Enlarged prostate surgery is a very common type of surgery that many have to undergo nowadays. An enlarged prostate causes many health problems including urinary tract obstructions and urinary tract infections. It may also lead to the passing of blood via urine. Thus, enlarged prostate must be treated as soon as possible as neglect may lead to prostate cancer and its associated health issues. There are various types of prostate surgeries that a doctor performs on his/her patients. However, of late, radical prostatectomy is the most popular of them all.

What is Radical Prostatectomy?

This process can be handled in two ways. Firstly, the prostate can be reached through an incision in the abdomen. This would help the doctor work with precision and carefully avoid all the other nerves and muscles in the area the operation take places. The prostate is examined and any nodule or lymph formed over it is carefully removed. The advantage of this surgery is that the patient is less likely to suffer from any erectile problems post- surgery. The second option would be to make an incision between the scrotum and the anus. This process is best for those who are obese. The surgery is performed quickly and there is less loss of blood. Furthermore, the healing time is less too.

How To Recover From The Surgery?

Like most other prostate operations, even in radical prostatectomy, you would have to wear a catheter till you recover completely. For a few days post the surgery your urine would be collected through a urine bag attached to the catheter. One might feel a little sore in his/her genitals after the surgery, but that is quite normal to occur. The soreness is caused due to the surgery and the incisions made and would heal in a matter of a few days. Interestingly, since the urethra plays an important role in this surgery, the catheter has to be in place for at least two to three weeks but the patient can be discharged after a two to three night stay at the hospital. It is advised that the patient takes ample rest. But this does not mean all rest and no work. In fact, it is seen that patients can walk a little and even go back to a normal diet within a week to ten days of the operation. But regular checkups, till the urethra is healed, are compulsory.

Hence, these are some of the recovery procedures after an enlarged prostate surgery. Such surgeries are quite common and heal quickly.

What To Expect Post An Enlarged Prostate Surgery?

Tummy tuck surgery or Abdominoplasty is a cosmetic plastic surgery procedure which tightens the muscles of your tummy. Loose skin and fat from your abdomen are also removed and as a result, the abdomen gets flat and toned. This surgery is common among women after pregnancy who want to restore their figure. This surgery also assists patients who have lost a large amount of weight in a short time period. Most tummy tuck surgeries are carried out for cosmetic reasons. However, there are certain medical benefits, which are gained after an abdominplasty is carried out. They are enlisted below.

Stress urinary incontinence is reduced: After giving birth, many women develop Stress Urinary Incontinence (SUI). This is a bladder control disorder that causes leakage of urine without control when you sneeze, cough or laugh loudly. Usually, this disorder can be treated without having a surgery, but in certain cases a tummy tuck enables speedy recovery in patients who did not have a caesarian section. A slight amount of bladder obstruction is created, which reduces the SUI.
Gives you a better posture and enhanced abdominal tone: The stomach muscles sometimes become distended due to extreme loss of weight or because of pregnancy. A tummy tuck surgery helps in tightening of the weak muscles, removes excess fat and skin and the abdomen gets flattened. After carrying out a tummy tuck, people get an improved posture as the tightened muscles provide better support to the vertebrae.
Correction of ventral hernia: A ventral hernia occurs due to the breake down of intestinal or abdominal tissues through the abdomen walls, and a sack is formed. The causes include abdominal weakness as a result of huge weight loss or previous surgeries.
The symptoms that lead to a ventral hernia correction are similar to the symptoms of a tummy tuck, as both the surgeries rectify abdominal muscles. Once you have a ventral hernia correction, you may need to repeat it again. In case you have this type of surgery, it is recommended that you should also have a tummy tuck done. This might prevent future occurrence as the combined methods leave you in a much safer condition. Medical expenses and recovery time are also reduced.

Tummy tuck surgery is becoming increasingly popular these days. It is a major surgery which requires almost five hours to be completed successfully. A tummy tuck can remove up to ten pounds of fat from a person s abdomen. It takes several weeks to recover after having a tummy tuck surgery.

Tummy Tuck -  Understanding the Benefits!

With the recent number of breast cancer cases on the rise, it is important that we should get the examination done on a regular basis as a preventive measure. Even if someone is suffering from it, it is important that we should make an effort and learn about.

