Hunner's ulcers, simply put are painful ulcers in your urinary bladder. These ulcers are inextricably linked to another disorder called the painful bladder syndrome or intestinal cystitis. They occur in 10 to 15 percent of people with interstitia cystitis. These, in fact, are red patches or lesions on the bladder wall which can stiffen tissue and cause reduced bladder capacity. Hunner s ulcers bleed, ooze pus and can be of different sizes. The ulcers in the bladder can be extremely painful and uncomfortable.

These are called Hunner s ulcers because they were first described by Dr. Guy LeRoy Hunner, a Johns Hopkins gynecologist, in 1915. Since Hunner s ulcers are seen only in people with intestinal cystitis, it s important to know more about this painful life-altering bladder disorder before we can even understand how to deal with them.

Interstitial cystitis (IC)
IC is also called painful bladder syndrome. Another important thing to know about IC is that it strikes more women than men. IC is a chronic disorder and there s no cure for it. It causes recurring bouts of pain and pressure in the urinary bladder and the pelvic area. This is often accompanied by an urgent and frequent need to urinate. Sufferers may have to rush to the  loo  as much as 40, 50, or 60 times a day.

Diagnosis
Hunner's ulcers can only be accurately diagnosed by doing a cytoscopy which involves inserting a fibre-optic tube through the urethra to look at the bladder wall closely. During this procedure, a tissue sample from the bladder wall is usually also taken to rule out bladder cancer. Cytoscopy is usually done with hydrodistention under local anesthesia. This involves filling the bladder with a liquid for stretching it to provide a closer view of the bladder wall. Usually, a urologist performs this surgery along with a gynaecologist. IC and also Hunner s ulcers are both a diagnosis of exclusion. This means that they re diagnosed only after a number of other conditions have been ruled out.

Hence, the urologist will first take your thorough medical history, followed by a physical exam and a pelvic exam for women patients and perform tests for ruling out infection, and other disorders like bladder stones and cancer, kidney disease, multiple sclerosis, endometriosis, sexually transmitted diseases amongst others. Only after these tests are inconclusive or uncertain and if there is blood in urine, will the urologist go for cystoscopy.

Treatment
There's no cure for IC, but Hunner s ulcers can be cured by burning them off the bladder wall. Called fulguration, the process uses electricity or laser to burn the ulcers on the bladder wall. Resection is also used in which skin from around the Hunner s ulcer is cut for removing both the ulcer and the inflamed tissue around it. The problem is that ulcers may recur in the same location.
So, managing IC becomes critical. Your doctor can try to treat the patient with one treatment or with a combination of treatment depending on the condition of the patient.

Pain medicines are the first line of treatment to manage Hunner s ulcers and IC both, and many patients do go in for this. Patients also find relief by modifying their diet to remove foods and drinks like caffeinated beverages- tea, coffee, colas etc. Sodas, artificial sugars and fruit juices, especially Cranberry juice can trigger intense pain and discomfort, so these are usually contraindicated. Another important aspect is patient education about normal bladder function and tips on self-care and behavioural modifications like stress control to manage Hunner s ulcers.

Hunner's Ulcer In Urinary Bladder - How They Can Be Treated?

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

Polycystic kidney disease is a disorder that is inherited; it is characterized by development of cysts in the kidneys. These cysts are round sacs that contain a water like fluid. Initially, the size of the cysts are small, they tend to increase in size after the fluid accumulation. This disorder can also cause cysts to develop in the liver and other parts of the body.

Symptoms and Complications
The most common symptoms of this disorder are back pain, headache, high blood pressure and kidney failure. It can also lead to formation of stones in the kidney, presence of blood in the urine and an urge to urinate frequently. It also make your kidney prone to various bacterial infections.

Causes
The disease is caused because of the presence of defective genes in the body, implying that this disorder is primarily hereditary. In some cases, the disease is caused by a genetic mutation. Based on the causes, it is classified into two types:

Autosomal recessive polycystic kidney disease: This disorder causes the symptoms to appear immediately after birth, although the symptoms are delayed until adolescence. This disorder only occurs when both the parents carry the defective gene which is passed to the offspring.
Autosomal dominant polycystic kidney disease: This disorder usually tends to occur only after the age of 30. Unlike the previous type, here only one parent needs to carry the defective gene that is passed on to the offspring.
Treatment
The treatment of polycystic kidney disease generally involves dealing with the following signs:

Pain: Chronic pain, usually in the sides of the body or the back, is a common symptom of this disorder. You can opt for pain reliving medication such as ibuprofen. If the cysts are large, then surgery is required to ease the pain.
High blood pressure: High blood pressure is best controlled by a following a healthy diet and lifestyle. High blood pressure can damage the kidneys severely. Medications may also be required to control blood pressure, if it rises abnormally.

Frequent Urination - Can it be a Sign of Kidney Disease?

Kidney stones are caused when certain minerals of your urine are retained and are not fully released, causing them to amalgamate and form a stone. Passing a kidney stone is one of the most painful experiences you may face physically. Its magnanimity is often compared to childbirth, and those who are suffering from kidney stones dread having this experience. If you are not yet affected by kidney stones and do not want to, read further to know what type of diet you need to follow in order to prevent it.

