain physical activities and the side effects of several medicines, treatment procedures and health supplements.
Consulting a doctor for painful urination
Your doctor will suggest you to undertake certain laboratory tests for the proper diagnosis of the cause of your painful urination. After this, a suitable treatment method is sought and undertaken. Before this, an overall physical examination is also carried out. Your doctor is likely to ask you some important questions regarding your painful irritation, how the condition worsens, and is felt during the onset of urination. It is also likely for your doctor to know about any other symptoms, which you might be experiencing such as fever, flank pain and vaginal discharge. You must tell your doctor about any changes observed in your urine flow, such as difficulty in initiating flow, an increased urge to urinate, and dribbling.
Apart from these, your doctor may also ask whether you experienced any character in urine after painful urination. These may include colour, amount, cloudiness, presence of pus in the urine and so on. If you wish to discuss about any specific problem, you can consult a doctor.
Those two, small bean-shaped organs are indeed essential for a perfectly healthy life. To check if a person is dead or living, medical practitioners need to confirm response from three organs of the human body heart, brain and kidneys. Kidneys absorb impurities from the blood, thus, purifying it and lead to the production of urine. Urine is necessary to rid your system of body wastes. Kidneys play a key role in maintaining hormone balance. The presence of any factor that could impede free functioning of this organ should be diagnosed, treated and eliminated at the earliest possible. Kidney diseases and subsequent kidney failure see no age bar. It affects both young and old people. In case of younger folks, the symptoms take years to surface and thus the chances of a fatal outcome are even higher.
Causes of kidney failure at a tender age:
- Chain smoking is a trigger: Smokers suffer from a higher risk of kidney failure. Smoking is a bad habit that has engulfed almost ninety percent of young adults. Irrespective of awareness programs and warning messages, there are millions who smoke nonchalantly. Smoking is known to impair kidney function which again can have frightening implications.
- High blood pressure levels must be controlled: Since stress is a common phenomenon among most individuals high blood pressure is also prevalent among a majority of these individuals. Younger people suffer from high blood pressure due to workplace politics and familial tensions. High blood pressure should not be taken lightly. Exercising and regular medications should be opted for in order to counter the threat of kidney failure at a young age.
- If you are obese, you are stepping closer to the threat: If not optimal; being close to the optimal body weight is very necessary to keep health disorders in check. If you are obese, you are not safe; one must make efforts to lose weight or else face the alarming situation when his or her kidneys fail to function properly.
- Consumption of junk food can cause complications: Junk food is fatty. One must keep away from high-protein and high-fat diet. Food items rich in protein and fats can push you towards chronic kidney diseases.
- Genetics may discern the health of your kidneys: The incidence of kidney failure in your family history can make you prone to a similar condition. Extra care should be taken to avoid any such possibility. Regular health check-ups should be undertaken. If you wish to discuss about any specific problem, you can consult a doctor and ask a free question.
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A kidney stone may not be as big as the stones in your garden, but can be quite a pain. Kidney stones are actually mineral crystals that are usually a combination of calcium and phosphates. The size of a kidney stone ranges from the size of a sugar crystal to a ping pong ball.
Following are treatment options for kidney stones:
- Pain relievers - There might be a considerable amount of pain and discomfort associated with passing the stone through urine. Your doctor may recommend pain killers like Ibuprofen, Naproxen sodium or acetaminophen.
- Drinking water - Drinking around 3 liters of water a day will regulate your urinary system and can effectively eliminate small stones. Unless your doctor advices otherwise, drinking ample amount of fluids, usually water, is one of the commonest way to get rid of small kidney stones.
- Medical therapy - In order to eliminate the kidney stone, your doctor may administer medical therapy. Medication like alpha blocker helps in passing the kidney stone with least pain and more quickly. It relaxes the muscles in the ureter and makes the process relatively easy.
Large stones with severe symptoms:
- Surgical removal of kidney stones Surgical removal of stones is done with the help of a procedure called nephrolithotomy. It uses small telescopes and other instruments which are inserted in your back through a small incision. It is generally done in case of large stones and when ESWL fails.
- Using sound waves to break up stones In this technique, a procedure called Extracorporeal Shock Wave Lithotripsy (ESWL), is employed. ESWL uses the help of sound waves to create vibrations which breaks the stones in smaller pieces. This procedure takes about an hour and can cause mild pain and discomfort. Your doctor may administer sedatives to reduce your sensitivity. ESWL has side effects like blood in urine or bruising in the abdomen. If you wish to discuss about any specific problem, you can consult a doctor and ask a free question.
Hard, crystalline deposits in the kidney which cause pain in the stomach are known as a kidney stones. The condition is common among people between the ages of 30 to 60. Made of various minerals and salts present in the urine, they stick conjunctly to form small pebbles which circulate in the kidney. Medically known as nephrolithiasis, kidney stones are also referred to as renal colic, in advanced stages, when they tend to cause severe pain.
