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

Hernia are bulges protruding form a weak point on belly (abdomen) through which intestine and abdominal fat comes out to lie just below the skin. It can also be found in groin, upper thigh and chest. There are several types of hernia like inguinal hernia (direct and indirect), femoral hernia, umbilical hernia, umbilical hernia, epigastria hernia and incision hernia.

Who get hernia?

Conditions that lead to increased abdominal pressure are at more risk of developing hernia  

o Persistent cough

o Being overweight or pregnant

o Lifting, carrying or pushing heavy loads

o Straining on the toilet

What are the symptoms of hernia?

o Mostly they are asymptomatic/ no symptoms.

o People just notice a swelling or bulge which gets bigger while standing or straining and disappear while lying down/sleeping.

o Some might feel a dragging/aching sensation.

o The swelling tends to get bigger with time.

o Symptoms develop when there is a complication like strangulation. This happens when the content of abdomen (intestine) come out and can not go back. There will be severe pain in the region and vomiting. Overlying skin will become red. Urgent surgery is needed in this situation otherwise the blood supply to intestine gets cut-off and the intestine in hernia might die (gangrene).

How are hernia treated?

Surgery is the only treatment for hernia. Now a days, most of the hernias are operated laparoscopically (key hole or minimally access technique)

Minimally Invasive Hernia Repair - The surgery is done with a laparoscope which has a small tiny camera, hernia mesh and small tool with it. So the patient can return back to their normal routine earlier as the incision made is smaller.

Advantages of Laparoscopy:

Laparoscopy has clear advantage over open repair in the way of less pain, less complications like wound infection, small and more cosmetic scar, shorter hospital stay, early return to work and daily activities and less chance of recurrence (repeat formation of hernia after surgery).

Before undergoing hernia surgery:

* One week before surgery it is much essential to stop taking drugs that are causing the thinning of the blood. Drugs like Clpodogrel and Acitrome or Warfarin should be stopped with the doctor s advice. 
* Stop herbal supplements and check the fitness of your cardio and diabetes. 
* Gain adequate knowledge about surgery and be prepared for post surgical care.

After hernia surgery:

* Avoid heavy weight lifting, exercises, and physical works with excessive strain a few weeks after surgery 
* Cough or laugh loud only with support to the surgical site until one week after surgery

DO s & DON T s in patients of Hernia:

DO s:

1. Increased intake of fibers in diet. ( Fruits, vegetables and grains)

2. Drink plenty of water and other fluid to prevent constipation.

3. Exercise regularly: sweat and loose excess weight and toxins.

4. Eat small meals more frequently in place of one or two large meals

DON T s:

1. Stop smoking and drinking

2. Don t reduce the amount of food you eat

3. Avoid lying down or bending after meal

4. Avoid wearing tight clothes

5. Avoid food difficult to digest

6. Avoid strenuous activities like heavy weight lifting

Types of Hernias:

Incisional hernia:

This happens at the site of previous surgery. This occurs as a result of poor wound healing at the time of previous surgery or as a result of complications like in infection. It is rare after laparoscopic or key hole surgery.

Umbilical hernia:

This occurs through or around belly button (umbilicus). It can be present at the time of birth and needs no repair as most of them resolve by the end of one year. If it persists or appears after 5 years of age then operation is required.

Inguinal hernia:

These are most common hernias and occur in groin region. They are more common in men.

All You Need To Know About Hernia!

