Vaginal cysts are closed packets of fluid, air or pus which develop along the vaginal lining. Vaginal cysts are of many types, and they are usually caused by accumulation of fluids, childbirth-related injuries or non-malignant tumors in the vagina. Usually these cysts do not yield many symptoms, but may cause a little discomfort.

Treatment might not be needed in case of cysts which are tiny. However, larger cysts would definitely warrant medical attention.

Types of Cysts-

The commonly occurring cysts are:

Gartner s Duct Cysts: This duct forms around a woman s reproductive canal during pregnancy and it disappears post childbirth. If the duct remains even after the delivery, it may lead to fluid accumulation, thus resulting in a cyst.

Vaginal Inclusion Cysts: Any injury to the vaginal walls, especially during childbirth or surgery, can lead to vaginal inclusion cysts.

Bartholin s Cyst: Bartholin s gland is situated near the vaginal opening. A flap of skin covering this gland may lead to accumulation of fluid. This fluid accumulation usually leads to a cyst which is called a Bartholin s cyst.

Treatment-

Usually, cysts in the vagina do not require any treatment. Most of the cysts do not grow in size and thus do not cause major problems. A biopsy of the cyst may require in order to rule out chances of cancer. A common treatment for vaginal cysts would be to sit inside a bathtub filled with warm water so that the cyst is allowed to soak in the water. If there are symptoms of infection in the vagina, then antibiotics are required.

If the size of the cyst is large and filled with fluids, then a catheter needs to be inserted into it to drain out the cyst. Usually, the catheter is kept in place for a few weeks before it is removed. A surgical procedure called marsupialization is used in some cases, wherein an incision is made around the affected area and into the cyst in order to drain out its contents.

Surgery to remove the entire cyst may also be recommended to prevent its recurrence.

Vaginal Cysts - Types and Treatment

What is the ovary and what are ovarian cysts?  

Ovarian cysts are fluid-filled sacs or pockets within or on the surface of an ovary. Women have two ovaries - each about the size and shape of an almond - located on each side of the uterus. Eggs (ova) develop and mature in the ovaries and are released in monthly cycles during your childbearing years.

Many women have ovarian cysts at some time during their lives. Most ovarian cysts present little or no discomfort and are harmless. The majority of ovarian cysts disappear without treatment within a few months.

However, ovarian cysts - especially those that have ruptured - sometimes produce serious symptoms. The best ways to protect your health are to know the symptoms that may signal a more significant problem, and to schedule regular pelvic examinations.

What causes ovarian cysts?
Most ovarian cysts start during the normal function of your menstrual cycle. These are known as functional cysts. Other types of cysts are much less common.

Functional cysts

Your ovaries normally grow cyst-like structures called follicles each month. Follicles produce the hormones estrogen and progesterone and release an egg when you ovulate. Sometimes a normal monthly follicle just keeps growing. When that happens, it becomes known as a functional cyst. There are two types of functional cysts:

Follicular cyst. Around the midpoint of your menstrual cycle, an egg bursts out of its follicle and begins its journey down the fallopian tube in search of sperm and fertilization. A follicular cyst begins when something goes wrong and the follicle doesn't rupture or release its egg. Instead it grows and turns into a cyst.
Corpus luteum cyst. When a follicle does release its egg, the ruptured follicle begins producing large quantities of estrogen and progesterone in preparation for conception. This changed follicle is now called the corpus luteum. Sometimes, however, the escape opening of the egg seals off and fluid accumulates inside the follicle, causing the corpus luteum to expand into a cyst.
The fertility drug clomiphene (Clomid, Serophene), which is used to induce ovulation, increases the risk of a corpus luteum cyst developing after ovulation. These cysts don't prevent or threaten a resulting pregnancy.

Functional cysts are usually harmless, rarely cause pain, and often disappear on their own within two or three menstrual cycles.

Other cysts

Some types of cysts are not related to the normal function of your menstrual cycle. These cysts include:

Dermoid cysts. These cysts may contain tissue such as hair, skin or teeth because they form from cells that produce human eggs. They are rarely cancerous.
Cystadenomas. These cysts develop from ovarian tissue and may be filled with a watery liquid or a mucous material.
Endometriomas. These cysts develop as a result of endometriosis, a condition in which uterine endometrial cells grow outside your uterus. Some of that tissue may attach to your ovary and form a growth.
Dermoid cysts and cystadenomas can become large, causing the ovary to move out of its usual position in the pelvis. This increases the chance of painful twisting of your ovary, called ovarian torsion.

 SYMPTOMS:

Menstrual irregularities
Pelvic pain - a constant or intermittent dull ache that may radiate to your lower back and thighs
Pelvic pain shortly before your period begins or just before it ends
Pelvic pain during intercourse (dyspareunia)
Pain during bowel movements or pressure on your bowels
Nausea, vomiting or breast tenderness similar to that experienced during pregnancy
Fullness or heaviness in your abdomen
Pressure on your rectum or bladder that causes a need to urinate more frequently or difficulty emptying your bladder completely.

Ovarian Cysts - Knowing The Types & Symptoms!

One of the most common issues with old age in men is the enlarged prostate. Any difficulty with urination (no constant stream, difficulty initiating, or incomplete emptying of the bladder for instance), and the first suspect is an enlarged prostate. These symptoms are followed by a digital rectal exam to check for an enlarged prostate. Once confirmed, the next step is to check for levels of prostate-specific antigen (PSA). If both the exam and the PSA are positive, it could mean prostate cancer. As with any cancer, it is believed that sooner it is diagnosed and the treatment is started, the better.

