Urinary incontinence, commonly known as loss of bladder control can really cause embarrassment. The severity of this condition may range from once in a while leaky urine to the sudden and forceful urge to urinate, due to which you end up urinating before reaching the toilet.

Types of urinary incontinence-

Stress incontinence- when you feel the urge to urinate due to sneezing, coughing, laughing or while doing physical exercise
Urge incontinence- when you feel the urge to urinate, suddenly. This may occur during the day and even at night.
Functional incontinence- when you cannot reach the toilet on time because of a physical or mental impairment.
Mixed incontinence- when you involuntarily urinate due to more than one incontinence
Stress incontinence is the most common type in women. The activities which increase your risk, are:

You have had more than one pregnancy and vaginal delivery.
You have pelvic prolapse. This is when your bladder, urethra, or rectum slide into the vagina. Delivering a baby can cause nerve or tissue damage in the pelvic area. This can lead to pelvic prolapse months or years after delivery.
Female urinary stress incontinence is the involuntary release of urine during any physical activity that puts pressure on your bladder. This potentially embarrassing condition differs from general incontinence in that it happens when the body is under immediate physical stress. Activities that can put stress on your bladder include coughing, sneezing, laughing, lifting heavy objects, or bending over. This condition is particular to women, many of whom experience symptoms after muscles have been weakened due to a vaginal childbirth, following menopause, or during pregnancy.

Ensure that you consult a doctor-

If this condition hinders your day to day activities
If the urinary incontinence is the result of a serious underlying problem
Causes of urinary incontinence-

Urinary incontinence may be temporary or permanent. Causes for temporary incontinence are-

Alcohol
Caffeine and caffeinated drinks
Decaffeinated tea or coffee
Spicy and sugary foods
High intake of vitamin b or c
Urinary tract infection (uti)
Constipation
Causes for permanent incontinence are:

Pregnancy
Childbirth
Old age
Menopause
Hysterectomy
Prostate cancer
Enlarged prostate
Neurological disorders
Complications-

Chronic urinary incontinence can lead to certain complications like.

Skin problems- skin rashes and infections can develop around the vaginal area, because of the constant wetness one feels. It may also cause sores.
Urinary tract infections- urinary incontinence can also result in uti
Impact on personal and social life- urinary incontinence can lead to great embarrassment, thus affecting the social and personal life of an individual.
Treatment for female stress urinary incontinence-

There are several types of treatment available. Treatment options include lifestyle changes, medications, nonsurgical treatments, and surgeries.

Lifestyle changes: make regular trips to the restroom to reduce the chance of urine leakage. Drink fewer fluids and avoid activities such as jumping and running.
Medications: medications that reduce bladder contractions.
Nonsurgical treatments: kegel exercises strengthen your pelvic muscles. Done regularly, these exercises can strengthen your muscles, allowing you to control when urine is released from your body.
Surgery:

If other treatments fail, you will have to go for surgical treatment. Types of surgery include:

Injectable therapy, in which collagen is injected into your urethra to reduce incontinence
Tension-free vaginal tape (tvt) surgery, in which mesh is placed around the urethra to give it support
Vaginal sling surgery, in which a sling is placed around the urethra to support it
Anterior or para-vaginal vaginal repair surgery to repair a bladder that is bulging into the vaginal canal
Retropubic suspension surgery to move the bladder and urethra back into their normal positions
Some doctors even try electrical stimulation and medication. When the condition is highly advanced interventional therapies and surgery is recommended.

Some interventional therapies are-

1. Bulking material injections
2. Botulinum toxin type-a
3. Nerve stimulators.

All About Urinary Incontinence

Urine is normally pale yellow or straw coloured. However, for various reasons, this can change. In fact, the change in the colour of urine is one of the first indications of a deeper underlying problem. This would also be one of the questions that the doctor would ask when suspecting any problem with the urinary tract, starting from infection to stones to cancer.

Hematuria is, therefore, a symptom and not a problem in itself. Some of the reasons for hematuria   presence of blood cells in the urine, producing a light pinkish urine, are listed below.

Urinary tract infections   starting from urethra all the way up to the kidneys

Glomerulonephritis

Kidney Stones-

Prostate enlargement

Tumours/cancers in the kidney, bladder, or prostate

Heavy exercises causing trauma to any of the internal urinary tract organs

Bleeding disorders

Certain medications

Appendicitis

Tuberculosis

As the disease progresses higher in the urinary tract, the severity of hematuria also increases. Though hematuria is a symptom in itself, there are some associated symptoms which are listed below-

Fever

Fatigue

Abdominal pain

Reduced appetite

Urge to urinate

Dysuria

Painful/burning urination

Feeling of incomplete emptying

Nocturnal urination (if prostate is enlarged)

Cloudy urine

Nausea, vomiting

Kidney pain (with stones especially)

Homeopathy believes in treating the person as a whole and not just the presenting symptoms. The doctor will ask a number of questions, some pertaining to unrelated organs, which will help them identify the reason for the hematuria. The treatment prescribed will be customised to the patient in question, but some of the common ingredients used in hematuria management are given below.

