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

What are Different Types of Bariatric Surgeries? 

Bariatric Surgery is one of the most popular options for obese people looking for a way to control their weight. To get bariatric surgery, one has to qualify for certain criteria like BMI (Body Mass Index), associated comorbidities like Diabetes, Hypertension, sleep apnea, infertility, hypercholesterolemia etc. There are many kinds of bariatric surgeries or weight loss surgeries, different surgeries work differently in order to give the desired effect, which is why it is important to understand these surgeries thoroughly. 

Weight loss surgeries are divided into different categories like - 

  Restrictive surgeries: Some bariatric surgeries are focused on limiting the amount of food that can be stored in the stomach. This allows a person to eat less than they used to, because of the limited capacity of the stomach. Sleeve gastrectomy, Adjustable gastric banding, Gastric imbrication, Gastric balloon surgery are examples of restrictive procedures. In sleeve gastrectomy, the stomach is divided into two halves first, then one half of the stomach is completely removed. The remaining part of the stomach is formed into a tube-like structure. This tube-like structure cannot hold enough food and restricts excessive food intake. It also limits the secretion of an appetite hormone called Ghrelin which limits the desire of a person to eat. 

  Malabsorptive procedures: In this procedure, a large segment of the small intestine is bypassed i.e the food is not allowed to enter a large segment of the small intestine and hence malabsorption will be there. Duodenal switch is a malabsorbtive surgery. 

To Summarize: The weight loss procedures that suit our Indian population are the Roux en Y gastric bypass and the sleeve gastrectomy. We do not come across any sign of malnutrition in patients who have undergone these procedures. For successful outcomes, vitamin, calcium and protein supplements are required. 

There are certain myths about bariatric surgery --- life will never be normal after the surgery, pregnancy is a problem after this surgery, one will never be able to eat after this surgery, marriage is a problem after this surgery etc. All these are incorrect as one live a better life after the surgery as one has shed the extra kilos, one is cured of existing problems like diabetes, high cholesterol, hypertension, obesity induced infertility and sleep apnea extra. IN FACT, the quality of life is phenomenal after this surgery. CHOICE of surgery depends on the existing BMI, existing associated problems and results of the investigations that are done prior to the surgery. Your surgeon is the best to decide the right procedure for you. As the procedure which your friend has undergone might not be good for you. Choice of procedure and proper follow up are the key points for a successful surgical outcome. 

  Combination of restrictive and Malabsorptive surgeries: In these procedures, the surgery is done on the stomach as well as the small intestine. It involves creating a small stomach pouch which is attached to the small intestine, thus bypassing a small segment of the small intestine to get the desired effect if the person has diabetes associated. The rest of the stomach produces important digestive juices and is also connected to the intestine so that it can transfer these digestive juices in it. As a part of the stomach and few centimetres of the small intestine are bypassed i.e food does not enter this part, the surgery is called the gastric bypass. The Roux en Y gastric bypass and the Mini Gastric bypass surgeries are examples of these combination procedures.

Bariatric Surgeries - Know Forms Of Them!

Obesity is a serious, chronic disease that can have a negative effect on many systems in your body. People who are overweight or obese have a much greater risk of developing serious conditions, including:

Heart disease
Type 2 diabetes
Bone and joint disease
The prevalence of childhood obesity has increased dramatically over the past few decades, and obesity during adolescence is associated with significant medical morbidity during adulthood. Eating disorders and obesity are usually seen as very different problems but actually share many similarities. Eating disorders (EDs) are the third most common chronic condition in adolescents, after obesity and asthma.

In fact, eating disorders, obesity, and other weight-related disorders may overlap as girls move from one problem, such as unhealthy dieting, to another, such as obesity. Understand the links between eating disorders and obesity and promote healthy attitudes and behaviors related to weight and eating.

What is an Eating Disorder?

Eating Disorders describe illnesses that are characterized by irregular eating habits and severe distress or concern about body weight or shape. Eating disturbances may include inadequate or excessive food intake which can ultimately damage an individual s well-being. The most common forms of eating disorders include Anorexia Nervosa, Bulimia Nervosa, and Binge Eating Disorder and affect both females and males.

Signs & Symptoms of an Eating Disorder:

A man or woman suffering from an eating disorder may reveal several signs and symptoms, some which are:

Chronic dieting despite being hazardously underweight
Constant weight fluctuations
Obsession with calories and fat contents of food
Engaging in ritualistic eating patterns, such as cutting food into tiny pieces, eating alone, and/or hiding food
Continued fixation with food, recipes, or cooking; the individual may cook intricate meals for others but refrain from partaking
Depression or lethargic stage
Avoidance of social functions, family and friends. May become isolated and withdrawn
Switching between periods of overeating and fasting
What are the health risks associated with these disorders?

