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

When do kidneys need dialysis?

Kidneys are a pair of organs that are located on either side of the spine, each about a size of a fist. The kidneys help in purifying blood by removing toxins, waste materials and excess fluids from the human body. Disorders and dysfunctions of the kidney can lead to severe and often fatal consequences. When the kidneys stop functioning as they are supposed to, dialysis is performed to resume normal functioning in the body.

Dialysis is a type of treatment, which filters and purifies the blood with the aid of a machine. It is an artificial way of purifying blood. There are two types of dialysis, namely hemodialysis and peritoneal dialysis. Hemodialysis, the most common form of dialysis, which involves using a manmade kidney called a hemodialyzer, which removes toxins and waste materials from blood.

Peritoneal Dialysis, on the other hand, is a type of treatment which involves implanting a catheter in the stomach. During the procedure, a fluid called dialysate flows into the abdomen that absorbs all the waste material, which is consequently drained out of the body.

You may need a dialysis if:

- Your kidneys are dysfunctional
- When waste materials and toxins start to accumulate in the body
- In an event of an injury or accident to the kidney such as internal lacerations (wound caused by the tearing of a tissue)
- If the creatinine (a type of a chemical waste product) level falls to 10-12 cc/minute
- In an event where the kidneys aren't able to work properly leading to accumulation of toxins, irregular amounts of chemicals in the body and other dysfunctions

Weakening of the abdominal muscles and weight gain are some of the risks involved in dialysis. Dialysis is a temporary treatment and serves to function till the time the actual kidneys get repaired. In chronic cases of kidney disease, kidney transplant may perhaps be the last resort.



When Do Kidneys Need Dialysis?

If you notice blood in the stool or the toilet bowl, it could be a case of rectal bleeding. There are many reasons why rectal bleeding can occur, the most common one being haemorrhoids. If the rectal bleeding is not significant then it is not a cause for concern. But if you lose a lot of blood then it can be a major problem.

What are the signs?

The most obvious one, in this case, is the presence of blood in your stool. But it's not just the presence of blood that is important here, the colour of the blood is also a very important indicator of what is wrong.

Black colour indicates that you are bleeding from the upper region of the small intestine

A bright red colour is an indication of the blood loss from the lower part of the gastrointestinal tract   rectum or colon

Dark red indicates that the bleeding is taking place at the initial region of the colon

Some other symptoms you may experience are  

Confusion

Pain in the rectum

Stomach cramps

A sensation of dizziness

Causes of rectal bleeding

Causes of rectal bleeding can be divided into mild and serious. 

Mild causes  

Constipation 

Small tears in the anal lining (anal fissures)

Haemorrhoids

Small growths of tissue in the rectum or colon

Serious causes  

Cancer of the colon and anus

Inflammatory bowel disease

An infection of the intestine such as salmonella

How is it treated?

If you lose a lot of blood, then it is a medical emergency. You should rush to the doctor if you experience the following   fainting, intense pain in the stomach, confusion, and rapid breathing.

The doctor will prescribe treatment based on the cause of your rectal bleeding. For example, if the cause is haemorrhoids then warm baths will help soothe the pain. If the haemorrhoids are large then invasive methods such as laser treatments and surgery are prescribed. 

Or if it is constipation then stool softeners are a good option. In addition, you may have to eat a high fibre diet and exercise regularly to normalize your bowel movements. 

Rectal bleeding can be a minor inconvenience or a major problem depending on the cause. So it is best to consult a doctor and seek immediate treatment.

Rectum Bleeding - How To Administer It?

Screening for cancer of the colon or large intestine and rectum is a proven way of saving a person from the impacts of colorectal diseases. This is partly because colon cancer is something that can be prevented if detected at an early stage and the polyps which may advance to cancer are removed properly. Thus if you are turning 50 soon, be prepared to present yourself for a screening colonoscopy that will help you ensure good health and well-being. It may sound uncanny, but do you know that 50,000 people across the world die from colorectal cancer every year, and it is ranked second in terms of cancer-centric deaths.

Understanding the importance of having colonoscopy
You may wonder how a painful, invasive, embarrassing, uncomfortable and time-consuming health test may be called a present. There are reasons enough. A screening colonoscopy is able to expose a cancerous tumour that's presently under way and cast light on the chances and risk factors that may precede it. When you choose to intervene early, you have the power to nip those risks at their budding stage, much before those malicious cells become malignant.

Spreading of the colorectal cancer
Your large intestine is really a big and last organ of the gastrointestinal system where the small intestine discontinues. Its primary function is to remove the water out of the leftover solids of digestion and get rid of them in the form of stool. Cancer may start to develop anywhere within the tube that expands 5 feet long and squares the vacant area of the abdomen. The large intestine expands up towards the right side, i.e. the ascending colon and then turns left through the liver, i.e., the transverse colon, bending down right at the spleen on its left, i.e. descending colon and loops to the middle, i.e., the sigmoid colon before it runs across the rectum and ends at the anus.

