Doctors in Siddhi Vinayak Clinic
Patient Review Highlights
I found the answers provided by the Dr. Neeraj Gupta to be sensible. Sir,Bina likhe check up krne wale mna kr denge
I found the answers provided by the Dr. Neeraj Gupta to be very helpful. Thank you very much.
What may be the reason of urinary incontinence? I had severe UTI Problem since last 3 months due to use of Nicotex 4 mg.
My father suffered epididymis orchitis due to urine infection last year and due to this his left testicle got painful swollen but it cured in 2-3 months. Now, again right testicle is swollen and sometime he gets fever too. He is taking ciplox tz twice a day. Also he is advised to take urimax 0.4 mg for 6 months since doctor told prostate gland is little enlarged. Kindly advise how much time does it take to heal painful swelling of right testicle. Why did he suffered again? Please provide you valuable suggestion.
Laparoscopy is one of the most common procedures for diagnosing and removing endometriosis. Instead of giving a big incision, this procedure of surgery uses lightweight instrument through a small hole or incision. There could be one or more incisions based on the number of instruments that require access inside the body. This procedure involves the use of a camera to ascertain endometriosis as well as treat it in the same sitting. This brings drastic improvement in infertility as well as pain associated with the endometriosis. If a cyst is found in the ovary, laparoscopic surgeon removes it very delicately without causing any harm to the normal ovary, as a part of the Laparoscopic Surgery for Endometriosis.
How does the procedure go?
Eating and drinking should be suspended before 8 hours of the laparoscopic surgery. The doctor takes a call on whether to give a general or local anesthesia. Mostly, General anaesthesia is given during such procedures. A person specialised in Gynecological Endoscopy ( Gynaec Laparoscopic Surgeon) is the best to perform such a procedure.
How is the procedure performed?
The abdomen is first inflated with gas with the help of a needle. It pushes the abdominal wall from the organs to give a clear visibility to a surgeon. The laparoscopic Camera is then pushed through an incision or a set of incisions to examine the internal organ. If the scar tissue or endometriosis needs to be removed, a doctor can use one of the several laparoscopic techniques such as electrocautery, excision etc. Post the surgery, the incision is closed with stitches. The whole procedure usually takes 30-60 minutes depending upon the severity of endometriosis.
Why is laparoscopy done?
- If the endometriosis pain has returned after a hormone therapy
- If there is a growing endometriotic cyst
- If the scar tissue found on the pelvic wall poses a threat on fertility
- If the endometriosis interferes with other organs such as the bladder etc.
- If the pain during menses ( dysmenorrhoea) refuses to subside
Duration of hospital stay:
Operations such as these are usually conducted at the outpatient facility owing to their less risky nature. A patient need not spent more than a day in the hospital. Rarely in severe cases of endometriosis overnight hospitalisation may also be required. One can successfully return to normal work within 1 week of the surgery.
Post-surgical recovery: Once the laparoscopy is done, the next steps of treatment are decided based on the patient's age and severity of endometriosis. Few hormonal medicines are advised according to the desire for fertility etc. If a patient is over and above 35 years of age, the risk of miscarriages double. Since the quality of egg declines by the year, it makes sense to undergo infertility treatment such as the in vitro fertilization, intake of fertility drugs, insemination etc. If, however, the patient is below 35 years of age, makes sense to conceive naturally first and consult a doctor simultaneously. A routine check-up post-laparoscopic surgery on alternate six months for a year will keep any risks at bay. In case you have a concern or query you can always consult an expert & get answers to your questions!
While some couples conceive with ease, conceiving a child can be extremely difficult for others. In cases where a woman is not able to get pregnant despite having regular intercourse in tune with her biological cycle, infertility tests may be suggested to investigate the reason behind this. In most cases, these tests are suggested if a year has gone by without intercourse resulting in a pregnancy. Women may also be said to be infertile, if they cannot carry a foetus to full term.
Infertility can affect both men and women and can be triggered by a number of different reasons. In some cases, it is treatable while in others, alternative ways of having a family may need to be discussed. Hence, it is very important to understand the different types and triggers for infertility and to undergo complete infertility investigations. Some of the common types of infertility investigations are as given below.
- Blood tests: A blood test of both partners is used to assess the general health of the couple and to identify any health factors that may be impeding fertility.
- Tests for women:
- Hysterosalpingogram: This is an X ray that can identify if a blockage or any other issue in the fallopian tubes are the cause for infertility.
- Pelvic ultrasound: This is used to have a look at the anatomy of the female reproductive system and to check for fibroids.
