The prostate gland in a man begins to grow in size on reaching 25 years of age quite naturally, and this is known as benign prostatic hyperplasia abbreviated as BPH. Now the problem arises when the enlargement of the prostate is more than normal.

In men, the urine flows through the urethra from the bladder. An abnormally enlarged prostate blocks the flow of urine through the urethra. The cells of the prostate slowly multiply to cause it to enlarge. This puts pressure on the urethra thereby giving rise to a number of problems, most of which manifest as symptoms.

Common Symptoms of an Enlarged Prostate Gland
The condition of enlarged prostate gives rise to some noticeable symptoms which provide the signs that you need to visit a doctor to get it treated. A weak or slow urinary system is one of the most common symptoms of being affected with an enlarged prostate. This includes urinating more often, an increase in the urgency to urinate, difficulty in starting urination and a feeling of incomplete bladder emptying immediately after urinating. At times, it is seen that passing urine becomes very strenuous. All these above symptoms indicate that there is an enlargement of the prostate gland and medical help should be sought immediately to prevent the condition from worsening.

Steps to Manage an Enlarged Prostrate

Effective medication is usually the first step in the management of an enlarged prostate gland. Alpha blockers are the drugs that are most commonly used in this situation. These drugs do not reduce the size of the prostate, but they are great in relieving the symptoms to allow free and painless passage of urine. Another group of drugs known as 5-alpha reductase inhibitors can help in shrinking an enlarged prostate. The drugs work by the reducing the levels of the male hormone called dihydrotestosterone.
In some advanced stages of prostate enlargement, minimally invasive treatments are used for the effective management of the condition. Transurethral Microwave Thermotherapy or TUMT is used to treat mild blockages that reduce the frequency of urination, the urgency, and straining. However, it is not able to correct the bladder emptying issues. Transurethral Radio Frequency Needle Ablation or TUNA helps in the destruction of the prostate tissues resulting in an improvement in the flow of urine.
Prostatic stents are also sometimes used for the management of the condition of an enlarged prostate. In this treatment procedure, a small metal coil is inserted into the urethra for widening it and keeping it open. In most severe case of prostate enlargement, only surgical methods remain as the opted method of treatment. Laser surgeries are performed to destroy the tissues of the prostate for easing of the condition. Ultimately, an open prostate surgery is performed when the transurethral procedure cannot be used. In this surgery, the tissues of the prostate are removed by the surgeon in case of great enlargement.
The condition of an enlarged prostate gland requires medical attention and treatment for the most effective management, and it is best that a medical professional is consulted as soon as any of the symptoms surface.
Enlargement starts usually after 50 years. Surgery 'Transurethral resection of prostate (TURP)' either by monopolar or bipolar electrocautery. Enucleation of prostate by laser is also an option.

Enlarged Prostate - How Can It Be Managed?

Ovaries are a part of a woman s reproductive system. The primary function of ovaries include producing  ova  or eggs and secreting hormones such as progesterone and estrogen. Cysts are fluid filled sacs that form the ovaries; they usually do not cause any symptom and are not painful.

There are primarily two types of ovarian cysts:

1. Follicle cysts: During a woman s menstrual cycle, the egg develops in a sac known as the follicle. Under normal circumstances, the sac breaks open and releases the egg. When this doesn t happen, fluids start accumulating in the follicle to form a cyst.

2. Corpus luteum cysts: Follicle sacs dissolve after releasing the egg, but in some cases, these sacs remain and the opening of the sacs gets sealed. It again results in fluid accumulation, leading to the formation of corpus luteum cysts.

Symptoms

Usually, cysts do not cause any symptom. If the size of the cysts increases, they may cause symptoms such as stomach pain, pain during bowel movements and sex as well as pelvic floor pain. The breasts may become tender and one may experience rapid breathing. Other symptoms of ovarian cysts are fever, nausea and dizziness. Usually, rupturing of a cyst leads to these symptoms surfacing; hence you would know when exactly to call the doctor.