If you have breast cancer then a surgery will be part of your treatment. Based on the condition, surgery will be carried out due to any of the following reasons:
1. To remove the cancerous tissues from the breast
2. To reconstruct the breast once the cancer is removed
3. To check whether the cancer has spread to the lymph nodes below the arm
4. To treat symptoms of cancer that has progressed to an advanced stage

Breast cancer surgery may be classified into two types
1. Mastectomy: Mastectomy involves removing the entire breast; tissues in the adjoining region may also be removed. A double mastectomy is a procedure where both the breasts are removed.
2. Breast-conserving surgery: In this surgery, only parts of the breast affected by cancer are removed. The area of the breast that is to be removed will depend on the severity of the cancer. Some healthy tissues may also be removed in this surgery.

Usually, if a woman is in the initial stages of cancer then she may opt for the latter as it entails removing parts of the breast. They may also undergo radiation therapy along with these surgeries.
For checking if the cancer has spread to the lymph nodes below the arm, the lymph nodes are removed from the body. Once they are removed, they are studied under a microscope to check if it has spread, if yes then the extent of their damage. This procedure is carried out along with the surgery to remove the cancer.

Once the mastectomy procedure is completed, you can opt for a breast reconstruction surgery to rebuild the area. You may opt for this procedure at the time of breast cancer removal or at a later stage. If you are considering breast reconstruction surgery then you should discuss it with your surgeon.

Surgery is sometimes not used to treat cancer, but in slowing the progression of cancer or even reducing its symptoms.It is important you talk to your surgeon before the procedure to understand the goal of the surgery.

Surgical Procedure for Treating Breast Cancer

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!

GERD is a digestive disorder that affects the lower esophageal sphincter, which is the ring of muscle between the esophagus and stomach. Gastroesophageal reflux is the backward flow of acids from the stomach into the esophagus. Doctors believe that some people usually suffer due to a condition called hiatal hernia. Pregnant women usually suffer from heartburn or acid indigestion caused by Gastroesophageal Reflux Disease.

The primary goals in the treatment of this disease are relief from symptoms, healing of erosive esophagitis and prevention of complications of esophagitis. The symptoms include heartburn and regurgitation. The setting includes a proton pump inhibitor (PPI). Patients suspected due to GERD with non-cardiac chest pain are recommended to have diagnostic evaluation before institution of therapy. For diagnosing GERD, barium radiographs should not be used.

The other points that must be remembered to diagnose GERD are
1. Endoscopy is recommended only in case of alarming symptoms. Even in typical symptoms, the upper endoscopy is not recommended.
2. For preoperative evaluation, esophageal manometry is recommended, but it has no role in diagnosing GERD.
3. Ambulatory reflux monitoring is a test that can assess association of reflux symptoms.

Management:
The suggested lifestyle modifications for the patients with GERD are

    Weight loss is recommended for patients who are overweight. So, avoid large meals and decrease dietary fat intake.
    Avoid alcohol, chocolate, onions, garlic, acidic foods and peppermint.
    Do not lie down within 3 to 4 hours after meal (recommended for nocturnal GERD patients).
    For symptom relief and to heal erosive esophagitis, a 8-week course of PPIs is the therapy of choice.
    Medications that help in potentiating GERD symptoms, including alpha-adrenergic agonists, nitrates, calcium channel blockers and theophylline should be avoided.
    For patients without diagnostic evaluation, therapy for GERD other than acid suppression, including prokinetic therapy should not be used.
    For patients with partial response to PPI therapy, additional symptom relief can be achieved by increasing the dose twice daily or switching to a different PPI.
    It is recommended to elevate the head of the bed 10 to 20 cm.
    Avoid wearing clothes which are tight around the waist.
    If patients experience heartburn relief, Histamine-receptor antagonists (H2RA) therapy can be used as a maintenance option in patients without erosive disease.

Some surgical options
1. For long-term therapy for patients suffering with GERD, surgical therapy is the best treatment option.
2. In patients who have no evidence of erosive esophagitis, preoperative ambulatory pH monitoring in mandatory.
3. Gastric bypass is the preferred operation for patients who are suffering with obesity and are contemplating surgical therapy for GERD.

Apart from these, there are potential risks that are associated with PPIs such as switching them can be considered in setting of side effects and the therapy can be a risk factor for Clostridium difficile infection.

Management of Gastroesphageal Reflux Disease (GERD)

Colorectal cancer is otherwise known as cancer of the colon or the rectum. This can affect both men and women with age being a major risk factor. Majority of such cancers are seen to occur after age of 50 years.

Type: colorectal cancers can present as one of the following types: 

Adenocarcinomas are the most common type of colorectal cancers. These cancers begin in the cells making mucous and other fluids. Certain colorectal cancers begin as adenomatous polyps (adenomas) that turn cancerous over a period of time. This is precisely why the adenomas are regarded as pre-cancerous or pre-malignant.

