Dr. Premkumar Krishnappa

Prostatitis is a very common infection of the prostate. However, it is worth to note that prostatitis can also be an inflammation of the prostate without infection. Only 5 to 10 percent of prostatitis is caused by bacterial infection. Prostate cancer does not normally have its chances increased by prostatitis. There are several forms of prostatitis, including acute bacterial prostatitis, chronic bacterial prostatitis and chronic nonbacterial prostatitis (which is also known as chronic pelvic pain syndrome ).

The exact cause for prostatitis is not known, but here are some factors which increase its risk, particularly acute bacterial prostatitis.

Possible causes:

1. Medical instrumentation: Putting an instrument like a urinary catheter may well cause prostatitis.
2. Rectal intercourse: This is basically another name for anal sex.
3. Abnormal urinary tract: The urinary tract comprises of the bladders, kidneys, ureters and urethra. If any one of these organs gets infected, then prostatitis is much more likely.
4. Bladder infection: A bladder infection may well spread to the prostate.

Symptoms
Prostatitis has a variety of symptoms. Here are the most common symptoms of prostatitis.

1. Constant need of urination: This is one of the most common symptoms of prostatitis.
2. Difficulty when urinating: Just like the constant need of urination, difficulty urinating is also a sign that you may have prostatitis.
3. Pain while urinating: This is because the prostate gland is a part of your urinary tract and if it does not work properly, there will be pain.
4. Chills and fever: This is a rarer symptom, but may indicate prostatitis if it is coupled with the other symptoms.
5. Pain in perineal area and genital organs: If you are experiencing pain in genital organs, than it may indicate prostatitis. 
6. Painful ejaculations or relief of perineal pain after ejaculations: If you are having painful ejaculation or the pain arises after ejaculation, then it may be due to prostatitis.
7. Hematospermia: Pinkish or brownish semen.

If these symptoms are persistent or bothersome, then a proper consultation is required. Evaluation includes physical examination along with few simple tests. This can be followed by proper treatment for cure or relief of symptoms.

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

The prostate gland is a male reproductive organ at the base of the urinary bladder and urethra is a thin tube that carries urine out of the penis. It runs through the prostate gland. A fluid produced by this gland helps to carry sperms produced by the testes outside during intercourse.

Cause of urinary problems in men

Men experience urinary symptoms either due to inflammation of the prostate gland or prostatitis or symptoms may be the result of a blockage of the passage due to enlargement of the prostate gland.

Symptoms of urinary problems

Urinary symptoms commonly experienced with prostate problems include;

1. The need to urinate frequently during the night.
2. Urinating more often during the day.
3. Urinary urgency is the urge to urinate can be so strong and sudden that one may not reach the toilet in time.
4. The urine stream is slow to start.
5. Urine dribbling for some time after finishing urination.
6. A sensation that the bladder is not fully emptied after urination.
7. A lack of force to the urine flow, which makes directing the stream difficult.
8. The sensation of needing to go again soon after urinating

Treatment

1. A long course of antibacterial medication (for bacterial prostatitis) is prescribed, because infection is difficult to get rid of, the antibacterial medication will need to be taken for many weeks.
2. Medication to improve urine flow and other symptoms (for obstruction caused by an enlarged prostate).
3. Surgical procedures (for blockage caused by an enlarged prostate), such as Transurethral Resection of the prostate(TURP), Laser Resection of prostate, Transurethral Incision of the prostate(TUIP).

A number of other procedures that have been developed to reduce urinary symptoms.

Medication for urinary problems

Various medications to help ease your urinary problems, including;

1. Medications to reduce the tone of the muscles of the urethra and prostate to minimize any obstruction to urine flow caused when these muscles contract.
2. Medication to reduce the size of the prostate gland. These drugs work by blocking the action of male hormones produced by the prostate gland.
3. Medications to relax the bladder, making unwanted contractions less likely and reducing the symptoms of urgency and frequency of urination.

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

Bladder is an organ of the lower abdomen which stores urine. Though it is a problem common to both men and women, women are two times more prone to be affected than men. 

The following are some of the causes that give rise to bladder pain.

