Enlarged prostate surgery is a very common type of surgery that many have to undergo nowadays. An enlarged prostate causes many health problems including urinary tract obstructions and urinary tract infections. It may also lead to the passing of blood via urine. Thus, enlarged prostate must be treated as soon as possible as neglect may lead to prostate cancer and its associated health issues. There are various types of prostate surgeries that a doctor performs on his/her patients. However, of late, radical prostatectomy is the most popular of them all.

What is Radical Prostatectomy?

This process can be handled in two ways. Firstly, the prostate can be reached through an incision in the abdomen. This would help the doctor work with precision and carefully avoid all the other nerves and muscles in the area the operation take places. The prostate is examined and any nodule or lymph formed over it is carefully removed. The advantage of this surgery is that the patient is less likely to suffer from any erectile problems post- surgery. The second option would be to make an incision between the scrotum and the anus. This process is best for those who are obese. The surgery is performed quickly and there is less loss of blood. Furthermore, the healing time is less too.

How To Recover From The Surgery?

Like most other prostate operations, even in radical prostatectomy, you would have to wear a catheter till you recover completely. For a few days post the surgery your urine would be collected through a urine bag attached to the catheter. One might feel a little sore in his/her genitals after the surgery, but that is quite normal to occur. The soreness is caused due to the surgery and the incisions made and would heal in a matter of a few days. Interestingly, since the urethra plays an important role in this surgery, the catheter has to be in place for at least two to three weeks but the patient can be discharged after a two to three night stay at the hospital. It is advised that the patient takes ample rest. But this does not mean all rest and no work. In fact, it is seen that patients can walk a little and even go back to a normal diet within a week to ten days of the operation. But regular checkups, till the urethra is healed, are compulsory.

Hence, these are some of the recovery procedures after an enlarged prostate surgery. Such surgeries are quite common and heal quickly.

What To Expect Post An Enlarged Prostate Surgery?

Urinary incontinence is the unintentional passing of urine. It's a common problem thought to affect millions of people. There are several types of urinary incontinence, including:

Stress Incontinence  when urine leaks out at times when your bladder is under pressure; for example, when you cough or laugh.
Urge Incontinence  when urine leaks as you feel a sudden, intense urge to pass urine, or soon afterwards.
Overflow Incontinence (chronic urinary retention)  when you're unable to fully empty your bladder, which causes frequent leaking.
Total Incontinence  when your bladder can't store any urine at all, which causes you to pass urine constantly or have frequent leaking.
It's also possible to have a mixture of both stress and urge urinary incontinence.

What causes urinary incontinence in men?

Urinary incontinence in men results when the brain does not properly signal the bladder, the sphincters do not squeeze strongly enough, or both. The bladder muscle may contract too much or not enough because of a problem with the muscle itself or the nerves controlling the bladder muscle. Damage to the sphincter muscles themselves or the nerves controlling these muscles can result in poor sphincter function. These problems can range from simple to complex.

A man may have factors that increase his chances of developing UI, including

birth defects problems with development of the urinary tract
a history of prostate cancer surgery or radiation treatment for prostate cancer can lead to temporary or permanent UI in men
UI is not a disease. Instead, it can be a symptom of certain conditions or the result of particular events during a man s life. Conditions or events that may increase a man s chance of developing UI include

benign prostatic hyperplasia (BPH) a condition in which the prostate is enlarged yet not cancerous. In men with BPH, the enlarged prostate presses against and pinches the urethra. The bladder wall becomes thicker. Eventually, the bladder may weaken and lose the ability to empty, leaving some urine in the bladder. The narrowing of the urethra and incomplete emptying of the bladder can lead to UI.
chronic coughing long-lasting coughing increases pressure on the bladder and pelvic floor muscles.
neurological problems men with diseases or conditions that affect the brain and spine may have trouble controlling urination.
physical inactivity decreased activity can increase a man s weight and contribute to muscle weakness.
obesity extra weight can put pressure on the bladder, causing a need to urinate before the bladder is full.
older age bladder muscles can weaken over time, leading to a decrease in the bladder s capacity to store urine.
Treating Urinary Incontinence

Initially, your GP may suggest some simple measures to see if they help improve your symptoms. These may include:

lifestyle changes   such as losing weight and cutting down on caffeine and alcohol
pelvic floor exercises   exercising your pelvic floor muscles by squeezing them, taught by a specialist 
bladder training   where you learn ways to wait longer between needing to urinate and passing urine, guided by a specialist
You may also benefit from the use of incontinence products, such as absorbent pads and handheld urinals.
Medication may be recommended if you're still unable to manage your symptoms.
Surgery may also be considered. The specific procedures suitable for you will depend on the type of incontinence you have.
Surgical treatments for stress incontinence, such as tape or sling procedures, are used to reduce pressure on the bladder or strengthen the muscles that control urination.
Operations to treat urge incontinence include enlarging the bladder or implanting a device that stimulates the nerve that controls the detrusor muscles.

Men Urinary Incontinence Treatment

One of the most common issues with old age in men is the enlarged prostate. Any difficulty with urination (no constant stream, difficulty initiating, or incomplete emptying of the bladder for instance), and the first suspect is an enlarged prostate. These symptoms are followed by a digital rectal exam to check for an enlarged prostate. Once confirmed, the next step is to check for levels of prostate-specific antigen (PSA). If both the exam and the PSA are positive, it could mean prostate cancer. As with any cancer, it is believed that sooner it is diagnosed and the treatment is started, the better.

Historically, the best way to rule out the prostate cancer had been to do a prostate biopsy. This is a minor invasive procedure, wherein biopsies are taken from various regions of the prostate which are known to develop cancer (about 12). A disadvantage of this procedure includes missing out on the front part of the prostate which can also develop cancer. Secondly, it is not a very pleasant experience and given a chance, most men would not want to have it done.

There is good news for these men who would like to avoid prostate biopsies. The first is the multiparametric MRI which uses no x-rays and is considered very safe with extremely accurate results. This MRI exam requires about an hour, and once the images are obtained, the doctor will analyse these images and check for several parameters to assess for prostate cancer. The absence of cancer can be confirmed with up to 90% accuracy, which is far greater than with usual biopsies. If there is a possibility of cancer, then a biopsy can be done to confirm it. 

Also, these images indicate the exact region where cancer likely is, and this guides the doctor to biopsy only where absolutely essential. The chances of false positive and false negative results are reduced drastically. The one disadvantage here is that MRI detected biopsies usually tend to be of a higher grade which requires immediate treatment.

Another way to reduce chances of the biopsy by 30% to 50% is by the 4K test. It helps detect a variety of prostate issues including cancer. It can be used once higher levels of PSA is identified and before going for a biopsy. It combined 4 prostate-specific biomarkers with clinical information to accurately provide men with a risk of developing prostate cancer. It can be used even after negative biopsies to confirm the diagnosis of prostate cancer.

These two measures can drastically reduce the incidence of prostate biopsies, which is neither pleasant for the patient nor very effective for the doctor.

Prostate Biopsies - Ways You Can Avoid It!

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?

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.

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