The presence of blood in urine is known as Haematuria. It is categorized under 2 types:

    Macroscopic haematuria, which means the patient has seen blood.
    Microscopic dipstick haematuria, which means blood is identified by urine microscopy or by dipstick testing either in association with other urological symptoms (symptomatic microscopic haematuria) or during a routine medical examination. It has been variably defined as 3 or more , 5 or more or 10 or more Red Blood Cells (RBCs) per high - power field.

Urological and other Causes of Hematuria

    Cancer: Bladder, Kidney and Prostate Cancer
    Stones: Kidney, Ureteric
    Bladder Infections: Bacterial tuberculosis, infective urethritis Inflammation
    Interstitial Cystitis Trauma : Kidney, bladder, urethra, pelvic fracture causing urethral rupture
    Renal cystic disease: (e.g. medullary sponge kidney)
    Other urological causes: Benign prostatic hyperplasia, vascular malformations
    Other medical causes of haematuria: anticoagulation therapy (e.g. asprin, anti platelet therapy) Nephrological Causes: more likely in children and young adults, proteinuria; red blood cell casts.
    Urological investigations: Urine culture, urine cytology, cystoscopy, renal ultrasonography and intravenous Urography and CT Urography.

Management of haematuria depends on the cause as determined by the urologist.

Causes and Treatment for Hematuria

Lumpectomy is a surgery where a cancerous or benign tumour is removed from a breast along with some surrounding tissues. The amount of tissue removed varies according to the nature of the tumour. It is a form of breast-conserving surgery. It is also called a partial mastectomy.

Lumpectomy is the first option of treatment for women diagnosed with early-stage breast cancer.

What is the goal of lumpectomy?

Lumpectomy aims to remove the cancerous cells from the breast and at the same time maintaining the appearance of the breast. Studies have proved that for early stage breast cancer, lumpectomy is as effective as mastectomy (complete removal of the breast).

Doctors may recommend lumpectomy to remove precancerous cells as well.

Pre lumpectomy measures-

If you are under any other medication or if you suffer from allergies, inform your doctor. Other pre-surgery measures include-

  Stop taking aspirins or any pain relieving medication

  Your doctor will recommend you to not drink or eat anything 8-12 hours prior to the surgery.

The procedure:

A mammogram and a biopsy reveal the exact location of a tumour. Lumpectomy is performed under general anaesthesia. The surgeon makes a small incision over a tumour to extract the cancerous cells and the surrounding tissues. Sometimes doctors have to perform sentinel lymph node surgery or axillary node dissection.

The surgeon then closes the incisions with sutures. The sutures may dissolve over time or may have to be extracted later by a doctor.

If you have undergone lumpectomy and sentinel node biopsy, you will be discharged on the same day as the surgery as soon as your blood pressure stabilizes.

However, after lumpectomy with axillary node extraction, you may have to stay in the hospital for 2-3 days.

Therapy after lumpectomy

Your oncologist will recommend a follow-up radiation therapy to destroy the mutated cells that may have remained in the area where a tumour had developed. Radiation reduces the risk of breast cancer recurrence.

You might also have to undergo hormone therapy. Some types of breast cancer need female hormones like estrogen and progesterone to grow. Hormone therapy inhibits the development of cancerous cells by not allowing these hormones to reach the cells.

Your doctor will advise you to avoid strenuous physical activities for at least a month after the surgery.

Lumpectomy is a safe surgical procedure that can root out tumours or precancerous cells from the breast without deforming the shape of it.

Breast Lumpectomy - All You Should Know!

Gestational diabetes, as the name suggests, occurs during gestation or pregnancy when the blood sugar levels exceed the normal level. Gestational diabetes, like other form of diabetes, affects how your body cells use glucose or sugar during pregnancy, and usually disappears after you ve given birth.

Causes and symptoms to look out for!
During gestation, the placenta produces hormones that lead to the accumulation of blood glucose. Under normal condition, the pancreas forms enough insulin to counter the buildup of blood glucose. The level of blood sugar rises when the pancreas fails to produce adequate insulin to manage your blood sugar.

Usually, women with gestational diabetes do not show symptoms. So, the presence of the condition can go unnoticed if they are not diagnosed during routine checkups and screening tests. Nevertheless, if the condition goes out of control, you may feel tired, feel thirsty or hungry, or feel the urge to urinate more often.