Gastrointestinal (GI) carcinoid tumors, GI stromal tumors, primary colorectal lymphoma, leiomyosarcoma, melanoma & squamous cell carcinoma are certain other colorectal cancers

Carcinoid tumors: start in specialized cells that produce hormones, in the intestine.

GI Stromal tumors: start in the interstitial cells of Cajal (ICC), in the wall of the colon.

Lymphomas: start typically in the lymph nodes but they may also start in colon or rectum.

Sarcomas: can start in the muscle and the connective tissue in the walls of the colon and rectum.

Gender: it affects both male and female populace.

Etiology: mostly, the factors that are associated with increased risk of colorectal cancer include the following  

Age exceeding 50 years.

Racial & ethnic background such as African Americans, in the USA, are known to have the highest incidence of colorectal cancer, and mortality rates.

Low fibre and high fat diet. Excessive consumption of red meat (e.g. goat meat, beef, pork, lamb, or liver), processed meats, butter, refined grains, sweets, sugary drinks etc all can increase the risk of colorectal cancer.

Personal history of inflammatory bowel disease (IBD) (e.g. ulcerative colitis), Crohn s disease, adenomatous colorectal polyps, colorectal cancer etc all.

Family history of colorectal cancer or adenomatous polyps etc all.

Inherited syndromes such as familial adenomatous polyposis (FAP) and Lynch syndrome (hereditary non-polyposis colon cancer or HNPCC).

Sedentary lifestyle/ associated Obesity.

Type 2 diabetes.

Tobacco and alcohol abuse.

Features or symptoms can vary from person to person depending on the size and location of the tumour. Following are the signs & symptoms mainly -

Changes in bowel habits, diarrhea or constipation or an alternating diarrhea and constipation.

Occult/ blood in the stool, and 

Problems related to blood loss (e.g. anemia, weakness, fatigue, intolerance to exercise, shortness of breath, increased heart rate, chest pain etc all),

Abdominal discomfort (frequent gas/ flatulence, bloating, fullness, cramps, and pain), vomiting etc.

Unexplained weight loss,

Pain with bowel movement,

Feeling that bowel does not empty completely,

Stools are narrower than usual.

Diagnosis: Following are the diagnostics employed. Abnormal blood test results may be indicative of malignancy, but a follow-up imaging/ biopsy is always the gold standard for accurate diagnosis.
Blood: fecal occult blood test, Carcinoembryonic Antigen (CEA) assay values are raised, Hb/ RBC counts may be low.
Imaging: Colonoscopy, Endorectal Scan/ CT Scan followed by Biopsy clinches the diagnosis and the nature of the disease.
Apart from the above-mentioned barium enema X-Ray, USG, Chest X-ray, PET CT scan etc all help detect metastasis, if any. An increase in level of the serum tumor marker  CEA  is indicative of metastatic spread/ proliferation that can be ascertained through a PET CT scan.
Treatment: Conventional treatment includes surgery, radiation and chemotherapy as contextually appropriate. Simultaneously, an adjunctive/ integrative naturopathic treatment with suitable complementary & alternative medicines (CAM)/ therapies too can help improve clinical outcomes and facilitate recovery as feasible contextually.
Prognosis: preventive measures, earlier diagnosis and right early treatment is key for better prognosis and efficient/ effective therapeutic management. Usually, the chances of cure for an early stage cancer are more. Above-mentioned apart, recovery chances are influenced by the grade, stage of cancer, recurrence and the patient s general health & vitality etc all too.

Prevention: rightly said, prevention is always a better choice. Although genetic risks are difficult to modify, still an adherence to a Mediterranean diet, maintaining an ideal body weight and an active lifestyle with due emphasis on regular exercising (for at least 30 minutes daily), de-stressing and relaxation is highly recommended for prevention or reducing the risks of colorectal cancer. A healthy eating plate comprises essentially a low fat diet, fibre rich foods including whole grain cereals, green leafy vegetables cooked using healthy vegetable oils, fresh fruits of all colours as seasonally available and healthy proteins/ fats including fresh fish, poultry, beans, nuts etc all. It is advisable to limit milk/ dairy, preferably of low fat content, to 1 to 2 servings max daily. Although alcohol is optional and is not for everyone, the consumption of the same, if any, has to be strictly in moderation, and is best avoided. Smoking is to be avoided as well. Again, red meat, butter, refined grains, sweets, sugary drinks including carbonated beverages and other high calorie foods etc all, if any, are to be taken sparingly or are best avoided too. Apart from the generic preventive measures as mentioned above, certain pre-malignant conditions, of which adenomas are the most common, can be successfully treated with complementary and alternative medicines too.

Colorectal Cancer - In a Nutshell!

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