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 Tumor and Its Common Causes

The human body is an intricate mechanism that functions amazingly. And when there is any trouble it does not fail to show signs of trouble, and all we need to do is, to notice it and solve our problems. This is applicable to all types of health issues, including a perianal abscess.

What is Perianal abscess?
Perianal abscess is an extremely painful condition of anal abscess that occurs when one cavity in the anus starts getting filled up with pus. Very often it appears as a painful swelling similar to boil just near the anus. Usually, it appears red in color as well as slightly warm to touch. If the location of the anal abscesses is in the deeper tissue, then it might be less visible and it occurs in people suffering from inflammatory bowel disease.

The worst part is that in certain cases, anal abscesses might lead to more painful anal fistulas. Generally, fistulas occur only if the abscesses fail to heal and break open on the skin s surface. Therefore, it is important that the abscess heals properly or else it may lead to intolerable pain and may even require surgery.

Symptoms of Perianal Abscess
The immediately noticeable and probably the most common anal abscess symptom is constant and throbbing pain around the anal area. Swelling accompanies the pain and its rate increases during bowel movements.

Various common signs of Perianal abscess are:

bleeding or rectal discharge
constipation 
fatigue
Swelling or tenderness,
Skin irritation all around the anus.
Patients with deeper abscess might also show symptoms such as chills, fever, malaise, etc. Various reports state that certain people also feel a lump or nodule at their anus s rim. Facing difficulty while urinating might also be experienced by some people affected by perianal abscess.

HOW TO DIAGNOSE PERIANAL ABSCESS?
One must immediately seek medical if they experience any of the above-mentioned signs or symptoms. Clinical evaluation along with digital rectal exam is sufficient for the proper diagnosis. But, in some cases, patients might need other tests to screen for rectal cancer, diverticular disease, inflammatory bowel disease and sexually transmitted infections. Your physician might also suggest a CT scan, an MRI, or an ultrasound.

HOW DO YOU TREAT PERIANAL ABSCESS?
Just after the diagnosis, prompt surgical drainage would be carried out by the doctor before the abscess erupts. A deeper or larger abscess might require hospitalization as well as an anesthesiologist s assistance. In most cases, patients are prescribed certain medications for pain relief just after the procedure. Antibiotics are mainly given to those people who have comparatively weaker immunity or suffer from diabetes.

Know More About Perianal Abscess!

Fibroadenomas are benign non carcinogenic tumors that occur in the breasts of women. Although the condition may affect females of any age; spanning from pubescent girls to middle aged ladies, yet it is most commonly diagnosed in young women below 30 years of age. Fibroadenomas can be described as a stiff, smooth, supple marble under the skin of your breasts, which move when touched. These tumors which occur in varied sizes, may shrink or expand with time. Diagnosing through biopsies and treatment by surgeries are commonly employed for such a condition.

Types of fibroadenomas
Fibroadenomas are of two types: simple fibroadenomas and complex fibroadenomas. The simple tumors are usually harmless and almost look the same under the lens of a microscope. On the other hand, the complex tumors are comprised of macro cysts (large fluid-filled sacs) and calcifications (deposits of calcium) which can slightly increase the chance of breast cancer.

What is the primary cause of fibroadenomas?
Doctors aren't able to pinpoint the chief cause of fibroadenomas, but they have reasons to believe that the condition may pertain to the reproductive hormones. The condition may occur during pregnancy or during the use of hormone therapy, owing to which, the tumors may increase in size. The tumors are usually seen to shrink postmenopause, when the hormone levels start to dwindle.

Fibroadenomas are apparent and you may be able to detect them even without a doctor. The marble like tumor within your breasts are usually:
1) painless
2) firm
3) rubbery and elastic
4) easily movable

These tumors can range from being too small to as big as 3 inches or more in diameter. These lumps, which are usually harmless may be a cause of concern if they start to grow or change. Consulting a doctor is duly advised in such cases.

Risks
Fibroadenomas, only in the rarest cases, increase the likelihood of breast cancer. A complex fibroadenoma comprising of cysts or thick tissues called calcifications may aggravate your condition. Causes of concern could be if the tumor pains, a family history of cancer or an event of a questionable biopsy report.

Causes and Symptoms of Fibroadenomas

The tube that carries food to your stomach from your throat is called the oesophagus. When the muscular valve (lower oesophagus sphincter) in the oesophagus fails to relax and carry the food to the stomach, the condition is termed as achalasia.

Achalasia has a variety of causes, and can be difficult for your doctor to diagnose the exact cause. Some common causes of Achalasia include:
1. Hereditary predispositions
2. Autoimmune disorders (The immune system erroneously destroys healthy cells in the body)
3. Nerve degeneration in the oesophagus
There other medical conditions that often lead to symptoms identical to achalasia, such as oesophageal cancer and Chagas  disease (an infectious disease caused by a parasite).

