As men enter their middle age, many of them develop issues with their prostate gland. There are certain symptoms that would tell you that your prostate glands have stopped functioning smoothly. It is recommended that you opt for a thorough check up when you suspect something wrong. This is because untreated prostate issues can lead to prostate cancer later in life. To avoid such a situation, it is best to get it treated as soon as possible.

Here are certain common symptoms which would make you aware of the issues that might affect your prostate gland.

Bladder Discomfort: When you frequently start experiencing the feeling of your bladder not emptying completely, then it is time to consult an urologist for the problem. Such bladder discomforts are linked to prostate gland malfunctioning.
Increased frequency of urination: Ideally a person urinates around six to eight times a day. Depending on the intake of liquid or water it can even rise up to ten times. But if you are urinating more than ten to twelve times, then it is definitely a matter of concern and you should approach medical help for it.
Dribbling of urine: when you notice that the flow of urine is not stable and it starts dribbling for a long time, then you must understand that the prostate gland is not functioning properly. This is one of the earliest signs of prostate disorders.
Waking up frequently at night to use the washroom: It is not very normal to wake up frequently at night to use the washroom. But when you notice an increase in your trips to the washroom at night, it can be a sign of prostate malfunctioning.
Pain in penis or blood in the flow of urine: If you feel pain when you are trying to empty your bladder or anytime during the day, then it is a matter of concern. Similarly, if there is a flow of blood, even in the slightest, in your urine, then it is time to opt for a check up with your medical practitioner.
Hence, these are the major symptoms which reflect that the functioning of your prostate gland is not as smooth as it is supposed to be. If you can relate with any of these symptoms, ideally you must immediately consult your medical practitioner and take an expert opinion. Medical science has progressed a lot in contemporary times and prostate disorders are very much treated by medicines and procedures. It is a very much curable problem provided you get the right help at the right time.

Prostate Enlargement - 5 Signs You Are Suffering From it!

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.
2. No hospitalization: This can be done either as an outpatient or with minimal one day stay at the hospital
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.

Know About Laser Prostate Surgery

Renal Tubular Acidosis is a medical condition. When the kidney is unable to acidify urine, it leads to the accumulation of acid in the body. Usually, when blood is filtered by the kidney, it passes through the tubules of the nephrons (the functional unit of the kidney).

Before it flows into the bladder from the kidney, the urine undergoes an exchange of salts, acids and other solutes. Renal tubular acidosis results in the formation of excessive amounts of acid because the kidneys cannot drain them. This may happen because the kidneys cannot reabsorb the alkaline bicarbonate ions from the urine in the early segment of the nephron or because of inadequate production of acidic hydrogen ions in the latter half of the nephron.

Renal Tubular Acidosis is simply associated with abnormal urinary acidification. Other functions of the kidneys remain unimpaired.
There are several different types of renal tubular acidosis-

  Distal Renal Tubular Acidosis (RTA)
This is the most fundamental form of RTA. It is characterized when the hydrogen ions are not secreted into the lumen of the nephron by the alpha-intercalated cells of the medullary collective duct of the distal nephron. When this happens the pH of urine cannot be brought down below 5.3. Renal excretion is inhibited and hydrogen ions are not eliminated which leads to academia. At the same time, Potassium ions cannot be absorbed by the cell which leads to hypokalemia. The end result is protein retention and potassium excretion. Distal RTA can lead to the urinary stone formation, calcium deposits in the kidney, rickets and osteomalacia and Sjogren s syndrome.

  Proximal RTA
When proximal tubular cells reabsorb 85% of filtered bicarbonates and 60% of filtered sodium from the urine, then this again leads to academia. The distal intercalated cells, however, function normally and so the academia is not as severe as in case of Distal RTA. The alpha-intercalated cells can acidify urine to a pH of 5.3 or less because they produce hydrogen ions. Proximal RTA is also associated with Fanconi Syndrome which is characterized by aminoaciduria, uricosuria, glucosuria, and tubular proteinuria.

  Combined distal and proximal RTA
Inherited carbonic anhydrase II deficit leads to combined distal and proximal RTA. This is accompanied by osteopetrosis, cerebral calcification, and renal tubular acidosis. Cases of combined distal and proximal RTA are very rare.

How is RTA understood?
The following steps are applied to analyze Renal Tubular Acidosis-
  Determining the anion gap in acidosis. The normal Anion Gap is 8-12 (4-6 mEq/L)
  Separating the renal from the extrarenal causes of normal anion gap acidosis
  Classifying the types of RTA
  If it is distal RTA, further tests will be necessary to support the diagnosis

How is RTA diagnosed?
Three types of tests can reveal if a person is affected by Renal Tubular Acidosis-
  Urine test
  Acid load test
  Physical examination

Treatment of RTA-
Doctors prescribe either or both of the following two types of therapies-

  Alkali therapy- The pH level of urine is restored and electrolytes are balanced
  Vitamin D supplements- If RTA leads to bone deformities or rickets, your doctor will prescribe vitamin supplements to strengthen your bones.

