Dr. N Nagarajaiah

Cancer is the most dangerous disease noticeable throughout the world. The most common type of cancer that affects men is prostate cancer. Prostate is a small exocrine gland situated directly below the bladder and in front of the rectum. This is gland is approximately in size of a walnut and plays an important role in production of a milky fluid during orgasm of sex in which the semen travels. During the climax stage of the prostate gland is forced to push the fluid and remove the semen out of the reproductive structures.

Prostate gland is a slow progressive disease which makes many males left unidentified even the presence of prostate cancer even until they die. 6 out of 100 male over the age of 60 are getting prostate cancer. Though prostate cancer can be cured at a better rate when compared to other type of cancer it is always best to stay protected. Prevention is always better than cure. Here are few tips to keep your prostate healthy.

Signs and symptoms of prostate cancer-

During the early stages of prostate cancer there are usually no symptoms. Most men at this stage find out they have prostate cancer after a routine check up or blood test. When symptoms do exist, they are usually one or more of the following:

1. The patient urinates more often

2. The patient gets up at night more often to urinate

3. He may find it hard to start urinating

4. He may find it hard to keep urinating once he has started

5. There may be blood in the urine

6. Urination might be painful

7. Ejaculation may be painful (less common)

8. Achieving or maintaining an erection may be difficult (less common).

If the prostate cancer is advanced the following symptoms are also possible:

1. Bone pain, often in the spine (vertebrae), pelvis, or ribs

2. The proximal part of the femur can be painful

3. Leg weakness

4. Urinary incontinence

5. Fecal incontinence

Ways to have a healthy prostate –

1. Diet and weight – the most important factor is the diet to maintain a healthy weight. Avoid fatty food items and take fats from vegetables than from animals. Avoid dairy products and increase the intake of fresh fruits and vegetables.

2. Exercise – have a regular practise of doing exercise at least for 30mins a day. This really helps you to keep your body fit.

3. Be precautious – if you have a family history of prostate cancer or if you feel you are at high risk of getting prostate cancer talk with your doctor about it and take preventive drugs as per the doctor’s advice.

4. Red foods – research shows that men who consume red foods like watermelon, tomato and other red fruits are at lower risk of getting prostate cancer as they contain a powerful antioxidant called lycopene

5. Caffeine – three to four cups of coffee per day reduces your risk of getting prostate cancer.

6. Stop smoking – if you are at high risk of getting prostate cancer it is best advised to quit smoking and alcohol.

In case you have a concern or query you can always consult an expert & get answers to your questions!

Interstitial cystitis (IC), also known as painful bladder syndrome, is a difficult condition. It is difficult to diagnose and though there are treatments that can make life easier, there is no long-term cure. Interstitial cystitis is a lifelong bladder problem, that causes pressure and pain below the belly button. Symptoms can be constant, or they may fluctuate. It causes painful and urgent trips to the bathroom. In severe cases, you may need to urinate about 40 to 60 times in a day.

What causes interstitial cystitis (IC)?

The bladder is a hollow, muscular organ that holds the urine your body needs to dispose. The reason why IC occurs isn’t that clear, but there a few ideas:
1. An issue with bladder tissue allows chemicals in your urine to irritate the bladder.
2. Chemicals that are released when there is an inflammation in your body can cause the symptoms.
3. The bladder can be attacked by your immune system
4. Substances in your urine can damage your bladder
5. Nerve problems can wreak havoc on your bladder

Signs and Symptoms
People suffering from IC don’t display the same symptoms. The symptoms keep changing, be it every day, every week or every month. Sometimes, the symptoms may entirely disappear without treatment. Some common IC symptoms include:

1. Bladder pressure and pain that worsens after the bladder gets filled with urine
2. Pain in your urethra (the tube that drains the urine from your bladder), pelvis, lower back and lower tummy
3. Women experience vaginal pain (or the area behind it) or in the vulva
4. In men, a sensation of pain in the penis, testicles, scrotum or the region behind the scrotum
5. The urge to urinate, even if you had urinated a few moments ago
6. Women experience pain during intercourse
7. Men experience pain after sex or during orgasm

One common symptom shared by all people suffering from IC is a swollen bladder. There are certain things that can worsen your condition. These include:
1. Certain drinks or foods
2. Physical or mental stress
3. Menstrual cycles

In case you have a concern or query you can always consult an expert & get answers to your questions!