Treatment

The treatment options for ovarian cysts are:

Laparoscopy: Laparoscopy is carried out if the cysts are small in size. An incision is made close to the navel, through which an instrument is inserted to get rid of the cyst.
Birth control pills: For chronic ovarian cysts, oral contraceptives are prescribed to stop the ovulation process in order to arrest the formation of cysts.
Laparotomy: In case of large cysts, this procedure is recommended. A relatively bigger incision is made in the abdomen, through which the cyst is removed.
Ovarian cysts, if left untreated, can certainly cause infertility. Pre-menopausal women and who suffer from frequent hormonal imbalances in the body are the most vulnerable to this condition.

Ovarian Cysts - 3 Ways it Can Treated

If your doctor ever diagnoses you with chronic kidney disease, he/she will give you two options to choose from. The first option is to undergo dialysis for the rest of your life, while the other option is to undergo a kidney transplant. While you may prefer avoiding a major surgery, such as a transplant, dialysis is not the best solution for your condition.

Here are some reasons why you should consider kidney transplant surgery over dialysis if you are looking for better health for the long-term:

1. Increases your life expectancy: What you may not know is that people on dialysis treatment have a severely reduced life expectancy. For instance, if you are 30 years old when dialysis starts, the treatment will keep you alive at most for 15 more years. Therefore, you may not even survive until your fifties with dialysis treatment for your damaged kidneys.

However, if you transplant a healthy kidney your life expectancy increases by 30 to 40 years. Keep in mind that kidneys from living donors are better and will help you live longer.

2. Eliminates the need for undergoing dialysis: If you choose dialysis over transplant surgery, you will need to undergo the treatment on a daily basis. This is not only costly but also affects your quality of life. For instance, a patient on dialysis will need to make special arrangements if he/she wants to go on a vacation with family so that his treatment continues even during the trip.

With a kidney transplant surgery, once you recover from the operation, you can live a normal life, without the need for daily treatment.

3. Lower cost of treatment: While you may think kidney transplant surgery is the costlier option between it and dialysis, you would be wrong to assume so. In kidney transplantation surgery, you pay a hefty amount at the time of the operation. However, in the case of dialysis, you pay smaller sums over very long periods. When you add up these small sums over 10-15 years of dialysis, you will find that transplantation is the cheaper option.

If you are young and have a long life ahead of you, kidney transplantation should be the first and foremost choice of treatment for chronic kidney disease. You can undergo dialysis while you wait for a donor and then receive a healthy organ.

Why Kidney Transplant Should Be Preferred Over Dialysis?