What are the risk factors?
About 2-10% of pregnant women are affected by gestational diabetes every year. The following factors are likely to put you at risk of developing gestational diabetes-

Excess body weight- You may develop gestational diabetes if you were overweight or had gained excess weight (BMI equal to or greater than 30) before getting pregnant
Family history- Women who have a family history of diabetes are likely to have gestational diabetes.
Age- Women aged more than 25 years are at a greater risk of developing this condition.
Diabetic history- A slightly raised blood sugar level may act as the precursor to Type-2 diabetes, which in turn increases your chance of getting affected by gestational diabetes.
Previous pregnancy- Women who ve previously given birth to a child weighing more than 4.1 Kg (9 pounds), or have delivered a stillborn child are likely to have gestational diabetes.
What is the treatment for gestational diabetes?
Urine tests are performed to check for ketones. In a non-diabetic person, glucagon, insulin and other hormones avert ketone levels in your blood from soaring up too high. Once you re diagnosed with gestational diabetes, it s important that you consult your doctor for treatment. Uncontrolled blood sugar level can affect you and your baby s health after birth. This condition can be treated in the following ways-

Keep a check on your blood sugar- During pregnancy, your doctor will have you tested for gestational diabetes 4-5times a day to keep a tab on your blood glucose level. For this, a small drop of blood is first drawn from the finger using a needle. The sample of blood is then placed on the test strip inserted into a device called the blood glucose meter to measure and monitor the level of blood sugar in your body.
Medication- Anti-diabetic medications and insulin are prescribed to control the amount of glucose or sugar in the bloodstream. Your doctor may also suggest oral medications like Diabeta and Glynase to manage your blood glucose level.
Healthy diet- Diabetic diet- one that helps control blood sugar levels- is highly prescribed by doctors during pregnancy. Cut down on carbohydrates and sugar, and switch to food items that provide your body sufficient nutrients and calories.
Post treatment the blood sugar levels usually come down to normal within 4-6 weeks of giving birth.

Gestational Diabetes - Know The Risk Factors!

There are certain changes that are noticed in the body post-pregnancy. One such change that might affect you is an overactive bladder. Usually, depending on the amount of liquid that goes into the body, an individual urinates eight to ten times a day. But post-pregnancy this statistic might increase to around ten to twelve times a day. While urinating helps the body to get rid of excessive body wastes, extreme urinating would also get rid of the necessary minerals and liquid that the body requires for its proper functioning. However, overactive bladders are quite common in women who have delivered and can be treated smoothly. Here are some of the top ways in which you can treat your overactive bladder post your pregnancy:

Losing Weight: A woman gains a lot of weight post pregnancy. This weight needs to be reduced through simple exercises and a proper balanced diet. Reduction of the post pregnancy weight helps in controlling the overactive bladder to a certain extent.

Avoiding Alcohol, Spicy and Acidic Food: Alcohol, spicy and acidic food actually creates havoc in the excretory system. Their compounds are such that these enable the body to get rid of water and necessary elements from the body. In fact, the power of urine itself is reduced, making discharging urine with high water content. This would make you more thirsty resulting in over-urinating at times. Similar conditions arise in the body when you consume coffee which contains caffeine and chocolate. Although, having a little bit of chocolate now and then does not really affect the system to quite an extent.

Exercises: Each exercise is carefully tuned to help a particular part of the body. For reducing the over activeness of your bladder, pelvic exercises are the best that you can carry out even for thirty minutes a day. Exercises would help you to remain active, shed the excess weight as well as manage your urination.

Avoid Smoking: Out of the many health hazards that arise out of smoking, one of them is the extreme urge to urinate often after pregnancy. Thus, to avoid over urination it is advised to refrain from smoking for some time.

Thus, these are some of the easiest ways to control the situation. In case you are embarrassed to go out in the public like this, you can always use incontinence pads. However, if the problem persists even after trying out all the said methods, then it would be in your best interest to take expert advice from the doctors.

Top Ways To Treat Overactive Bladder Post-Pregnancy

What is recurrent miscarriage?

If you have three or more miscarriages in a row, doctors call it recurrent miscarriage. If you have experienced recurrent miscarriage, your GP or midwife will refer you to a gynaecologist. Your gynaecologist will try to identify the reason for your losses.

Having miscarriage after miscarriage may leave you feeling utterly drained of hope. At times, it may be hard to keep trusting in the future. This experience affects every aspect of a woman s life from her mental and emotional health to her physical health and social well-being. 