Second hand smoke may cause bladder cancer. True or false? Take this quiz to know more. 

People with the highest bladder cancer risk are those who?
• Smoke heavily
• Started smoking at a young age
• Have smoked for a long time
• All of the above - Right
Smoking cigarettes enhance the chances of an onset of the bladder cancer. As per studies over one-third of all bladder cancer cases have a link with smoking. Smokers are at increasing risk of getting bladder cancer, which may be up to 4 times that of someone who has never smoked. People who smoke may reduce their risk of getting cancer by passing urine more often. However, there is not enough evidence to support that this is true for everyone. The more you stay away from cigarettes, the better it is.

Which type of chemicals present in cigarette smoke may cause of bladder cancer?
• Formaldehyde
• Carcinogenic chemicals - Right
• Hydrogen cyanide
• All of the above
Cigarette smoke contains carcinogenic chemicals which are harmful to our body and known to cause cancer. When tobacco smoke is inhaled, these cancer-causing chemicals are absorbed into the blood stream. When the blood passes through your kidneys, these chemicals may often get deposited in the urine. As the urine waits in the bladder to be expelled, these harmful chemicals damage the cells lining the bladder, increasing your risk of bladder cancer. Experts believe that healthy eating habits may help in preventing bladder cancer.

Second hand smoke may cause bladder cancer.

• True - Right
• False
The health risks brought on by cigarette smoking are not restricted to smokers. Exposure to secondhand smoke or environmental tobacco smoke significantly increases the risk of cancer in nonsmokers, as well as also a few respiratory ailments in kids. Secondhand smoke is a combination of the smoke that is discharged from the end of a burning cigarette and the smoke emitted from the lungs of smokers. You may use medical masks when going outside, to protect yourself from second-hand smoke.

Aryl-amines present in tobacco decreases the risk of bladder cancer.
• True
• False - Right
As per medical research arylamines such as benzidine, 2-naphthylamine, and 4-aminobiphenyl which are present in tobacco smoke are associated with increasing the chances of getting bladder cancer. Aryl-amines use both an early and a late-stage activity, compatible with a two-mutation theory of bladder carcinogenesis. You may consult your doctor to educate yourself about these harmful effects.

Quitting smoking is a critical step in preventing bladder cancer.
• True - Right
• False
Quitting smoking has major and immediate health benefits for men and women of all ages. Quitting smoking not only decreases the risk of bladder cancer but also reduce the risk of getting a heart attack or chronic lung disease. As per research people who quit before reaching the age 50 reduce their chance of dying by half for the next fifteen years compared with those who continue to smoke. Smoking low-yield cigarettes, as compared to cigarettes with higher tar and nicotine, provides no clear benefit to health. The earlier a person quits, the greater the health benefit.
 

Only men have prostate gland and it surrounds that part of the tube which carries urine out of the body from the bladder. When cells in this gland start growing without any control and get clumped with each other, they form tumors. It is then the chances of prostate cancer arise in the men's body. These tumors can be malignant, and they can kill the healthy tissues of your body and spread to other body parts. 

Chances of getting prostate cancer
The chances of getting prostate cancer are among men who are over 65 years of age. The ratio of getting prostate cancer is one among six men. It is more common in black men compared to white men, Hispanic men and Asian men. Moreover, when there is history of prostate cancer in your family, the chances of having prostate cancer increases.

Now, let's find out the symptoms that will let you know that you may have prostate cancer.

Symptoms of prostate cancer
There are different stages of prostate cancer and depending upon the stage you can get to know various symptoms. 
However, the problem is that in the early stages there are no specific symptoms of prostate cancer. Certain urinary symptoms may suggest that you are suffering from prostate cancer. Such symptoms are: 

• Frequent urination
• Difficulty with starting urine flow
• Urination that burns
• Blood in the urine
• Weak flow, or 'dribbling'

These symptoms always do not mean that you are suffering from prostate cancer, as these symptoms may be there when your prostate gland gets enlarged. 