1. Bacterial infection or urinary tract infection is one of the common causes of bladder pain. Women are more likely to encounter uninary tract infection. It occurs if bacteria sneak in through the urethra leading to develop an infection in the urinary tract, which in turn affects the urinary bladder.
2. Sometimes bladder stones can also give rise to bladder pain.
3. Painful Bladder Syndrome is yet another cause, wherein your bladder holds pee after your kidneys have filtered it but before you pee it out. This condition causes pain and pressure below your belly button, causing pain in the bladder.
4. Chronic pelvic pain is pain in the area below your bellybutton and between your hips that lasts six months or longer. There are multiple causes for such pain.
5. Bladder cancer in occasional cases can cause pain, otherwise usually it is painless with blood in the urine. 
6. Urethral stricture is another cause of bladder pain. Men are likely to be more affected by this condition. In this case, the urethra becomes inflamed and narrow creating difficulties to pass urine.
7. Yeast infection also known as, Candidiasis is another cause of bladder pain.

Bladder pain can vary from being mild to severe. But, no matter what the degree of pain is, it requires serious medical attention. It is highly recommended that if you are suffering from bladder pain you must consult and seek a doctor's advice right from the beginning. 

What menstrual problems are to women, prostate problems are to men. The prostate is a gland in the lower abdomen that aids in the production of semen. The prostate is walnut sized in a young man, but can get enlarged with age. As it grows bigger, it can cause a number of problems. These are commonly seen after a man celebrates his 50th birthday.

There are three common prostate problems faced by men. Some of the symptoms that can tell if a man has a prostate problem are:

1. Difficulty faced while urinating.
2. The urge to urinate frequently at night.
3. Constant feeling of a full bladder.
4. Pain while urinating.
5. Blood in urine.

Prostatitis

This can be defined as inflammation of the prostate gland. In most cases the cause of this inflammation is unknown. However, there are two types of prostatitis; bacterial and nonbacterial. While the former reacts well to antibiotics, the latter is more difficult to control. Symptoms of this disease vary from one person to the next. Some of the factors that could trigger this disease are:

1. Chemical irritants
2. Past bacterial infection
3. Dysfunctional pelvic floor muscles
4. Sexual abuse
5. Chronic anxiety

Enlarged prostate

As mentioned earlier, as men get older, the prostate gland tends to grow in size. This growth is benign, but can block the bladder neck and prostatic urethra. This can cause problems urinating and lead to acute urinary retention. This can be very painful. Inserting a catheter can provide temporary relief and help release stored urine. Chronic retention is much less common and is associated with high bladder pressure and can damage the kidneys.

Prostate cancer

Advancing age and family genetic history are said to be the main triggers of prostate cancer. This type of cancer can remain restricted to the prostate gland in its early stages but may spread to the other glands as the cancer advances. This can also cause the growth of secondary tumors in the bones.

The only way to correctly diagnose a prostate problem is with a thorough physical examination. This includes a digital rectal exam where the doctor will insert a gloved finger into your rectum to check the size of your prostate, a blood test, mid stream urine tests and ultrasounds. In some cases a biopsy of the prostate may also be required. Depending on the diagnosis, your doctor may prescribe antibiotics, surgery, radiotherapy or hormone therapy to manage your prostate. If you wish to discuss any specific problem, you can consult an urologist.

The bladder is a hollow storage organ that collects urine from the kidneys and stores it until it can be passed out of the body through the urethra during the process of micturition or urination. It has a thin inner lining of cells called urothelial cells and a thick muscular wall, which exerts pressure to push the urine out of the body.

Causes of Bladder Tumors

In most cases, the bladder tumor develops on the inner layer due to a combination of some of the following factors.

1. Hereditary: A strong family history of cancer predisposes a person to cancer.
2. Gender: Men are 3 times more prone for bladder cancer than women.
3. Ethnicity: White people are more prone for bladder cancer black people.
4. Smoking: Smokers develop bladder cancer 2-6 times more frequently than non-smokers. cigarettes contain toxic, carcinogenic substances which reach the kidney and are stored in the bladder, leading to their damage.
5. Occupational hazards: Some workplaces have a higher likelihood of causing bladder cancers, especially dye and rubber industries. The effects can be damaging, and the person may develop cancers years after the exposure has happened.
6. Recurrent bladder infections: In some people, this can also lead to bladder cancer in the long run.