Timely diagnosis can prevent the effects of Renal tubular Acidosis from becoming compounded. With the right medication, a person can lead a healthy normal life.

What Should You Know About Renal Tubular Acidosis?

An anal fissure is a small tear or crack in the lining of the anus which causes sharp pain, bleeding, itching, or burning.

An anal fissure can affect people of all ages, and it s often seen in infants and young children. Constipation is a common problem in this age group and it is a major cause of this problem.

An anal fissure usually isn t a serious condition. In most cases, the tear heals on its own within four to six weeks. In cases where the fissure persists beyond eight weeks, it s considered chronic, or long term.

Symptoms-

A visible tear in the skin around the anus
A small lump of skin just next to the tear
A sharp pain in the anal area during bowel movements
Streaks of blood on stools or on wiping
Burning or itching around the anus
Causes-

Straining during childbirth
Straining during bowel movements as a result of constipation
Chronic constipation
Diarrhea
Inflammatory bowel disease (IBD)
Overly tight anal sphincter muscles
In rare cases, an anal fissure may develop due to:

Anal cancer which occurs due mostly to ano-receptive sex without barrier protection
HIV infection
Tuberculosis
Syphilis
Herpes
Let s take a closer look at these risk factors.

Anal fissures are common in infants and young kids. Older adults also become prone to anal fissures as the blood flow to the anorectal region decreases.
Women also become prone to these fissures due to straining during childbirth.
The inflammation that occurs in the intestinal lining in people with IBD makes the tissue around the anus more prone to tearing, further causing fissures.
People who frequently experience constipation are at an increased risk for fissures. Also, one can suffer from fissures due to straining and passing large, hard stools. In both these cases, one may experience tears in the anal lining.
Frequent diarrhea can also tear the skin around the anus and so can ano-receptive sex without protection. This can lead to sexually transmitted diseases like genital herpes, HIV/AIDS and infection with HPV virus which causes anal cancer.
Treatment-

Treatment usually helps control anal fissures and the discomfort it causes. Your doctor will prescribe stool softeners and topical pain relievers to stem discomfort. However, if these do not make your anal fissure go away then surgery may be required. And in addition to this, your doctor will also need to look for other underlying causes that can cause anal fissures like for example anal cancer.

Diagnosis

An anal fissure can be diagnosed by simple physical exam. The doctor looks at the area around your anus and follows it up with a rectal exam to confirm the diagnosis.
This can mean the use of an anoscope. In this, the doctor inserts an anoscope into your rectum to be able to see the anal tear.
An anoscope is a thin tube and it allows doctors to inspect the anal canal. An anoscope is also used to diagnose other causes of anal or rectal pain such as hemorrhoids or piles.

How Anal Fissures are Diagnosed?

A hysterectomy is an operation to remove the uterus and, usually, the cervix. The ovaries and tubes may or may not be removed during this procedure, depending on the reasons for the surgery being performed. If the ovaries are removed, you will commence menopause. A hysterectomy is a major surgical procedure with physical and psychological consequences.

Why is a hysterectomy performed?

Common reasons include painful or heavy periods, pelvic pain, fibroids or as a part of therapy for cancer. You should have a clear understanding of your reason for this surgery.

How is this done?

The procedure is normally performed under a general anesthetic and takes approximately one hour. To commence your anesthetic a drip is inserted into your arm. Once you are asleep, you will have a urinary catheter inserted. The importance of the catheter is to reduce the size of your bladder, keeping it away from the operation site and reducing the risk of complications.

There are three ways to remove the uterus:

Vaginal hysterectomy - The removal of the uterus and the closing of the wound is performed through the vagina. There is no cut in the abdomen. 
Laparoscopic hysterectomy - About four small keyhole cuts are made in the abdomen to divide the attachments of uterus, ovaries, and tubes in the pelvis. The uterus is usually then removed through the vagina.
Abdominal hysterectomy - The uterus is removed through a cut in the lower abdomen. The cut is about 15 20 cm in length and runs across your abdomen, usually below the bikini line. Less commonly, it may be necessary to have a cut that runs from the belly button down to the pubic area.
What are the risks of undergoing this procedure?

Although the risks associated with hysterectomy are low, you should be aware that every surgical procedure has some risk. This may also depend upon the type of surgery you have. 
Severe bleeding from large blood vessels around the uterus or top of the vagina. This is not common. A blood transfusion may be required to replace blood loss. A vaginal pack may also be used to control the bleeding.
Infection in the operation site, pelvis or urinary tract.
Nearby organs such as the ureter (tube leading from kidney to bladder), bladder or bowel may be injured expected to happen to approximately one in every 140 women. Further surgery will be needed to repair the injuries.
The bowel may not work well after the operation; this is usually temporary. Treatment may include a drip to give fluids into the vein and no food or fluids by mouth.
Things to do before you come to the hospital

It is important for you to have all the tests ordered at your outpatient clinic appointment completed prior to coming to the hospital these include blood tests and an ECG and chest X-ray, if you are more than 50 years old

You may be required to have a bowel preparation, which will empty your bowel prior to the surgery.