Q1. What exactly is Laparoscopy?
Laparoscopy is an alternative to 'Open' surgery wherein the abdomen is opened by tiny 'key hole' incisions and surgery is done. 'Scopy' means the use of an endoscope or telescope to see inside the abdomen. This is attached to a camera and a light source and the inside of the abdomen is projected on to a monitor. The surgeon performs surgery looking at this screen. The surgeon makes a total of 2-4 small cuts on the abdomen ranging from half to 1 cm through which the telescope and other thin surgical instruments are passed into the abdomen. When the uterus is removed , known as hysterectomy, there is also a cut at the top of the vagina where the uterus is attached.
Q2. What kind of gynaecological surgeries can be performed by Laparoscopy?
Most surgeries done in gynaecology can now be performed by Laparoscopy and do not require the large incision as for open surgery. Laparoscopy can be done sometimes only for diagnosis and is called Diagnostic Laparoscopy, as in checking whether the tubes are open or not and to look for any causes of infertility or pain outside the uterus. In women who are unable to conceive, Diagnostic Laparoscopy is often combined with Hysteroscopy (endoscope inside the uterus, inserted from below, via the vagina). When laparoscopy is done to perform some surgical procedure inside the abdomen it is called Operative Laparoscopy. This may be for simple procedures like sterilization, minor adhesions, drilling ovaries; or for intermediate or major reasons like fibroids, endometriosis, removal of ovaries or tubes or both or removal of uterus, for staging of cancers or radical surgeries for cancer. However, about 5% of all surgeries including those for cancer or very large tumours may benefit from open surgery.
Q3. Why does an expert surgeon recommend Laparoscopy over Open Surgery?
Laparoscopic surgery has many advantages above open surgery: the incisions are much smaller (open surgery incisions are 8-10 cms long), therefore pain is much less; requirement for pain killers (which can have side-effects like sleepiness, impaired judgement) is lesser; hospital stay is shorter; complications fewer; requirement for blood transfusions infrequent; recovery in terms of physical, emotional and mental state is much better and quicker; return to work is faster with consequent lesser loss of working and earning days. Surgery with laparoscope is more precise because it is magnified view. Further vision is much better because it's like having your eye behind the structure because you can see with the telescope at places where the surgeon's eye cannot reach.
Q4. If the cuts on the abdomen are so small in Laparoscopic surgery, how do you remove the uterus or a large tumour from inside the abdomen?
Quite often if the tumour is not malignant and contains fluid, it is punctured to collapse it into a smaller size. If it is solid, it can be cut into smaller pieces inside the abdomen using a special instrument. The collapsed or cut structures can be removed gently through the 1 cm cut on the abdomen which may be increased a bit if required. After hysterectomy, the uterus can be removed easily from below, through the vagina.
Q5. Will there be much pain or discomfort after Laparoscopic Surgery?
There may be some pain and discomfort in lower abdomen for one day to few days after Laparoscopic surgery but this is much less as compared to open surgery because the incisions on the abdomen are much smaller and there is much less tissue handling inside the abdomen by fine instruments instead of rough, big, gloved hands which can cause tissue injury in open surgery. There may be some pain in the shoulder following laparoscopy. This is not serious and is due to the gas used in the surgery to make space for instruments.
Q6. When can I be discharged from hospital?
Following Diagnostic Laparoscopy or with simple Operative Laparoscopy you can expect to be discharged from hospital latest by the morning after surgery. In most other cases of intermediate or even major surgery, discharge is generally 1-2 days following the surgery unless there is some health issues prior to the surgery or any complication during the surgery. The complication rates for Laparoscopic surgery are not more than for open surgery and depend upon patient factors like anaemia, diabetes, obesity and skill of the surgeon.
Q7. When can I perform routine household activities or return to work after Laparoscopic Surgery?
Recovery after surgery depends upon many factors: presence of health problems before surgery; why the surgery is required; what surgery is being done; problems or complications of surgery, anaesthesia or blood transfusions. If all is well, one can perform routine household activities by 1 week, provided one doesn't feel tired. Although there may not be any harm, it may be unwise to be normally active within 48 hours of procedure. Following Diagnostic Laparoscopy or Operative Laparoscopy for simple procedures, one can return to work in 1 week. For other procedures, a 2-3 week off from work is reasonable. It depends on the type of work you are returning to. Avoid too rapid return to work if it is manually hard or requires standing for long durations of time. Sometimes a surgical procedure brings on a well needed rest and break from a lifetime of work. Mostly, when you return to work depends upon your own body and its signals of tiredness. You need to listen to those signals.


Know All About Gynae Laparoscopy Surgery

Colorectal surgery deals with the disorders of the rectum, anus and colon. Another name of colon is  large intestine . These three body parts form the last stages of the digestive process. When the human waste passes through the colon, its salt and water are extracted before it exits the body as human excreta.