- Laparoscopy / hysteroscopy: This is used to get a clearer picture of the ovaries, uterus and other parts of the reproductive system.
- Tracking cycle: Ovulation and the thickness of the uterus lining may also affect infertility, This can be diagnosed by tracking and assessing the menstrual cycle.
- Tests for men
- Semen analysis:This test is used to get an idea of sperm concentration, motility and the appearance of sperm in a man’s semen. In some cases, the semen may not include any sperm cells. In such cases, a follow up investigation may be required to assess if sperm cells are being created in the testicles. This is known as testicular sperm aspiration or a testicular biopsy.
- Sperm DNA: The DNA in sperm also plays an important role in fertility. This test is used to assess the sperm DNA integrity and to see how it may affect embryo development and chances of an on-going pregnancy.
Infertility treatment depends on the cause identified by the above tests and hence it is important for both partners to undergo complete testing. In case you have a concern or query you can always consult an expert & get answers to your questions!
Intra uterine insemination is a common fertility treatment which involves positioning a sperm within the woman’s uterus in order to help it fertilize. The primary objective of this treatment is to surge the number of sperms that are supposed to reach the fallopian tubes for multiplying the chance of fertilization. It offers an advantage to the sperms by minimizing its area of traversal, but the sperm must reach the eggs for fertilizing the ovum on its own. It is a minimally invasive method and much lesser expensive when compared to in vitro fertilization.
When do the doctors recommend intra uterine insemination?
The most common reason behind opting for intra uterine insemination is decreased sperm mobility and low sperm count. But there are various other reasons why gynecologists recommend this treatment and these include unexplained infertility, cervical scar tissues from past operations, cervical mucus problems, ejaculation dysfunction and several others.
On the other hand, intra uterine insemination is not recommended for women with conditions of pelvic infections, moderate to severe endometriosis and women with acute problems in the fallopian tubes.
How does the process of intra uterine insemination work?
- Before opting for the intra uterine insemination, doctors may recommend ovulation stimulating medicines which require careful monitoring of the eggs to determine when they are mature. The intra uterine insemination will be done between 24 and 36 hours after the rise in LH hormones which indicates high chances of ovulation.
- A semen sample is separated from the semen, and then the sperm is inserted directly into the uterus with the help of a catheter. This procedure improves the positioning of sperm cells into the uterus which, in turn, increases the chances of conception.
- The whole procedure takes about a couple of minutes and gives only minimal discomfort. Then the doctors closely monitor your signs and symptoms of pregnancy. In most cases, there is minimal risk of infection after the intra uterine insemination. Also, women who take fertility medications while having IUI also have chances to become pregnant with multiples.
What is the success rate of intra uterine insemination?
The success of intra uterine insemination depends on a host of factors. If a couple chooses to opt for this treatment every month, the chances of successful pregnancy are increased by 20 percent per cycle. But factors like age of the woman, use of fertility drugs, and the reason behind infertility play a critical role.
Since intra uterine insemination is a cheaper process compared to in vitro fertilization, the success rate of this procedure can sometimes be lower than the latter. It however in most cases gives good results. So, if you are interested in this treatment, you must consult with an expert gynaecologist for discussing your options. In case you have a concern or query you can always consult an expert & get answers to your questions!
Most women stay confused with the time of their ovulation. Couples who are sexually healthy and are in their 20s and 30s and are not using any birth control measures have 20% chances of getting pregnant. It is interesting to know that you have a high chance of getting pregnant at the time of ovulation. It is a small window period that comes each month. It is the time when your ovary produces ovum or egg and the egg is open for fertilisation. Even if you are having sex two or three days before ovulation, there is a high possibility of fertilisation. After ovulation is over, the window period gets shut for the next cycle. It is the safe period. Though doctors say that it cannot be considered 100% safe to have unprotected sex during this period, the chances of getting pregnant are considerably lower.
When does ovulation actually start?
It should be remembered that ovulation takes place at the middle of your menstrual cycle. It usually occurs halfway through the cycle. Commonly, the average time period of a cycle is 28 days. But, in some cases, women may have cycles as long as 23 to 35 days.
How will you know that you are ovulating?
- Check your calendar: It is a healthy habit to keep a menstrual calendar. You must maintain the dates for a few months. This will give you an idea as to when you actually ovulate.It is difficult to know the actual time of ovulation if you are having irregular periods.
- Carefully listen to your body: It is a common thing that your body spontaneously sends a memo to you before ovulation starts. You get cramps or feel pain in the lower abdomen before ovulation starts. This pain is called mittelschmerz. It is a reminder of the coming periods.