If you can, try to draw comfort from the fact that most women who experience recurrent losses do go on to have a baby. This is especially the case if tests can find no reason for the losses. Six out of 10 women who have had three miscarriages will go on to have a baby in their next pregnancy.

Treatment of Recurrent Pregnancy Loss

Treatment for anatomic abnormalities of the uterus involves surgical restoration through removal of local lesions such as fibroids, scar tissue and endometrial polyps or timely insertion of a cervical cerclage (a stitch placed around the neck of the weakened cervix) or the excision of a uterine septum when indicated.

A thin endometrial lining has been shown to correlate with compromised pregnancy outcome. Often times this will be associated with reduced resistance to blood flow to the endometrium. Such decreased blood flow to the uterus can be improved through treatment with sildenafil (Viagra), Terbutaline and possibly aspirin.

Sildenafil (Viagra) Therapy Viagra has been used successfully to increase uterine blood flow. However, to be effective it must be administered starting as soon as the period stops up until the day of ovulation and it must be administered vaginally (not orally). Viagra in the form of vaginal suppositories given in the dosage of 25 mg four times a day has been shown to increase uterine blood flow as well as thickness of the uterine lining. To date, we have seen significant improvement of the thickness of the uterine lining in about 70% of women treated. Successful pregnancy resulted in 42% of women who responded to the Viagra. It should be remembered that most of these women had previously experienced repeated IVF failures.

Terbutaline this is a medication that relaxes the muscle in the uterine wall and so permits improved hormone delivery to the endometrium. The use of Terbutaline will often cause an increase in heart rate. It should not be prescribed to women who have irregular heart beats (arrhythmias), and women who have decreased cardiac reserve.

Aspirin this is an antiprostaglandin that improves blood flow to the endometrium. It is administered at a dosage of 81mg orally, daily from the beginning of the cycle until ovulation.

Selective Immunotherapy Using Intralipid, heparin, aspirin and corticosteroid

Many causes of pregnancy loss or failure can be treated with immunotherapy comprising combinations of aspirin and heparin and corticosteroids (dexamethasone or prednisone) and Intralipid (IL) to regulate increased NKa. Achievement of optimal success with Intralipid/corticosteroid therapy requires that the treatment be initiated well before ovulation takes place (about 7-14 days prior to anticipated implantation). Given the fact that only 10-15% of natural cycles (with or without the use of insemination and/or fertility drugs) will result in a pregnancy, it follows that repeated administration of Intralipid will be required in most cases before a pregnancy will occur. IVF achieves pregnancy rates that are often 2-3 times higher. This often makes IVF a treatment of choice in cases of immunologic recurrent pregnancy loss.

Role of IVF

Preimplantation genetic diagnosis (PGD) a procedure whereby the embryo can be tested for genetic or structural chromosomal abnormalities requires the use of IVF to select the best embryo(s) for transfer to the uterus. In cases of structural chromosomal (translocations) egg or sperm donation is often another option worth considering.

In those cases where due to intractable anatomical or alloimmune dysfunction IVF repeatedly is unsuccessful or is not an option, Gestational Surrogacy might represent the only recourse other than adoption.
If a couple with Recurrent Pregnancy Loss is open to all of the diagnostic and treatment options referred to above, a live birth rate of 70%   80% is ultimately achievable.

Recurrent Miscarriage - How to Deal With It?

Contraception is not only restricted to married couples in today's world. Most of the young couples refrain from seeking medical advice for contraception may be because of social concerns or simply because they feel hesitant and shy.

There are many contraceptive pills available over the counter which youngsters are tempted to buy and use as it seems to be the easy way out. Frequent and improper use of such emergency pills can lead to a lot of hormonal disturbances and the menstrual cycle goes topsy turvy. Then the dilemma starts. As it becomes difficult to interpret the cycle dates and erratic bleeding which happens is disturbing.

In my practice I have seen many young girls popping in pills randomly every now and then. Sometimes at weekly intervals as they are unable to manage the stress of their relationship getting disturbed. What youngsters should try and understand is there is nothing wrong in having pills for contraception but it should be done with proper guidance and the selection of the right pill for that particular individual is important which can be done easily by getting into consultation with a doctor. Need not necessarily be a gynecologist always.

Emergency pills are ok for once in a blue moon kind of use. But it should not become a habit.


Misuse Of Emergency Contraceptive Pills

Don't wait any longer, manage your Sperm Donor Program online with a Lybrate doctor today

Consult for Sperm Donor Program - Online and Easy!

FilterClear All

COMMON SPECIALITIES

COMMON ISSUES