Q1. What exactly is Laparoscopy?
Laparoscopy is an alternative to 'Open' surgery wherein the abdomen is opened by tiny 'key hole' incisions and surgery is done. 'Scopy' means the use of an endoscope or telescope to see inside the abdomen. This is attached to a camera and a light source and the inside of the abdomen is projected on to a monitor. The surgeon performs surgery looking at this screen. The surgeon makes a total of 2-4 small cuts on the abdomen ranging from half to 1 cm through which the telescope and other thin surgical instruments are passed into the abdomen. When the uterus is removed , known as hysterectomy, there is also a cut at the top of the vagina where the uterus is attached.
Q2. What kind of gynaecological surgeries can be performed by Laparoscopy?
Most surgeries done in gynaecology can now be performed by Laparoscopy and do not require the large incision as for open surgery. Laparoscopy can be done sometimes only for diagnosis and is called Diagnostic Laparoscopy, as in checking whether the tubes are open or not and to look for any causes of infertility or pain outside the uterus. In women who are unable to conceive, Diagnostic Laparoscopy is often combined with Hysteroscopy (endoscope inside the uterus, inserted from below, via the vagina). When laparoscopy is done to perform some surgical procedure inside the abdomen it is called Operative Laparoscopy. This may be for simple procedures like sterilization, minor adhesions, drilling ovaries; or for intermediate or major reasons like fibroids, endometriosis, removal of ovaries or tubes or both or removal of uterus, for staging of cancers or radical surgeries for cancer. However, about 5% of all surgeries including those for cancer or very large tumours may benefit from open surgery.
Q3. Why does an expert surgeon recommend Laparoscopy over Open Surgery?
Laparoscopic surgery has many advantages above open surgery: the incisions are much smaller (open surgery incisions are 8-10 cms long), therefore pain is much less; requirement for pain killers (which can have side-effects like sleepiness, impaired judgement) is lesser; hospital stay is shorter; complications fewer; requirement for blood transfusions infrequent; recovery in terms of physical, emotional and mental state is much better and quicker; return to work is faster with consequent lesser loss of working and earning days. Surgery with laparoscope is more precise because it is magnified view. Further vision is much better because it's like having your eye behind the structure because you can see with the telescope at places where the surgeon's eye cannot reach.
Q4. If the cuts on the abdomen are so small in Laparoscopic surgery, how do you remove the uterus or a large tumour from inside the abdomen?
Quite often if the tumour is not malignant and contains fluid, it is punctured to collapse it into a smaller size. If it is solid, it can be cut into smaller pieces inside the abdomen using a special instrument. The collapsed or cut structures can be removed gently through the 1 cm cut on the abdomen which may be increased a bit if required. After hysterectomy, the uterus can be removed easily from below, through the vagina.
Q5. Will there be much pain or discomfort after Laparoscopic Surgery?
There may be some pain and discomfort in lower abdomen for one day to few days after Laparoscopic surgery but this is much less as compared to open surgery because the incisions on the abdomen are much smaller and there is much less tissue handling inside the abdomen by fine instruments instead of rough, big, gloved hands which can cause tissue injury in open surgery. There may be some pain in the shoulder following laparoscopy. This is not serious and is due to the gas used in the surgery to make space for instruments.
Q6. When can I be discharged from hospital?
Following Diagnostic Laparoscopy or with simple Operative Laparoscopy you can expect to be discharged from hospital latest by the morning after surgery. In most other cases of intermediate or even major surgery, discharge is generally 1-2 days following the surgery unless there is some health issues prior to the surgery or any complication during the surgery. The complication rates for Laparoscopic surgery are not more than for open surgery and depend upon patient factors like anaemia, diabetes, obesity and skill of the surgeon.
Q7. When can I perform routine household activities or return to work after Laparoscopic Surgery?
Recovery after surgery depends upon many factors: presence of health problems before surgery; why the surgery is required; what surgery is being done; problems or complications of surgery, anaesthesia or blood transfusions. If all is well, one can perform routine household activities by 1 week, provided one doesn't feel tired. Although there may not be any harm, it may be unwise to be normally active within 48 hours of procedure. Following Diagnostic Laparoscopy or Operative Laparoscopy for simple procedures, one can return to work in 1 week. For other procedures, a 2-3 week off from work is reasonable. It depends on the type of work you are returning to. Avoid too rapid return to work if it is manually hard or requires standing for long durations of time. Sometimes a surgical procedure brings on a well needed rest and break from a lifetime of work. Mostly, when you return to work depends upon your own body and its signals of tiredness. You need to listen to those signals.


Know All About Gynae Laparoscopy Surgery

Kidney transplantation is a major surgery. In this surgery, doctors will remove your damaged/malfunctioning kidney and replace it with a healthy kidney from a donor. A successful kidney transplantation surgery will greatly increase your life expectancy if doctors have diagnosed you with chronic kidney disease.

However, some kidney transplantation surgeries have a better outcome than others do. This is mainly due to some factors that can affect the chances of success before and after the surgery. Here is a look at what these factors are.