People who need a colonoscopy
To simplify matters, it can be said that all adults are at a potential risk of the colorectal cancer, including those people who lead a healthy life. But some people are at a higher risk. Those individuals have a specific gene mutation that predisposes them to develop into numerous polyps. The risk is also high with people who are first-degree relatives of a person diagnosed with cancer before the age of 50. People with Ulcerative colitis, various types of inflammatory bowel diseases and Crohn's disease are also at a higher risk.

Colorectal cancer is a serious ailment and screening colonoscopy is a feasible means of detecting any polyps that may be cancerous in the future. Speak with a reputed gastroenterologist today to stay ahead of the disease.

When Should You Start Having Colonoscopies?

Urinary incontinence is a health condition in men, which causes loss of bladder control. Urinary incontinence usually occurs in cases of medical conditions such as an enlarged prostate, Parkinson's disease and diabetes, and may also occur after a prostate surgery. Urinary incontinence is an irritating and embarrassing condition, but with proper treatment, it can be cured.

Here are several methods used to treat urinary incontinence:
1. Caffeine, soda and carbonated drinks cause irritation in the bladder and worsen the symptoms of urinary incontinence. Alcohol is a diuretic and increases the amount of urine too. So abstain from coffee, alcohol and soft drinks to make a difference.

2. Dietary adjustments are required for the treatment of urinary incontinence. Several spicy and acidic food items can make urinary incontinence worse. Hence, you should avoid having such foods for some time.

3. Urinary incontinence can lead to stress and you must get rid of it for better health. You can try relaxation techniques, such as meditation and breathing exercises. Biofeedback is another option by which you can observe your bladder muscle contractions on a monitor.

4. You should try a behavioral technique known as bladder training. This would require you to urinate every half hour, in spite of not having the urge. Slowly try to increase the time in between the bathroom breaks.

5. You need to flex your muscles to gain control over urinary incontinence. Kegel exercises can be practiced as these boost the strength of your pelvic muscles. You should find the right muscles that are required to stop the passing of gas.

6. Pads and disposable undergarments can be used by men. These help in preventing leaks and also protect the skin from irritation and odor.

7. There are several medicines, which help in the treatment of urinary incontinence in men. Some of these work to relax muscles for preventing unwanted bladder contractions, while others help in blocking the nerve signals to the bladder. Drugs used for the shrinking of an enlarged prostate may also be used in some cases.

Surgery is the ultimate option for the treatment of urinary incontinence. Options include a male sling for urinary incontinence. A type of material is wrapped around the urethra for compressing it. Leaks because of coughing, sneezing or laughing are prevented. Artificial sphincter implants may also be used for treatment of urinary incontinence. A cuff is used in order to close the urethra. Urine is released by squeezing the pump to open the cuff. A device similar to a pacemaker is used to stimulate nerves, which help in relaxing the bladder and pelvic floor.

Urinary incontinence is a condition which causes reduced self confidence in men. But there are several ways to treat this condition which include home remedies as well as medications and surgery.

Urinary Incontinence Treatment Options in Men

The urethra is a thin tube that is responsible for carrying urine from the bladder. The urethra is wide enough to facilitate a free flow of urine. However, in some cases, the tube can narrow down and it can restrict urinary flow. This condition is known as a urethral stricture. It is a condition that affects mostly men.

Causes:
The inflammation of the tubular tissues or the presence of scar tissue is the number one cause for urethral stricture. In some cases, an accident or the injury to the groin area can also lead to the formation of such thin tubes. The other factors can include pelvic fractures, radiation, urinary infection and in some cases even STDs(Sexually Transmitted Disease).

Symptoms:
Most of the symptoms of Urethral stricture are mild. Only in some rare cases, the symptoms can be extreme. These can include weak or restricted urine flow, frequent urges to urinate, and feeling of heaviness in the bladder, a burning sensation during urination, swelling and pain while urinating. Sometimes your urine may discharge volts of blood and the color of urine may change.

Diagnosis:
Diagnosis is by a physical examination and by analyzing the urine samples. In most of the cases, the thickness of the walls is measured by cystoscopy. The rate of the urine passed may also be checked for identifying the symptoms.

Treatment:
Treatment depends on the severity of the condition. Nonsurgical methods aim to improve the width of the urethra. This is done by using an instrument called a dilator. This is done as an outpatient procedure. This procedure is the most common method done and is done for most of the milder cases. Surgery is another option. The surgery aims to remove the heaviness of the urethra and enlarges the size of the flow.

Urine Flow Diversion:
This is done in extremely rare cases if the bladder has to be completely removed. In those cases, hole in the abdomen is done and urine is bypassed to that hole. However, this is an extremely rare scenario.

Prevention:
Try to avoid injuries in the groin area. If you are playing sports or a fitness enthusiast, use proper protection for your abdominal and groin regions. Try to always have safe sex and if you feel that there is some discomfort or some uneasiness while passing urine, do consult with a doctor immediately. In many cases, the condition can be avoided if proper precautions are taken.

What Is Urethral Stricture?

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