Hematuria from all causes can be managed with Terebinthina.

Bladder hematuria is better managed with Erigeron Canadense at 80% concentration while renal hematuria responds better to the same at 60% dilution.

Inflammatory hematuria can be reduced with Cantharis (80%)

Renal hematuria is better managed with Gossypium herbaceous (60%).

Renal colic with pain in the glans, groyne, and thighs responds well to Pereira brava.

Cocus cacti thrice a day is useful where there is itching of the urinary meatus along with the passing of red-coloured urine.

When there are small stones or sand particles in the urine along with pain at the end of the micturition process, Sarsaparilla thrice a day is known to be beneficial.

In some other people, Arnica Montana, Cantharis, phosphorus, and Hepar Sulphur are also used to relieve symptoms of hematuria.

As with any homeopathic treatment, the actual ingredient chosen would depend on the actual symptom that the patient presents with. Though these compounds are used, self-medication is not advisable. Talk to a specialized homeopath who will identify the right ingredient for a given clinical presentation.

Hematuria - Symptoms and Treatment

Kidney failure is happening even to 20-year-old Indians now! 4 Reasons why.

Usually more common in the elderly as a consequence of the chronic kidney disease, kidney failure is now increasingly becoming common amongst 20-somethings in the country. 

Why?
Mainly because of their unhealthy lifestyle habits, they are falling prey to a disease that normally strikes later on in life. 

Kidney failure, also known as renal failure, occurs when the kidneys stop functioning properly, that is, they are unable to filter out waste and toxins efficiently from the body. It is the most severe stage of chronic kidney disease. To ensure that toxins don't build up in the body, treatment usually involves dialysis (process for removing excess fluid and waste from the blood) or kidney transplant, among others. It is said that about 1 million people all over the world are on dialysis or are surviving on transplanted kidneys. The condition is permanent and can occur either very suddenly or slowly over time. 

These frightening habits of the young are leading to the rise of the incidence of renal failure:
1. A sedentary lifestyle - A research conducted by the University of Utah School of Medicine suggests that if you spend 80 minutes a day sitting, you see a 20% increase in the risk of developing chronic kidney disease and, in turn, renal failure.Sedentary behaviour can also increase your risk of diabetes, hypertension as well as obesity (causes of chronic kidney disease).India is said to have about 60% of patients who suffer from hypertension and diabetes also suffer from kidney problem. 

2. Poor eating habits - Studies suggest that the right diet consisting of fruits legumes, nuts, and whole grains can help in preventing kidney disease.On the other hand, a diet that is high in processed meats; salt and sugar can worsen the vicious cycle of high blood pressure, high blood sugar, and kidney disease. Furthermore, a BMI of over 30 can increase your risk of developing common kidney ailments by two-fold. With the proliferation of fast food outlets and junk food due to lack of time, Indians are increasingly now at a risk.

3. Smoking - Smoking brings about a decrease in blood flow to the kidneys, rendering the organs inefficient. When you smoke, the arteries of your body harden and the blood vessels become narrow, leading to a worsening of conditions like high blood pressure. A study by the John Hopkins University says that smoking can increase your chances of developing kidney disease by about 60%. Many young Indians view smoking as fashionable and some even take it up to 'look cool', to beat stress or just to blend in with their peers. 

4. Drinking alcohol - Excessive alcohol consumption can bring about significant changes to the way your kidneys may function. Your kidneys end up becoming less efficient at removing alcohol from the blood due to regular drinking. Additionally, more than 2 drinks a day has been found to significantly increase your risk of high blood pressure, a common cause of kidney disease.



20-Year-Old Indians Experiencing Kidney Failure! 4 Killer Reasons.

Colorectal surgery is the broad term for surgical procedures performed on the colon, the rectum and the anus. There are various different surgical procedures which fall under colorectal surgery and these are used to treat a vast array of disorders, such as:
1. Anal cancer
2. Colorectal cancer
3. Severe complications related to constipation
4. Anal injuries
5. Inflammatory conditions of the gastrointestinal tract
6. Congenital defects

Procedures
The surgeries under colorectal surgery are performed after diagnostic tests such as proctoscopy, sigmoidoscopy and defecating proctography. The most common diagnostic test is colonoscopy. These help to identify the origin and nature of the problem and decide which surgical procedure is to be followed. The procedures under colorectal surgery are as follows:

Colectomy
This procedure involves removal of a section of the large intestine. This is known as partial colectomy. In extreme cases, such as advanced cancer or severe gastrointestinal infection, the entire colon is removed and this is called total colectomy. Sometimes, the rectum is also taken out along with the colon and this is called proctocolectomy.

Colonic polypectomy
An abnormal growth of tissues in the inner lining of an organ is known as a polyp. Colonic polypectomy is done to eliminate polyps from the colon and rectum before they become malignant. This can be done endoscopically. Surgery is required in case of large polyps.

Strictureplasty
Chronic or repeated bowel inflammation causes scar tissue to accumulate in the large intestine. This results in the narrowing of the colon. Stricturoplasty removes the scar tissue so that proper flow of digestive contents is resumed.