Types of Bladder Tumor

Depending on the extent of the cancerous spread, it can be of two types:

1. Non-muscle-invasive bladder tumors: The tumor spread is limited to the inner part of the bladder (urothelial cells)
2. Muscle-invasive bladder tumor: The tumor has spread to the thick muscular outer layer. This is more advanced and prognosis is poor compared to the noninvasive type.

The most common and diagnostic symptom of bladder cancer is the presence of blood in the urine, known as hematuria. This will be intermittent and happens whenever the tumor bleeding happens. Other symptoms include pain in the lower abdomen and frequent urination.

Diagnosis

From the most noninvasive to the most invasive diagnostic test, these include:

1. Urine microscopy to detect cancer cells in the urine
2. Cystoscopy A tube inserted into the urethra to look into the inner wall of the bladder is highly diagnostic
3. Ultrasound, CT Scan, and biopsy can also be further used to identify severity of the tumor.

Treatment

Once the tumor is diagnosed, treatment would depend on the severity of the tumor. For both invasive and noninvasive tumors, definitive therapy is surgery, known as transurethral resection of the bladder tumor (TURBT). The cancerous bladder tissue is removed through a cystoscope as done for diagnosis. The bladder is then flushed with chemotherapy agent to kill any residual cancer cells in the bladder. This is then followed by BCG vaccine, which is again done 1 to 4 weeks for several months to avoid recurrence. In some cases, radiotherapy may also be included.

Bladder cancer BCG vaccination is once in a week for 6 weeks. Surgical removal of bladder is the best available treatment for muscle invasive bladder cancer. If you wish to discuss about any specific problem, you can consult a Urologist.

Our kidneys are an important organ in the body and are responsible for the filtration of blood and creation of urine. Sometimes, during this process salt and other chemicals get stuck together to form small crystals also known as kidney stones. The size of a kidney stone can range from the size of a sugar crystal to the size of a ping pong ball. However, it is noticed only if it is large enough to cause a blockage. Smaller stones may pass out of the body without you realizing it.

Kidney stones can be a very painful experience. Some of the symptoms exhibited by patients suffering from kidney stones are:

1. Severe back pain
2. Pain in the belly or groin
3. Painful urination
4. Frequent urination
5. Nausea and vomiting
6. Blood in the urine

Excruciating pain is usually the symptom that makes a patient consult a doctor in cases of kidney stone problems. A confirmed diagnosis can then be made by using a series of tests that include an X-ray, ultrasound, CT scan and urine analysis. A blood test may also be conducted to check the mineral levels in the body.

Kidney stones are a common condition faced by many people, but some people are at a higher risk of suffering from this than others. Some of these factors are:

1. Family history of kidney stones
2. High uric acid levels in the blood
3. Being between 20-50 years of age

Between men and women, the former are at a higher risk of suffering from kidney stones. Asians and Caucasians also suffer from this condition more than people from other races. Hormone changes during pregnancy can also trigger the formation of kidney stones.

The first thing to do if you suffer from a kidney stone is to increase your water intake. This can help dissolve some of the minerals in the stone and make it a small enough to pass through the urethra. Injectable anti-inflammatory drugs and pain relievers may be used to ease the pain caused by kidney stones.

If the kidney stone does not pass on its own, a process known as lithotripsy may also be used. This involves the administration of shock waves that can break a large stone into smaller pieces. In extreme cases, surgical techniques may also be used. However, Lithotripsy in only one of the ways of treatment and given in only selected cases nowadays. Better ways of treatment are: 

1. Ureteroscopy- seeing the stone through a long telescope through the urine passage and removing it.
2. PCNL- removing kidney stone by a small puncture into the kidney through the skin.
3. RIRS- visualising the stone in the kidney with a bendable telescope and breaking the stone using laser.

   If you wish to discuss about any specific problem, you can consult an urologist.