Colorectal disorders

Swelling and inflammation of the veins in the anus (also called as Haemorrhoids)
Anal fissures- unnatural cracks and fissures in the anal area
Fistulas or the unnatural connections between the anus and other anorectal areas
Conditions of constipation
Incontinence in passing of faeces
When the walls of the rectum protrude through the anus- also called as Rectal prolapse
Birth defects such as imperforate anus
Anal cancer- this condition is rare
Colorectal cancer- cancer of colon and rectum
Any injuries to the anus
Removal of any objects inserted into the anus
Bowel habits after colorectal surgery
Many patients report cases of diarrhoea, leakage of stool or gas, urgency to use the toilet and a feeling of insufficient evacuation of faeces. Relax; these conditions are not going to last forever. Your rectum and anus are adjusting to new conditions after this surgery. These organs may take six to twelve months to adjust to new bowel habits.

Is there a need to take a laxative or stool softener?
There is no need to take laxatives after a colorectal surgery. Drink lots of water to make your stool softer and easy to pass. If there is a water deficiency in your body, then it may lead to your faeces becoming hard. In that case, take milk of magnesium, colace etc.

Activities post surgery
You can continue with your normal schedule after this surgical procedure. Carry on running, jogging, exercising, climbing up the stairs etc. even after your surgery. Gastroenterologists recommend that patients should desist from lifting loads weighing more than 10 pounds so that there are no post surgery complications.

Diet after colorectal surgery
Avoid spicy and heavy to digest meals after your surgery. Once the intestines begin working normally, you can continue having your spicy food. Chew your food well to aid its digestion.

Returning to work after colorectal surgery
Most people are back to their work after taking a break of 2-5 days. If the surgery is pretty detailed, you may have to take a break of up to a month. Patients undergoing laparoscopic surgery may have to take a rest of 2- 4 weeks before they report back to work. Take it easy before slipping into your regular schedule. If working hurts after your surgery, don t do it.

Colorectal Surgery - Disorders It Can Treat!

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?

Chronic kidney disease or CKD is the decreased function of the function of the kidney for a minimum of three months or more. In this the end stage renal disease usually refers to the end of the kidney function where the kidneys work for less than 15% of what they are supposed to. The kidneys play a vital role in the human body and if they do not function properly then a person can die. The functioning of many organs depends on the kidneys. However, the main function of the kidneys is to remove the products and regulate blood and water, control blood pressure, promote healthy and strong bones, and produce hormones.

Here are 5 facts about kidney disease you should know about:

1. Causes of the kidney disease: There are two main common causes of the end-stage kidney disease. These are preventable causes. These are diabetes and high blood pressure, but then kidney disease can be caused by other inherited diseases such as infection, trauma or polycystic kidney disease.

2. Serious Stages: The kidney disease has five stages and stage 5 is known as the end stage renal disease; this is the point where patients usually need dialysis or kidney transplant to lead a sane life. The stages of kidney disease are:

Stage 1   Slight kidney disease
Stage 2   Mild decrease in kidney function
Stage 3   Moderate decrease in kidney function
Stage 4   Severe decrease in kidney function
Stage 5   End stage renal disease

3. Detection of the disease: Kidney disease is usually difficult to detect because of the presence of very few symptoms. Age, gender along with the blood test is one way to determine information regarding kidney function. The people who are at a risk of getting kidney disease are:

    Over the age of 55 years
    People who suffer from hypertension and diabetes
    Ethnic groups such as Asians, Africans, Americans, Pacific Islanders and Hispanics

4. Signs and Symptoms: CKD is usually considered to be a silent disease and many people don t know that they are suffering from the disease. The signs and symptoms of the disease are:

    Fatigue and weakness
    Nausea, vomiting and loss of appetite
    Dizziness
    Numbness and headaches in hand and feet
    Frequent urination

5. Renal Replacement Treatment: This is the treatment for the end stage of the kidney disease. Dialysis involves the replacement of some part of the lost function of the kidneys and is usually continued throughout life. There are 2 types of dialysis:

    Hemodialysis: This cleans the blood via an artificial kidney which is hooked to the machine
    Peritoneal Dialysis: This removes the excess water and waste products and cleans the blood of the body by using the peritoneal cavity as a filter. 

5 Facts About Kidney Disease You Should Know

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