- Chart your body temperature: Well, you will need to keep a record of your basal body temperature. You can measure it after three to five hours of sleep. Your basal body temperature changes throughout the monthly ovulation cycle. Progesterone hormone is responsible for the increase in body temperature. In the first half of the month, the progesterone levels are low and hence the temperature remains low as compared to the second half of ovulation.
- You can go for saliva test: Your saliva contains the estrogen hormone. Its level changes throughout the cycle. You can also use an ovulation detector kit to know the dates.
- One can also track the timing when there is increase in vaginal discharge which starts just before the ovulation and is there for 24 to 48 hours. We can easily notice this as it is intermenstrual.
In case you have a concern or query you can always consult an expert & get answers to your questions!
It is very common for women to have heavy and painful periods or have a feeling of fullness in the lower abdomen. Although, it may not sound very alarming these could be the symptoms of uterine fibroids. These are the most common types of benign tumours found in women. The fibroids are basically some tissues and muscle cells that grow within the uterus, outside the uterus, or along the wall of the uterus. The fibroids are usually benign and asymptomatic and do not require any treatment unless they cause problems.
Know the causes
Though the exact cause of fibroid formation is not known, it is believed that the female hormones estrogen and progesterone have a role to play in their formation. Fibroids are formed only when a woman is producing these hormones and they are not seen in women in non-reproductive age i.e. before starting of menses or after stoppage of menses (menopause). If fibroids are persisting even after menopause or especially if increasing in size then it is an alarming sign. Such a fibroid needs to be taken care of immediately.
What are the symptoms?
Fibroids often remain quiet for long periods of time. They cause nonspecific symptoms in the pelvis and abdomen including:
- Fullness in the abdomen
- Low back pain
- Irregular menstruation
- Cramping with menstruation
- Painful sex
- Increased urgency to urinate
- Anemia, leading to tiredness and weakness
- Infertility Diagnosing the fibroids
When these symptoms are recurrent, it is good to confirm the diagnosis. This can happen with a pelvic exam followed by ultrasound scanning to confirm the size and location of the fibroids. A blood test also may be done to confirm anemia, which is common due to heavy periods.
Management of fibroids can range from doing nothing to periodic monitoring to surgical removal.
- If pain and heavy bleeding are the only symptoms, then pain killers like ibuprofen should suffice for symptomatic relief. Anemia, if severe, may require iron supplementation.
- Embolization is an option which shrinks the fibroid, at the same time preserving the uterus. The blood flow to the fibroid is cut off, thereby preventing its further growth. It takes about 1 to 3 hours and requires some bed rest after the procedure. There could be some pelvic pain and vaginal bleeding, which will gradually subside. The fibroids may grow back, but the benefits of keeping the uterus are definitely there. This is suitable in case of single fibroid with specific blood supply.
- The next surgical option is myomectomy, where the portion of the uterus which contains the fibroid alone is removed. This is done in women who still wish to get pregnant and in women who would like to retain the uterus. This can also be achieved laparoscopically( key hole surgery). In such cases, fibroids are cut into small pieces and then removed from the body. This procedure should be done by a doctor specialised in advanced gynecological endoscopy as all this cutting should be done in a bag to avoid any spillage of cells inside the abdominal cavity. This procedure is known as Laparoscopic Myomectomy with In-bag Moecellation.
- In women who have crossed their pregnancy phase, hysterectomy or complete removal of the uterus is advised. In these women, the bleeding and pain may not have subsided even after years of treatment with hormones. The growing fibroids could be pressing on the adjacent organs, causing pressure. This is the only definitive treatment and should be done in women have completed their family and don’t desire to be pregnant.
- Myomectomy and hysterectomy may be done laparoscopically or with an open method depending on the overall health, the size and location of the fibroids in the uterus.
In case you have a concern or query you can always consult an expert & get answers to your questions! In case you have a concern or query you can always consult an expert & get answers to your questions!
After carrying the baby for nine months and delivering it, the next big step for the mother is to learn to breastfeed. For a woman who has had her first delivery, this could be a thing that can scare her and put her at discomfort. In addition, some mothers can also experience physical pain, which is even more worrisome.
In the initial stages of breastfeeding, it is normal to have pain as the baby and the mother have not yet identified the correct method i.e. the mother in terms of holding the baby, while the baby in terms of latch correctly to get milk. However, in most cases, the mother detaches and repositions the baby. This often helps in relieving the pain and after some repetition of this exercise, both the mother and the baby would know the correct position.