Stunted growth.
Delayed menstruation.
Damage to vital organs such as the heart and brain.
Nutritional deficiencies, including starvation.
Cardiac arrest.
Emotional problems such as depression and anxiety.
What is Obesity?

Obesity means being overweight by the accumulation of excess fat within the body. Obesity is defined to some extent by measuring Body Mass Index (BMI). People become obese by consumption of excess calories, imbalance between calories intake and calories outgoing, leading a sedentary life, lack of sleep , disturbances in lipid metabolism and intake of medications that put on obese.

What are the risks associated with obesity?

Obesity increases the risk for:

High blood pressure
Stroke
Cardiovascular disease
Gallbladder disease
Diabetes
Respiratory problems
Arthritis
Cancer
Emotional problems such as depression and anxiety
How eating disorder and obesity are related?

Eating disorders and obesity are part of a range of weight-related problems.

Body dissatisfaction and unhealthy dieting practices are linked to the development of eating disorders, obesity, and other problems.
Binge eating is common among people with eating disorders and people who are obese.
Depression, anxiety, and other mood disorders are associated with both eating disorders and obesity.
The environment may contribute to both eating disorders and obesity.
Help adolescents develop healthy eating habits:

Help children learn to control their own eating.
Offer children a variety of healthy foods at meal and snack times.
Eat dinner together as a family most days of the week.
Be aware of your child's emotional health or else consult a psychologist
Encourage children to participate in sports, dance, swimming and other physical activities.
Counteract harmful media messages about body image. 
The splendid approach:

The approach should be quite simple. A proper diet plan, nutritious foods and fruits with proper exercise can do a world of good to you. 

Obesity Due To Eating Disorders!

Hectic lifestyle, unhealthy food habits, poor bowel movements, and stress can all add up to one condition called the GERD. Gastroesophageal reflux disease or GERD refers to a particular type of digestive disease, and mainly affects the LES or lower esophageal sphincter, which is a muscle ring between the stomach and the esophagus resulting in the symptoms such as burning sensation in the chest or difficulty in swallowing.

Treatment options
While the moderate or mild GERD can usually be treated with healthy lifestyle changes, diet, and medications, when the condition gets severe, surgery becomes the only option to prevent the issue from deteriorating further. Here are some of the common surgical options available for treating GERD:

Fundoplication: This surgical procedure is the most common and standard surgical option for treating GERD. It focuses on tightening and reinforcing the LES by wrapping the upper portion of the stomach around the outer side of the lower esophagus which strengthens the sphincter.
Transoral Incisionless Fundoplication: Transoral incisionless fundoplication or TIF is another surgical procedure available for treating GERD and can be performed when an open fundoplication cannot be performed. It is performed by creating a barrier between the esophagus and the stomach which prevents the stomach acid from reflux or going backwards.
Stretta: This surgical procedure is performed as an outpatient option using an endoscope. Here, a flexible tube is passed into the esophagus where the electrode present at the tip of the tube creates tiny cuts on the esophagus by heating the esophageal tissues. As a result, the scar tissues formed, block the nerves that are responsible for acid reflux.
Bard EndoCinch System: This surgical procedure also uses an endoscope to create stitches to make pleats in the lower esophageal sphincter, which strengthens the LES. However, this surgical treatment option is not as common as other GERD treating procedures.
Linx Surgery: In Linx surgery, a special device called Linx, a ring containing microbeads of magnetic titanium, is wrapped around the sphincter to make it strong. As the beads are magnetized, they help in keeping the opening between the esophagus and stomach closed, while letting the food pass normally.
Recovery
As long as the surgical option is laparoscopy, they are the least time-consuming as well as less painful with lesser downtime, but may not be ideal for everyone. When it comes to traditional surgical treatment options like fundoplication, it takes around minimum six weeks to resume the daily activities. However, for laparoscopic fundoplication, the downtime is one or two weeks. Linx surgery is a minimally invasive surgical option and therefore, the recovery time is shorter than other traditional surgeries for treating GERD. Depending on the patient's health conditions and response to surgery, the recovery time may vary for each surgical treatment options for GERD.

So, seek the advice of your gastroenterologist for the best possible treatment option to get completely cured of the condition.

Treating GERD: 5 Surgery Options That Can Help!