Another symptom associated with prostate cancer is pain in different parts of the body. When the cancerous cells spread they cause pain around the prostate gland. There can be pain in the hips, pelvis, and lower back or upper thighs. 

Prostate gland also plays a major role in the male reproductive system. Thus, if there is any sexual dysfunction, there are chances that it may be due to prostate cancer. If you are having a problem in getting an erection or maintaining it also becomes difficult, one problem can be prostate cancer.  Sometimes you may experience painful ejaculation, which also points towards chances of having prostate cancer. 

Thus, if you experience any of the above mentioned symptoms, its right time to get to your physician. Remember that as there are no early symptoms, the moment you find any of these symptoms, you should pay a visit to your Doctor.

In case you have a concern or query you can always consult an expert & get answers to your questions!

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. While some kidney stones pass out of the body along with urine, others can block the urethra and become painful. 

In addition to being painful, a kidney stone can cause permanent damage to your kidneys. Since large kidney stones are usually painful, they rarely go undiagnosed. However, if a kidney stone is left untreated, it could cause the kidney to atrophy and lower the functionality of the kidney. Kidney stones that are related to an infection can also lead to chronic urinary tract infections and damage the kidney through scarring and inflammation. This could eventually lead to kidney failure.
 
Not all kidney stones need to be treated with surgery. If the kidney stone is very small, your doctor may prescribe plenty of water and medication to treat the pain. With plenty of water, you should be able to pass the stone in your urine. Ideally, you should take plenty of rest until the stone is passed. 

Larger kidney stones may need you to be hospitalized for treatment. These are:

• Extracorporeal shock wave lithotripsy (ESWL): To begin this of treatment, a painkiller is administered. Ultrasonic waves are used to determine the location of the kidney stone. Shock waves are then passed through the kidney stone to break it into smaller pieces, which can then pass out of the body through urine.
• Ureteroscopy: This is also called retrograde intrarenal surgery and is performed when the kidney stone is stuck in the ureter. A ureteroscope is passed through the urethra and bladder into the ureter. Laser energy may then be used to break the stone into smaller pieces to unblock the ureter. 
• Percutaneous nephrolithotomy (PCNL): This surgery is performed under general anesthesia.  It involves a small incision being made in the back and a nephroscope passed into the kidney through it. Laser or pneumatic energy is then used to break up the stone into smaller pieces and pull them out. 
• Open surgery: Open surgery is performed only in the case of an abnormally large stone or abnormal anatomy of the person. An incision is made in the back that allows the doctor to access the kidney and manually remove the stone. If you wish to discuss about any specific problem, you can consult a Urologist.

Urinary incontinence, commonly known as loss of bladder control can really cause embarrassment. The severity of this condition may range from once in a while leaky urine to the sudden and forceful urge to urinate, due to which you end up urinating before reaching the toilet.

Types of Urinary Incontinence:

1. Stress Incontinence: When you feel the urge to urinate due to sneezing, coughing, laughing or while doing physical exercise
2. Urge Incontinence: When you feel the urge to urinate, suddenly. This may occur during the day and even at night.
3. Functional Incontinence: When you cannot reach the toilet on time because of a physical or mental impairment.
4. Mixed Incontinence: When you involuntarily urinate due to more than one incontinence

Stress incontinence is the most common type in women. The activities which increase your risk, are:

You have had more than one pregnancy and vaginal delivery.

You have pelvic prolapse. This is when your bladder, urethra, or rectum slide into the vagina. Delivering a baby can cause nerve or tissue damage in the pelvic area. This can lead to pelvic prolapse months or years after delivery.

Female urinary stress incontinence is the involuntary release of urine during any physical activity that puts pressure on your bladder. This potentially embarrassing condition differs from general incontinence in that it happens when the body is under immediate physical stress. Activities that can put stress on your bladder include coughing, sneezing, laughing, lifting heavy objects, or bending over. This condition is particular to women, many of whom experience symptoms after muscles have been weakened due to a vaginal childbirth, following menopause, or during pregnancy.