Let down reflex, also called milk ejection reflex, is set off by hormone oxitocin which is released whenever your baby feeds, it stimulates muscle cells in your breast to squeeze milk and may cause pain. Oral thrush, which is a yeast infection, in baby's mouth, can cause sore nipples and pain. The baby’s oral features like a short mouth, short tongue, small chin, high palate, etc., can lead to improper suction and cause pain. However, this pain from suctioning will disappear within a couple of days. Another cause for breast pain could be engorgement. When the breasts are engorged, due to feeding after a long break, there is too much milk, which can cause pain as soon as the baby latches on. Pressing out some milk before the baby latches on can help reduce the pain. lmproper size of bra, too tight or too loose, can be a cause of breast pain.
Nipple pain, when exposed to cold weather, is another condition. This occurs due to constricted blood vessels and is known as Raynaud’s phenomenon. If required, pain medication can be taken, but this type of pain usually subsides.
Allergies such as poison ivy and eczema can also lead to nipple soreness. Even topical issues like use of creams, soaps and deodorants can cause soreness. These require no intervention and minute changes would usually suffice. It is important to remember that any medication taken can reach the baby during the breastfeeding and unless absolutely essential, it is best to avoid any medication for the mother. If a baby is being fed well after the 6th month of life, teething begins and this can be a cause for pain during breastfeeding.
In most cases, proper breastfeeding techniques usually take care of the issue. However, if there are other issues, for instance, the child’s oral features, they may require correction as they not only need to be addressed because of this problem, but also otherwise.
Using warm moist compresses is useful in soothing the pain. Empty the breast properly after feeding the baby. Try to avoid chemicals like Linolin, hydrogel, as far as possible, if applied to cracked nipples, clean it properly before feeding the baby. Applying freshly squeezed milk from the breast is another wonderful option, given its antibacterial properties. The warmth of wet tea bags may also give a soothing effect. Remember to avoid chemicals like lanolin or hydrogel, as this pain is a temporary issue and usually disappears over a period of time. In case you have a concern or query you can always consult an expert & get answers to your questions!
Sir I am having stone in ureter 7 mm .4 mm left kidney 5 mm right kidney. I went from lithotripsy 2 times over still not dissolve. Dr. has given tamsulin 0.4 mg with deflazacort 30 mg. How long I can take this and what is the solution?
The perineum is the area between the vagina and the anus. This fragile area plays a significant role in the female reproductive system. This is often intentionally or accidentally torn open to allow for the normal delivery of the baby. This needs to be repaired meticulously to ensure that the pelvic floor is safeguarded from further damage.
The pelvic floor contains multiple muscles and supporting tissues which help in keeping the vagina, rectum, uterus and supporting structures in their places. When these muscles become weak due to childbirth, ageing, perineal injury etc, the uterus, bladder and rectum loosen up and prolapse down.The most common problem that is encountered is urine and fecal incontinence, where the woman has difficulty holding urine and feces. Though not often discussed openly given the private nature of the topic, many women suffer from a weak pelvic floor. Read on to know some of the common causes, symptoms, and management measures.
- Chronic cough: The next time you cough for prolonged periods, notice how much pressure it puts on the pelvic area. This goes unnoticed, but chronic cough can weaken the pelvic floor muscles. It is not common for women to lose some urine during these long-drawn coughing spells.
- Chronic constipation: The pressure exerted during constipation weakens the pelvic floor, often leading to incontinence.
- Pregnancy and delivery: Most common cause of perineal injury, where the perineum is torn (accidentally or intentionally) to allow for easy passage of the baby. If it is not repaired meticulously, the pelvic floor is weakened.
Urinary incontinence is the most common symptom that women present to doctors with. However, there are minor symptoms which a woman would experience prior to reaching this stage. Most often, these are ignored, and only brought to doctor’s notice when symptoms become quite severe. If left unattended, there could be more severe repercussions too.
- A heavy feeling in the pelvic area, commonly referring to as a bearing down sensation, a feeling that the internal organs are going to pop out through the vagina
- A small lump that can be felt and/or seen at the vaginal opening
- Feeling of incomplete emptying of the bladder and/or bowel
- Pain or bleeding from the vagina or the rectum
- Recurrent pelvic and/or urinary tract infections
- Kegel exercises are often used to strengthen the pelvic floor. This is very effective if the problem is identified quite early.
- In more progressive cases, surgical repair is the most effective option. This not only corrects the prolapses but also helps boost confidence of the person, by correcting the incontinence problems and improving sexual experiences.