Causes of Kidney Stones:
Kidney stones are essentially made of calcium, ammonia, uric acid and cysteine. Such superfluous products when present in the blood, occasionally form crystals that accumulate inside the kidneys. With time, those crystals form a hard pebble-like chunk which eventually lead to kidney stones.
Not drinking sufficient fluids is often attributed as a common cause for kidney stones. Yet oftentimes, certain medications that you may use also tend to increase the levels of unwanted substance in the urine. Once formed, the kidney stones pass through the urinary system (namely the bladder, kidneys and their tubules) where sometime they get stuck, consequently leading to the condition.
Some tiny stones go unsuspected and pass out painlessly during urination. But quite fairly, kidney stones obstruct a part of the urinary system which include:
Ureter: the tube which connects the kidney to the bladder
Urethra: the final tube from which the urine passes
Such obstructions can cause grievous pain in the groin and abdomen and at times, lead to UTI (urinary tract infection). Urinary tract infections affect the kidneys, tubes and the bladder and cause discomfort and pain.
Also, a grievous data estimates that around half the people who experience kidney stones are likelier to face them again within the subsequent 5 years.
Most kidney stones are miniscule and they smoothly pass through your urine. Yet some become large and require medications at home. Even larger stones require ultrasound or laser energy to be shattered. Keyhole surgery (a minimally invasive surgery that is carried out with the help of an incision, very small in size and with the help of special techniques and instruments such as fibre optics) may be also opted for as an alternative treatment.
Infection caused in the kidneys, bladder, urethra or the ureters is known as urinary tract infection. According to doctors, women are generally more at risk of suffering from this condition than men.
Some of the causes which contribute to the development of this infection are:
- Invasion of bacteria: Like any other infection, one of the causes of urinary tract infection is the invasion of the bacteria Escherichia coli in the bladder. This type of bacteria is most commonly found in the gastrointestinal tract and is most often held responsible for urinary tract infection.
- Spreading of the bacteria from anus to urethra: The spread of the gastrointestinal bacteria from the anus to the urethra leads to the infection of the urethra thereby causing urinary tract infection.
Some of the symptoms of urinary tract infection are:
- A nagging urge to urinate: One of the most predominant symptoms of urinary tract infection is a persistent, nagging urge to urinate. You would know your urinary tract is infected when you feel the urgency to urinate extremely frequently.
- There is a burning sensation when you urinate: The symptoms of urinary infection are extremely visible and are felt intensely by the one suffering from it. If you feel a burning sensation while urinating, chances are extremely high that you are suffering from urinary tract infection.
- Red colored urine: Sometimes your urine may contain perceptible amount of blood in them. In most cases, presence of blood in urine is a definite sign of urinary tract infection.
- Foul smelled urine: An internal infection in the urinary tract manifests itself in different ways. One of the chief symptoms of this infection is discharging foul smelling urine.
- Pain in the pelvic area: Women who suffer from urinary tract infection experience excruciating pain near the pelvic area, sometimes extending to the pubic bone.
A problem pertaining to the storage function of the bladder that results in bouts of sudden, often uncontrollable urge to urinate is referred to as an overactive bladder. This condition which is marked by unconditioned or involuntary loss of urine can sometimes be quite difficult to stop. People who experience such a condition often feel humiliated and as such tend to limit their social and work life. Despite such, only a few are conscious that a brief evaluation can help them manage and overcome an overactive bladder.
Mechanism of Urination
During urination, the urine proceeds from the bladder and flows into the urethra which is located at the tip of the penis in men and above the vagina in women. As the bladder fills, the nerve signals in the brain prompts urination by coordinating the relaxation and contraction of the urinary sphincter muscles.
Causes and Symptoms of an Overactive Bladder
Primarily caused due to involuntary contraction and relaxation of sphincter muscles, several conditions can lead to overactive bladder.
Some of them are:
1. Parkinson's disease, Alzheimer's and other neurological disorders
2. Poor kidney function due to diabetes
3. Medications that lead to increased production of urine
4. Bladder abnormalities like tumors or stones
6. Excessive consumption of caffeine or alcohol
Some of the common signs of an overactive bladder are:
1. Bouts of sudden, uncontrollable urge to urinate
2. Awakening at night frequently to urinate
3. Urinating more than eight times a day
The risk of an overactive bladder gradually increases with age. Conditions, such as diabetes and an enlarged prostate results in the increased likelihood of an overactive bladder. People who have previously faced strokes and heart attacks experience cognitive decline, which often times lead to the development of an overactive bladder.
Urinary incontinence as well as a host of associated factors can be detrimental to your life. Emotional distress, interrupted sleep cycles and depression are some of the observed complications of this condition.
Thus if you experience or entertain suspicion of an overactive bladder, you should consider visiting a general physician who might refer you to a specialist, if need be.