Other symptoms of achalasia include:

The most prominent symptom of achalasia is dysphagia, which is characterised by swallowing difficulties or sensations of food stuck in the oesophagus. Dysphagia often triggers coughing and shortness of breath or choking on food.
1. Discomfort or pain in the chest
2. Weight loss
3. Heartburn
4. Intense discomfort or pain after eating

Some of the treatments include:

Most of the methods to treat achalasia focus on the lower oesophageal sphincter (LES). The treatments used can either permanently alter the sphincter s function, or reduce symptoms.
1. Oral medications such as calcium channel blockers or nitrates are prescribed, which can relax the LES to let food pass through with more ease. Your doctor may also treat the LES with Botox.
2. For a more permanent treatment, the sphincter can be dilated or altered. In dilation, a balloon is inserted into the oesophagus and it is inflated. This will stretch out your oesophagus to improve function.
3. To alter the oesophagus, oesophagomyotomy is performed. It is a kind of surgery where minimal incisions are made to gain access to the LES, and then it is carefully altered to improve flow of food to the stomach.

Unlike dilation, which can cause complications such as tears in the oesophagus, oesophagomyotomy has a greater success rate. However, certain complications may still arise, such as:
1. Acid reflux
2. Respiratory conditions that are caused by food entering your windpipe

Achalasia - Can Autoimmune Disorders be the Cause Behind it

Kidney transplant surgery is a surgical procedure where a healthy kidney is used to substitute a diseased one. The healthy kidney is obtained from either a deceased donor or a family member who has a good blood type match with the recipient. Usually, the recipient receives one kidney if the donor is alive and/or both the kidneys from a deceased donor.

Certain reasons for going for a kidney transplant surgery might include:
1. Kidney failure due to diabetes
2. Infections in the urinary tract
3. Autoimmune disorders such as lupus (an autoimmune disorder)
4. Polycystic kidney disorders
5. Obstructions in the kidney
6. Glomerulonephritis, where inflammation occurs in the kidney

Preparation for the surgery
Before the procedure, certain tests are carried out to determine your suitability for the procedure. The tests start with a psychological evaluation followed by blood tests and diagnostic tests to check for health problems. Once the tests are done, you will be placed on the waiting list for kidney recipients. Once the donor is available, you will be asked to get ready for the surgery.

Procedure: The procedure begins with you being administered general anesthesia. An incision is made in the lower part of the stomach, through which the donated kidney is inserted in the body. The next step involves attaching adjacent blood vessels to the kidney so that it has a proper supply of blood. Finally, the ureter of the kidney is linked with the bladder, facilitating normal disposal of bodily wastes. A plastic tube, known as a stent, is placed in the ureter to facilitate urine flow. This is later removed by a procedure called cystoscopy. Once the surgery is completed, the incision is closed by stitches.

Aftercare: After the procedure is completed, you will be given painkillers to ease the pain. Immunosuppressant medications will be prescribed to prevent your immune system from destroying the cells of the donated kidney. Usually, the duration of stay at the hospital post-surgery is about a week. 

Kidney Transplant Surgery and What You Should Know About It

Following are some common Gall Bladder and Biliary Disorders. Read on to know in brief about them. 

1. Gall stones: Gall stones also known as cholelitiasis is a condition in which gall bladder contains stones or calculi. Usually, these stones are asymptomatic and do not cause any trouble to the patients. Few patients experience recurrent right upper abdominal pain. This condition is known as biliary colic and if it persists, the patiet is adviced gall bladder removal surgery. Sometimes the patient presents with severe right upper abdominal pain with fever and deranged Liver function tests. This condition is known as acute cholecystitis. The surgery is minimally invasive and is called Laproscopic cholecystectomy. If there are dense adhesions, the surgeon may plan to convert the surgery to open cholecystectomy. The patient is usually discharged by day 3 of surgery.

2. Common bile duct stone or choledocholithiasis: Occasionally stone from the gall bladder slips into the common bile duct (CBD stone).This causes obstruction of the bile duct causing Fever, abdominal pain and Jaundice. This is called Cholangitis and is a medical emergency. The patient requires urgent hospitalisation and decompression of the bile duct by inserting a plastic stent in the CBD with the help of ERCP. Severe untreated cholangitis can be life threatenig.CBD Stones which are detected because of dull aching abdominal pain, deranged liver function tests or by ultrasonography also need removal. The CBD stone is removed by an endoscopic modality called ERCP, which is minimally invasive and needs no surgery.

3. Bile duct cancer or cholangiocarcinoma: Cancer of bile duct usually occurs in the elderly patients who present with gradually progressive jaundice. Because of the obstruction to the flow of bile, produced in the liver, the patient develops jaundice. Gastroenterologists examine the patient and CT scan abdomen with MRCP is required to fully evaluate the stage and extent of the tumour. The treatment is multimodality and requires the expertise of Radiologists, Surgeons, Oncologists and gastroenterologists. The Gastroenterologists can help in decreasing Jaundice by inserting plastic or a metal stent (SEMS self-expanding metal stent ) in the common bile duct. These are very aggressive tumours and very few patients are fit for surgery. Survival is very low for these tumours.

4. Gall bladder cancer: Gall bladder cancers are very aggressive and lethal cancers. The patients present with obstructive Jaundice and Itching all over the body. Definitive treatment is surgery but very patients present in the early stage. Advanced stage cancers are treated with palliative intent by metal stenting (SEMS for cancer of gall bladder) to reduce jaundice.

Learn More About Gall Bladder And Biliary Disorders!

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