Colostomy or ileostomy
A damaged section of the colon is removed and the shortened intestine is then attached to another opening (stoma) in the anterior wall of the abdomen.

Hemorrhoidectomy
This surgical process is used for swollen hemorrhoids or blood vessels, which form in the anal canal. Hemorrhoidectomy is extremely effective in removing hemorrhoids, but the surgery also involves a number of complications.

Anoplasty
Anoplasty or imperforate anus correction is done to correct birth defects in the rectum and the anus. The structural flaw does not allow the stool to pass properly from the rectum and so it is repaired through surgery.

All About Colorectal Surgery

Causes and symptoms of acute tubular necrosis

Damage or destruction to tube-like structures known as tubules in the kidneys can bring about the development of acute tubular necrosis (ATN) and subsequently, acute kidney failure.

What causes acute tubular necrosis (ATN)?

A lack of supply of oxygen to the cells in the kidney is the most common cause of this condition. The reason as to why oxygen may not reach the cells and tissues of this organ could be restriction or blockage of the pathways. When this happens, the kidneys get damaged. Dehydration is the most important cause of ATN which may be because of loose motions, vomitings, heat stroke etc.

Health conditions such as diabetes, heart attack, and stroke can bring about a decrease in blood flow to the organs resulting in ATN and death of cells. Similarly, the presence of toxic substances in the blood can also lead to tubules damage and change the way the cells function in the tubules.

Other causes that may lead you to develop ATN may be medications, radiology dyes, anesthetics and chemicals that cause your body to react adversely.

In addition to these causes, a number of factors can put you at risk of ATN and there are:

- An injury to the body, more specifically your kidneys can cause clotting of the blood vessels
- An adverse response to blood transfusion
- Instances of septic shock can slow down blood flow to the organs
- A major surgery that can interrupt blood supply to the organs

What are the symptoms of the condition?

The symptoms associated with the condition can vary depending on the severity of the problem.

You may experience:

- Troubles in waking up
- Drowsy feeling even during daytime
- Feelings of lethargy
- Feelings of excessive thirstiness
- Problems with urination
- Fluid retention problems
- Instances of confusion
- Feelings of nausea



Can Acute Tubular Necrosis Cause Kidney Failure?

Our kidneys act as filters which constantly flushes out toxins and excess minerals with water in form of urine. Urine contains lots of minerals which may precipitate and form stones. Urine has lots of pro-precipitating agents and anti-precipitating agents. When their balance disturbs due to some disease, stones start forming. These stones may often lead to abdominal pain which is referred to as renal colic. 

What exactly is renal colic? 

Renal or ureteric colic is the term used for typical pain in one side of abdomen in flank region starting from back and radiating forward towards lower abdomen up to scrotum. This is usually associated with nausea, vomiting and urinary discomfort. There may be blood in urine. 

How kidney stones are related to renal colic? 

Kidney stones usually form inside kidney and lies there without causing any pain. But whenever they are dislodged and stuck at mouth of kidney (pelvis) or anywhere in ureter, they block the passage of urine of that kidney. This causes swelling in kidney termed as hydronephrosis. This swelling in kidney causes renal / ureteric colic. This colic is protective phenomenon and tries to push out the stones. Small stones do come out in urine by this natural process. This spontaneous expulsion of small stones is common and many local practitioners used to get credit of it feigning benefit of their medicine. However large stones need some form of intervention to come out. Otherwise, they do harm to kidneys in long term. 

Symptoms of kidney stones along with renal /ureteric colic - 

Most stones which are lying in calyces of kidney are asymptomatic 
Nausea & vomiting 
Frequent urinary tract infections 
Fever with chills 
Foul smelling urine 
Hesitency, frequency and burning in urination 
Blood in urine (urine with a reddish, pink or brownish hue) 
Passage of small stones in urine 
Treatment of renal colic 

Treatment of ureteric/renal stones involves control of symptoms and stone removal. 

Expectant Treatment or Medical Expulsion Therapy: Small stones of less than 4 mm size usually pass on its own and some medicines like alpha-blockers and steroid hasten up their expulsion. Medium size stone (4-6 mm), sometimes passes with aid of these medications. But stones larger than 6 mm usually require intervention. 
Lithotripsy: This method involves breaking of stones by shock waves into small dusty particles which pass through urine on its own. This is usually suitable for stones upto 1.5 cm and lying in kidneys. This is non-operative treatment which can be done on OPD or Daycare basis. 
Ureteroscopy (URS): This method involves entry of very thin semirigid scope through urethra into ureter. Stone is broken by LASER and removed. This involves single day admission and spinal anaesthesia. 
RIRS- Retrograde Intra Renal Surgery: In this method very thin flexible scope in maneuvered through urethra into the upper ureter and pelvi-calyceal system of kidney. Stones in kidney or upper ureter are broken by LASER and removed. This is also done under anaesthesia and requires a day admission. 
Mini- PCNL: This method is suitable for large renal stones. In this technique, a small hole is made into the kidney through back and tiny scope is entered into the kidney. Stones are broken by LASER and removed. This is done under anaesthesia and require two to three days admission.

Renal Colic - Ways it Can Be Treated?

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