Pre-surgery:

You may not be able to control what happens before the transplantation surgery, but here are some things that can affect your chances of a healthy life:

1. Age of the donor and the recipient: Younger people have healthier bodies and easily recover from surgery. Therefore, to achieve the best results in kidney transplantation surgery, it is important for the kidney donor to be young. Kidneys from a younger donor are likely to be healthier and function better for a longer time. For instance, if donor A is 60 years old and donor B is 30 years old, the outcome of transplant will be better if you receive the kidney from donor B. Similarly, if you are too old, your body may reject the transplanted kidney. However, your body will easily adjust to the transplant if you are young.

2. Living donors are better: If you receive a kidney from a living donor, the surgery is much more likely to be successful. In most cases of living donors, a friend or family member donates the kidney to the patient. Therefore, if you have a friend or relative willing to donate a kidney to you, you should opt for that instead of waiting for a kidney from a dead donor.

Post-surgery:

When you undergo a kidney transplant, you can develop heart diseases. Here are some things that will help you prevent that-

1. Keep blood pressure low

Some medications for your kidney disease can lead to an increase in blood pressure. Therefore, you should consult the doctor and report the elevated blood pressure, so that he/she can change the medicine. Additional medication may be required to keep your blood pressure under check so that you do not develop cardiac conditions.

2. Keep cholesterol levels in check:

To prevent organ rejection after the transplant surgery, doctors prescribe immunosuppressants. These drugs can increase cholesterol levels in the blood, which leads to blood and heart disorders. Therefore, you need to reduce cholesterol intake through diet. Ask your doctor about exercises that you can do to reduce cholesterol build up in the body.

Lastly, maintaining proper body weight is also essential after kidney transplantation surgery. Taking these measures will keep your overall body healthy while keeping heart disease and other problems at bay.

How To Achieve Best Results In Kidney Transplantation?

Menorrhagia is menstrual condition characterized by an abnormal loss of blood or heavy, prolonged bleeding. Although heavy bleeding is not uncommon in premenopausal women, menorrhagia is a severe condition which generally interferes with your daily activities. If your vagina bleeds irregularly or between periods, in addition to such heavy bleeding that at least one pad or tampon gets soaked every few hours, it is highly recommended that you seek medical attention.

Symptoms
Signs and symptoms of menorrhagia include:

    Soaking through more than one tampon or sanitary pad for every few hours
    The need to use double sanitary protection
    Heavy bleeding for weeks on end
    The need to wake up at night to change your sanitary protection
    Restriction of daily activities due to heavy menstrual flow
    Symptoms of fatigue, such as excessive tiredness as well as shortness of breath

Causes
Although the exact causes are unknown, here are a few causes that may be responsible:

    Hormonal imbalance is when there is an hormone imbalance, the endometrium develops in excess and sheds away with menstruation
    In Ovary dysfunction, if your ovaries do not ovulate, your body won't be able to produce the hormone progesterone resulting in a hormonal imbalance which may lead to menorrhagia
    Uterine fibroids are benign tumors which start appearing in your childbearing years
    Polyps are small benign growths found on the uterine lining
    Adenomyosis occurs when your glands from the endometrium becomes embedded in the uterine muscle
    By using Intrauterine device (IUD) menorrhagia may occur as a side-effect
    Pregnancy complications, for instance, an ectopic pregnancy can cause it
    Inherited bleeding disorders, such as von Willebrand disease
    Certain medications like anti-inflammatory drugs
    Other medical conditions, like pelvic inflammatory disease or endometriosis

Treatment
Treatment for menorrhagia depends on a number of factors like the cause and severity of the condition, or your tolerance for specific therapies or medications.
Some drug therapies for menorrhagia include:

    Iron supplements
    Tranexamic acid
    Oral progesterone
    Non steroidal anti-inflammatory drugs
    Oral contraceptives
    Hormonal IUD

If drug therapy is ineffective, other treatment options may include:

    Dilation and curettage
    Focused ultrasound ablation
    Uterine artery embolization
    Endometrial ablation
    Myomectomy
    Endometrial resection
    Hysterectomy

All about Menorrhagia

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