Dr. Sathish

My name is Dr Vandana Singh, I am a gynaecologist practising at the women clinic at sector- 30, Noida and my field of choice are high-risk pregnancy and infertility.Today, I want to talk about cervical cancer which is the most common cancer in India in women.

Cervical cancer is the cancer of the lowermost part of the uterus called cervix. This virus is caused by a virus called the human papillomavirus. This virus comes around in 90-100 days but in that 4 types of human papillomavirus can cause infection and then cause cervical cancer in the future. Some women get infected with this virus in their early reproductive stage and in 5-10 % cases this HPV virus infection catch cord can cause cervical cancer in future. There is a vaccine which is available nowadays for last 10 to 15 years and the awareness for this vaccine is very less in our country. I want to create awareness for this cervical cancer vaccination. This cervical cancer vaccination is for females around 9-14 years, but we can give up to 45 years.

Two types of the vaccine are available in our country, one is Cervarix, one is Gardasil.

Cervarix is all against human papilloma virus and we give this vaccine in three doses, 0, then one month, then 6 months.

The Gardasil is also available against the human papilloma virus and the doses of this vaccine are at 0 doses, then 2 months, then 6 months. Gardasil can be given to male also to prevent the ward infection in males. This vaccine can be given at the age of 9 years, but according to the WHO recommendation we should give it to people at 10 to 14 years and the doses are different according to the age group.

If you want further information about the vaccination and the benefit of the vaccination and who can get this vaccination, you can call me at my number and can definitely book an appointment from the lybrate.com.
 

One of the most common problems faced by ageing men is benign prostatic hypertrophy. Prostate is the gland at the base of the urethra near the bladder and when it enlarges it can lead to symptoms, mostly related to urination.

1. Frequent urge to pass urine
2. Prolonged urination
3. Frequent nocturnal visits to the toilet
4. Intermittent urination
5. Difficulty to start urinating
6. Inability to completely empty the bladder
7. Urinary tract infections

There are medications available to manage this, but offer only temporary relief. Many men therefore prefer to have the surgery undergone to manage these bothersome symptoms. However, like any surgery, the risks and benefits need to be considered along with other conditions like age, overall health status, other comorbid conditions, etc.

Surgical removal of the enlarged prostate gland is a more definitive approach to manage these symptoms. In addition to providing a quick cure, it also is used in the following cases:

1. Patients who do not respond to medications
2. Presence of blood in the urine
3. Associated bladder stones
4. Frequent infections of the urinary tract
5. Associated damage to the kidneys

Procedure of Surgery
During the procedure, a tube is passed through the tip of the penis into the urethra towards the bladder neck. Once it is in the desired position, laser is passed through it to deliver energy that acts on the prostate to either completely or partially destroy it. There are two methods by which laser acts on the enlarged prostate and making way for free flow of the urine.

1. Ablation: Excess prostate tissue is melted away by the laser by using photosensitive vaporization of the prostate. This is also known as Greenlight laser therapy or KTP laser vaporization. Alternately, Holmium can be used as the source of laser energy to ablate the prostate tissue.

2. Enucleation: Excess prostate tissue is cut and teased out through the urethra. Holmium laser is used to resect the prostate into smaller pieces, which are then removed out through a resectoscope. Another technique uses a tissue morcellator which grinds the enlarged prostate into smaller pieces to enable easy retrieval.

More men now opt for laser prostate removal as it has the following advantages:

1. Reduced risk of bleeding: This becomes essentially important in patients who are on blood thinners.
3. Immediate symptom relief: As compared to medications, the relief is felt almost immediately after the surgery
4. No catheter: With laser surgery, a catheter may be required for less than 24 hours unlike in open surgical cases.

As noted above, as with any surgery, once enlarged prostate symptoms set in, have a detailed discussion with your doctor to identify if you are a suitable candidate for laser surgery. If you wish to discuss about any specific problem, you can consult a Urologist.

Benign Prostate Hyperplasia (BPH) is a condition which results in the enlargement of the prostate gland. The Prostate gland is situated near the Urethra (a tube which helps flush out the urine from the bladder). Generally, the chance of developing BPH increases after one crosses the age of 50. But it is yet unknown as to why some men experience more severe symptoms than others.

Causes of BPH
This condition generally occurs because of old age and affects almost all men above the age of 75. It occurs because of the various hormonal changes and changes in cell growth that the body goes through, as one becomes old. Sometimes BPH can set in due to genetics. If BPH sets in due to genetically reasons, it usually is quite severe and affects men before they reach 60.

Symptoms of BPH
Quite a few men who develop BPH, experience no symptoms at all. But when symptoms of BPH, known as lower urinary tract symptoms (LUT) start, they can be either mild or very severe. The severity of the symptoms is not related to the extent of the enlargement. Many a times men with only a mild enlargement complain about severe symptoms, while men with a highly enlarged prostate gland have not complained about any discomfort faced. 

Symptoms of BPH tend to worsen due to cold weather and also because of physical and emotional overexertion. There are certain medicines, which should be avoided if you suffer from BPH, as they have a tendency to worsen your symptoms, for example diphenhydramine, pseudoephedrine, oxymetazoline spray and other antidepressants.

The symptoms of BPH are related to bladder emptying and issues with bladder storage.

Symptoms related to the urine drainage from the bladder are:

1. Strain while urinating
2. Weak urine flow
3. Some dribbling after urination
4. Sudden urge to urinate
5. Pain while urinating

Symptoms related to storage of urine in the bladder are:

1. Waking during the night to urinate
2. Urinating frequently during the day and at night
3. Sudden urge to urinate, which may be hard to control

It however, has to be kept in mind that these symptoms may not primarily occur due to prostate enlargement, but are the result of other conditions like urinary tract infections, prostatitis, prostate cancer, neurological disorders and even diabetes. Thus, it is essential that you visit a doctor and get the cause for these symptoms diagnosed properly.