Ensure that you consult a doctor:

1. If this condition hinders your day to day activities
2. If the urinary incontinence is the result of a serious underlying problem

Causes of Urinary Incontinence:

Urinary incontinence may be temporary or permanent. Causes for temporary incontinence are-

1. Alcohol
2. Caffeine and caffeinated drinks
3. Decaffeinated tea or coffee
4. Spicy and sugary foods
5. High intake of Vitamin B or C
6. Urinary tract infection (UTI)
7. Constipation

Causes for Permanent Incontinence are:

1. Pregnancy
2. Childbirth
3. Old age
4. Menopause
5. Hysterectomy
6. Prostate cancer
7. Enlarged prostate
8. Neurological disorders

Complications:

Chronic urinary incontinence can lead to certain complications like:

1. Skin Problems: Skin rashes and infections can develop around the vaginal area, because of the constant wetness one feels. It may also cause sores.
2. Urinary Tract Infections: Urinary incontinence can also result in UTI
3. Impact on Personal and Social Life: Urinary incontinence can lead to great embarrassment, thus affecting the social and personal life of an individual.

Treatment for Female Stress Urinary Incontinence:

There are several types of treatment available. Treatment options include lifestyle changes, medications, nonsurgical treatments, and surgeries.

1. Lifestyle Changes: Make regular trips to the restroom to reduce the chance of urine leakage. Drink fewer fluids and avoid activities such as jumping and running.
2. Medications: Medications that reduce bladder contractions.
3. Nonsurgical Treatments: Kegel exercises strengthen your pelvic muscles. Done regularly, these exercises can strengthen your muscles, allowing you to control when urine is released from your body.

Surgery:

If other treatments fail, you will have to go for surgical treatment. Types of surgery include:

1. injectable therapy, in which collagen is injected into your urethra to reduce incontinence
2. tension-free vaginal tape (TVT) surgery, in which mesh is placed around the urethra to give it support
3. vaginal sling surgery, in which a sling is placed around the urethra to support it
4. anterior or para-vaginal vaginal repair surgery to repair a bladder that is bulging into the vaginal canal
5. retropubic suspension surgery to move the bladder and urethra back into their normal positions

Some doctors even try electrical stimulation and medication. When the condition is highly advanced interventional therapies and surgery is recommended.

Some interventional therapies are:

1. Bulking material injections
2. Botulinum toxin Type-A
3. Nerve stimulators. If you wish to discuss about any specific problem, you can consult a Urologist.

The kidneys are small organs that filter about 200 liters of water each day, removing out about 2 liters of toxins and wastes in a water medium as urine. In addition to maintaining the fluid levels in the body, they also produce hormones that regulate blood pressure, produce red blood cells, and play a vital role in maintaining bone health. Any problem with the kidney, infection or otherwise, can lead to its improper functioning, causing damaging results on the rest of the body organs.

While the bad news is that most diseases from infections to diabetes to hypertension and cancer have an adverse effect on the kidneys, there are signs that can be watched out for, which can indicate a problem with the kidneys and so further damage prevented. Read on to know some of the most common symptoms of kidney disease and how further progression can be prevented.

1. Change in urination process: Any change in the process of urination should be a warning for a test. It could be change in color or the appearance of the urine, painful urination, burning on urination, difficulty to start and stop a stream, or too frequent or infrequent urinations. These are usually the first symptoms of kidney disease and should be an alarm to get a kidney function test done. If you have hypertension or a strong family history of kidney disease, then getting a simple urine test to check optimal kidney function is definitely mandated. These could indicate conditions like infection, diabetes, kidney failure, or other conditions which can all be identified with further testing and then treated accordingly. The progress of the disease can be halted, which can help improve overall quality of life.
2. Fatigue, loss of energy: As noted above, impaired kidney function leads to other organs being affected and buildup of toxins in the body. There is also anemia which sets in due to decrease in red blood cells and therefore reduced overall energy levels, loss of sleep, and fatigue.
3. Swollen eyes, feet, and ankles: Reduced kidney function leads to fluid accumulation, sodium retention, loss of protein, which all lead to swollen eyes and ankles and feet. These are easy to identify and should ring a bell to get checked for kidney functions.
4. Muscle cramps: Improper electrolyte levels can affect muscle functioning, leading to painful cramps. Along with changes in the process of urination, this should be an indication of underlying kidney disease.

Keep a track of any above mentioned problems as they can help in saving not just the kidneys but all the vital organs. If you wish to discuss about any specific problem, you can consult an urologist.