Historically, the best way to rule out the prostate cancer had been to do a prostate biopsy. This is a minor invasive procedure, wherein biopsies are taken from various regions of the prostate which are known to develop cancer (about 12). A disadvantage of this procedure includes missing out on the front part of the prostate which can also develop cancer. Secondly, it is not a very pleasant experience and given a chance, most men would not want to have it done.

There is good news for these men who would like to avoid prostate biopsies. The first is the multiparametric MRI which uses no x-rays and is considered very safe with extremely accurate results. This MRI exam requires about an hour, and once the images are obtained, the doctor will analyse these images and check for several parameters to assess for prostate cancer. The absence of cancer can be confirmed with up to 90% accuracy, which is far greater than with usual biopsies. If there is a possibility of cancer, then a biopsy can be done to confirm it. 

Also, these images indicate the exact region where cancer likely is, and this guides the doctor to biopsy only where absolutely essential. The chances of false positive and false negative results are reduced drastically. The one disadvantage here is that MRI detected biopsies usually tend to be of a higher grade which requires immediate treatment.

Another way to reduce chances of the biopsy by 30% to 50% is by the 4K test. It helps detect a variety of prostate issues including cancer. It can be used once higher levels of PSA is identified and before going for a biopsy. It combined 4 prostate-specific biomarkers with clinical information to accurately provide men with a risk of developing prostate cancer. It can be used even after negative biopsies to confirm the diagnosis of prostate cancer.

These two measures can drastically reduce the incidence of prostate biopsies, which is neither pleasant for the patient nor very effective for the doctor.

Prostate Biopsies - Ways You Can Avoid It!

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)

The kidneys are two small organs located in the abdomen. The main function performed by these organs is filtering of the blood. Kidneys help remove waste from the blood which they turn into urine so that it may be excreted from the body. In doing this they also help regulate blood pressure, maintain the production of red blood cells, and sustain the electrolyte balance. When the kidneys do not function properly, the results could be fatal. 

Hence, it is important to be able to recognize the early signs and symptoms of Kidney failure.

Tiredness: A decrease in kidney functioning can cause toxins to build up in the body and blood. This can make a person feel more tired than usual and keep them from concentrating on simple tasks. Kidney failure is also associated with anemia which can also contribute to fatigue.
Trouble sleeping: Chronic kidney disease has been linked to obesity and sleep apnea. Both these conditions can make it difficult for a person to fall asleep and stay asleep. The buildup of toxins in the blood can also contribute to insomnia.
Dry skin: The skin is one of the first organs to show signs of internal organ failure. Thus, when the kidneys stop functioning as well as they are supposed to, the skin turns dry and itchy. This is because the production of red blood cells is reduced and the amount of minerals or nutrients in the body is unbalanced.
Increased urge to urinate: An increased urge to urinate frequently especially at night could be a sign of kidney disease. This may also be a sign of a urinary infection.
Blood in the urine: Urine should ideally be clear and pale yellow in color. Seeing blood mixed with urine should never be ignored. This is a sign that the kidneys have been damaged and blood is leaking into the urine. It could also be a sign of kidney stones, an infection, or a tumor in the kidney.
Foamy urine: Excessive foam in the urine that does not go away even after flushing could be a sign of protein in the urine. This foam may look similar to a beaten egg white as it is produced by albumin; the same protein present in eggs.
Swollen ankles: Swollen ankles are a sign of sodium retention. This is caused by the improper filtration of blood by the kidneys. The patient may also notice his or her feet getting swollen.

Kidney Failure - Recognising The Early Signs!

Adrenal Glands are endocrine glands located right above the kidneys. They produce important hormones such as adrenaline, aldosterone and cortisol which are involved in a number of biological functions. The dysfunction of the adrenal glands can cause serious endocrine diseases.

Need for Surgery?
The adrenal glands may not function properly due to a number of reasons, including any kind of infection in the glands, kidney disorders, genetic ailments, lesions, tumours on or around the adrenal glands. Due to the irregularity in the release of hormones and enzymes that are essential to the normal functioning of a human body, a number of serious illnesses arise. There is an excess or absolute insufficiency in the release of hormones. This can even turn into a medical emergency. It can lead to uncontrollable obesity, very high or low blood pressure, dermatological problems, menstrual irregularities, blood sugar level irregularities, severe headaches, cramps, fluctuations in potassium levels and so on. That is when surgery is required.

How surgery is performed?
Laparoscopy is the type of surgery which requires minimum invasion. This is fairly a new and successful method of surgery. The patient recovers speedily and is able to go back home within a short span of time after the surgery. Removal of adrenal glands can be performed by making a maximum of three or four-and-a-half inches incision. This results in quicker cosmetic recovery compared to other patients of open surgery.
The surgery is performed under general anaesthesia. A narrow tube-like instrument, known as the cannula is placed into the upper abdominal cavity, below the ribs. Through the cannula, a tiny telescope, known as the laparoscope is inserted. It is connected to a special camera that provides a magnified view of the patient s internal organs on a large monitor. Using such technology, the adrenal glands are dissected free from other organs and removed.

Post Operative Care
In case of a simple laparoscopic surgery, there are hardly any post operative complications. In case of mild pain or discomfort, the doctors may however prescribe some medications. It is important to go for a medical check up after a couple of weeks of the surgery, to make sure you are completely fine.

Laparoscopic Adrenal Gland Removal Surgery - What Is It?

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