Are you experiencing frequent and extended heartburn on a regular basis? This might indicate that you are having gastroesophageal reflux disease (GERD). It is a type of digestive disorder that affects your lower esophageal sphincters. The condition involves the return of the stomach s content back to your esophagus. Although heartburns are common, GERD involves chronic heartburns, which require an adequate treatment. 

Here the some important reasons why you should not ignore the symptoms of GERD:

Esophagitis: In case of GERD, the food, acid and digestive juices flow back from the stomach to the esophagus. This leads to irritation and swelling with time, which is called esophagitis. In case you have acid exposure in your esophagus for a few weeks, inflammation of the lining is indicated. This can be very painful and uncomfortable, making the esophagus more prone to scarring and further erosion.
Esophageal stricture: If esophagitis continues for a long time, scar tissues can lead to the narrowing of the esophagus. This is known as a stricture, which makes swallowing very difficult and painful. Large chunks of food may get stuck and you are more likely to choke while eating or drinking. You may tend to avoid food and water because of esophageal stricture, which may result in weight loss.
Throat and voice problems: Apart from heartburn, several other symptoms may also appear because of GERD. These are called cases of silent reflux where you may not experience heartburn. Instead, other issues are indicated which include voice hoarseness, voice changes, sore throat and chronic coughing.
Breathing problems: If stomach acid is inhaled after regurgitation, the symptoms of asthma and pneumonia may worsen because of GERD. Shortness of breath and breathing difficulties are likely, even without any lung problem.
Tooth decay: When the stomach acids and digestive juices go back to the esophagus and into the mouth, it leaves a sour taste. In case it occurs frequently, it wears away your tooth enamel and results in tooth decay. People experiencing acid reflux induced erosion may be unaware of the damage being caused until it reaches peak stages.
Esophageal ulcers: Stomach acid may result in the wearing away of the esophageal lining, resulting in ulcers and sores. These esophageal ulcers are different from stomach ulcers, which occur from bacteria. Patients with esophageal ulcers may vomit blood, and notice blood in stool. It is usually darker than its usual shade and may have the texture of coffee ground like particles.
It is important for you to visit a doctor immediately after experiencing the symptoms of GERD. This condition may cause severe distress if you let it advance, and hence, early diagnosis and treatment are very important.

GERD - Reasons Why You Should Not Ignore The Signs!

Obesity can shorten your lifespan by decades and also limit and reduce the quality of your life. Obesity cannot always be controlled by dieting and exercise and thus more complicated means such as bariatric surgery has to be employed.

Types of bariatric surgery
Most bariatric surgeries either limit your ability to consume food and thus make you feel fuller quickly or limit the absorption of nutrients from the food you eat. Certain surgeries use a combination of the two in varying degrees. Mentioned below are the most commonly employed forms of bariatric surgery  

Gastric Balloon   This is a form of surgery wherein a specially made balloon is inserted into the stomach. In certain cases even two balloons are inserted into the stomach to reduce the room left for food. This causes you to have less food resulting in weight loss over a period of time.
Gastric Sleeve   This is a form of surgery wherein a major portion of the stomach is removed through the procedure. Also known as Vertical Sleeve Gastrectomy, the surgeon creates a pouch within the stomach which essentially becomes a connecting tube between the esophagus and the large intestine. The reduced stomach size causes fewer hunger related enzymes and hormones to be secreted, causing less hunger and also reducing your food intake capability. This results in weight loss over a period of time.
Gastric Bypass   Gastric bypass uses the combination of two techniques, lesser absorption of minerals as well as reduced intake capacity. In this method, a part of the stomach is rearranged akin to the gastric sleeve. However the leftover portion of the stomach is not removed as it can continue to secrete stomach acids. Because of the reduced size of the stomach, you would eat less and if you happen to over eat, it would cause dumping syndrome (quick and repeated bowel evacuation) which would deter you from eating more.
Lap band surgery   This is one form of surgery where the stomach is not reduced or cut but rather limited by a band that is put around it. This band constricts the stomach and causes the upper part to become smaller. Hence you would feel fuller from eating less, thus resulting in weight loss.
V-bloc therapy   This is a very modern approach to bariatric procedures which works in a very similar way to a pacemaker. A device is placed just under your skin and two leads or wires are connected to the vagal nerve. This nerve is responsible for sending the hunger signals to the brain from the stomach. This device acts as a block to the nerve signals and thus ensures you eat less.
Duodenal switch   This surgery is also known as a Biliopancreatic Diversion wherein the surgeons cut out the part of the stomach similar to a gastric sleeve surgery but also make adjustments to the pancreatic chain and the small intestine to reduce the absorption of minerals.

6 Types Of Bariatric Surgery You Can Think of!

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