You should stop eating and drinking at the following times on the day of your surgery unless otherwise notified

At midnight if your procedure is in the morning

At 6 am if your procedure is in the afternoon.

You will need to shower and dress in clean clothes prior to coming into hospital. It is important that you do not shave your operation site as this increases the risk of wound infection.

Please remove all body jewelry.

After your surgery

When you wake from the anesthetic, you will be ready to be transferred, in your bed, for recovery.

Having an anesthetic can make you feel sick and may cause vomiting. You will have a drip in your arm which is necessary to maintain fluid intake and provide pain relief. This will remain in until you can tolerate food and fluids and your pain control is changed to oral medication.

Your nurse will take frequent observations of your vital signs e.g. temperature, pulse, blood pressure.

You may have small amounts of water or ice to suck, then progress from fluids to a normal diet as tolerated.

If you have pain or nausea, please tell your nurse. Effective pain management is important.

You will have a urinary catheter in place. The catheter will normally be removed the day following your surgery.

Recovering at home

What to expect

You may have a blood-stained vaginal discharge which is similar to a light period. This will gradually reduce to nil over 4-6 weeks as your internal wounds heal

You may need to take some simple analgesia for pain/discomfort, especially on waking and settling at night

You may feel fatigued

You may require up to four to six weeks off work. You should have returned to normal activity by two to three months, depending on the type of surgery, although full recovery may take longer

After the operation, you will no longer have a period

For the majority of women, hysterectomy surgery does not have a negative effect on sexual function

What to avoid

For the first two to three weeks lift nothing greater than two kilograms. Increase gently as tolerated over six weeks.

It will take about three weeks before you should drive a car. Only when you know you can act confidently with emergency breaking should you attempt driving the car.

Avoid sexual intercourse for six weeks to allow healing to take place.

Avoid inserting anything into the vagina for six weeks to allow time for healing to take place (e.g. use sanitary pads and not tampons).

It is important to avoid constipation and straining immediately after your surgery as this will assist healing and improve your comfort.

Contact your doctor if you develop any of the following complications:

Your wound becomes red or inflamed, painful.

You have heavy vaginal bleeding heavier than a normal period.

You have offensive vaginal discharge.

You develop a fever i.e. temperature of about 38  C, or you are feeling unwell.

You have pain that is not relieved by simple analgesia.

You are having difficulty passing urine or opening your bowels.

 In case you have a concern or query you can always consult an expert & get answers to your questions!

Surgery For Womb Removal - What You Need To Be Aware Of?

You will definitely face many complications after a hernia surgery, but certain measures can lead you to a speedy recovery. Your main aim must be to ensure you don t get any infection. Avoid any jerking like sneezing or coughing. Some of the tips for speedy recovery are mentioned below:

Apply ice to reduce pain: If you experience any form of swelling or pain, ice will help reduce it. Apply ice for 10-20 minutes in a day, and you will get your results. However, refrain from applying ice for too long. It might make the condition worse. Also, wrap up the ice in plastic or a piece of cloth and then apply it to the intended portion.
Take regular medication: Patients experience fever and pain after a hernia surgery. To combat these, you can take prescribed medications from your doctor. Medications also aim in improving your immunity so that you do not get infections easily. Hence, the medications are not to be missed.
Keep your wounds clean: The operated area must always be kept clean to prevent any form of infection. You must dress the wound daily and keep the incision points clean and dry. Change the dressing as your doctor has advised you to do. You can apply any antiseptic or any other cream but take your doctor s permission first.
Keep a pillow near you: When you get an urge to sneeze or an urge to a cough, just cover your incision with the pillow and do it.
Maintain a proper diet: A proper diet plays a significant role in the recovery process. Consume fruits to replenish your storehouse of nutrients. Include high-fiber food in your diet so that you don t have to suffer from constipation. You need to avoid constipation as much as you can. If food doesn t work, you can take stool softeners. Constipation will lead to extra pressure on the cuts which can lead to bleeding.
Wear loose clothing: Don t wear tight pants or clothing that will stick to your skin. The waistbands must be loose and not tight.
Avoid lifting weights: Don t lift weights. Lifting weights will cause stress at the cuts and may even lead to rupture so avoid doing strenuous activities.
Go for a small walk: As soon as you feel a bit better go for a little walk. You need to move your muscles otherwise they will become stiff.
Don t smoke: Avoid smoking after the surgery as it will hamper your breathing and circulation process.
Check out for warning signs: Always keep an eye on your wounds. Report to your doctor as soon as you see bleeding or anything abnormal.
Follow the tips mentioned above, and you will see how fast you will recover.

Hernia Surgery - 10 Effective Tips For Speedy Recovery!

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