1. Drink lots of water: On an average, a person must be drinking at least 3 liters of water every day. If you live in a more hot and humid climate, your water intake must be even more than that, so that on an average, 2.5 liters of urine is passed throughout the day, which decreases the chance of unnecessary retention of minerals from the urine and release them more easily from the body.

2. Continue eating foods rich in calcium: It is a common misconception that calcium accelerates the formation of kidney stones. Calcium is digested by the intestine, only excess calcium cannot be digested by the intestine and is sent to the kidney. Continue consuming calcium rich foods unless your doctor prescribes you against it. Make sure your diet includes enough dairy products such as milk, cheeses, etc., or other calcium rich foods, such as oats and broccoli.

3. Limit intake of oxalic acid: Oxalic acid is mostly found in foods obtained from plants. It restricts the absorption of calcium in the intestines and as a result, more calcium is passed into the kidneys; thus, forming calcium oxalate, or oxalate stones. Try to avoid foods, such as rhubarb, Swiss chard, nuts, tea, sweet potatoes, etc.;mainly leguminous plant products.

4. Decrease the ingestion of sodium salts, sugar and meat protein: Salts and sugars, mainly found in packaged foods are used to prevent them from expiring. They increase the release of calcium and oxalates into the blood, which thus increases the chance to develop kidney stones. Meat contains fibers which affect certain nutrients in the kidney, thus aggravating the formation of stones.

5. Increase the consumption of insoluble fibers: Insoluble fibers are those rough fibers which are not soluble in water during the process of digestion. They are found in rice, wheat, barley, etc., and are found to decrease calcium absorption in the kidney. They attach themselves to the calcium and oxalates, which enable them to be released as stool instead of urine.

Kidney Stones and Your Diet

A prostate operation involves the removal of a part of the prostate gland or sometimes the removal of the entire prostate gland. Such a surgery is a serious one and several recovery tips must be followed by a patient to ensure quick and successful healing. 

Here are some important tips for recuperating from a prostate operation:

After the surgery, you need to spend up to three days in the hospital for initial recovery. You might be given fluids, which go directly into your veins until you fully recover from anesthesia.
After the operation, normal urination will be disrupted in the beginning, as the urethra stays swollen. Urinating gets a little difficult and uncomfortable for a few days after the removal of the catheter.
You may feel fatigued and may feel under the weather for some weeks after a prostate operation. So you must take things easy for at least two months.
Avoid lifting or moving heavy objects for some weeks following the surgery. Do not perform any exercise, which causes strain. You should ask your friends and family members to carry out chores for you.
After becoming slightly stable you should start gentle exercises. Walking is an effective remedy, which helps in blood circulation and lowers the risk of getting blood clots in the legs.
You should drink lots of water during the recovery stage. This will reduce the risk of getting a urinary tract infection and also help in clearing any trace of blood from your urine.
For improving bladder control, you should perform several pelvic floor exercises.
In case of any kind of pain, you can take over the counter painkillers to ease the pain.
It will take you a time span of three to six weeks for total recovery after a prostate operation. You should consult your surgeon about the best time to return to normal daily activities.
You can get back to work soon, but it depends on your nature of work. Office jobs are not much of a problem, but in case of physical labour, more time is needed before you can resume your duties.
Activities such as driving can be started quite soon after initial recovery. However, it varies from person to person. Some people may get back to driving within two weeks while some may need a month.
You have to wait for 6 to 8 weeks after a prostate operation before getting back to sexual activities.
In case you experience high fever, pain during urination or the inability to urinate, you must consult your doctor immediately.
It takes a person several weeks to recover from a prostate operation completely. Initially, total rest is required. But eventually, he can return to normal activities and lead a healthy life.

14 Tips to Help You Recuperate from Prostate Operation

What is diabetic kidney disease?
Diabetic nephropathy, also known as Diabetic Kidney Disease is a type of complication that occurs in people who are a victim to diabetes. That does not mean every individual with diabetes will have this disease, but if the necessary precautions are not taken, then it can lead to this disease. Diabetic Kidney Disease is characterised by excessive amounts of albumin as well as protein in the urine. In diabetics, certain chemicals in the kidneys shoot up and hamper the function of the glomeruli.

The glomeruli are the main units of kidneys that are responsible for the filtration. Diabetic kidney diseases result in the leakage of essential products like albumin and protein into the urine. When this happens, the protein levels in the blood reduce. If proper precautions are not taken and treatment is not done, then the disease may worsen and the condition will progress to  end-stage renal failure .

How to avoid diabetic kidney disease?
The best way to treat diabetic kidney disease is to prevent it in the first place. Foremost, you should prevent the risk factors in order to avoid coming down with Diabetic Nephropathy. The risk factors include high blood pressure, high levels of blood sugar, dyslipidemia and smoking. Avoid excess of following 5S Sugar, Salt, smoke, stress and sedentary life.

Intensive control over blood sugar
According to certain clinical trials, maintaining and keeping a good control over your blood sugar levels drastically reduces the risk of developing diabetic kidney disease. If you are diabetic, make it a point to get your regular checkups and maintain your diet to prevent the levels of sugar in your blood to shoot up. Other things that you must keep in your mind are to take proper medication that has been prescribed to you. You must adhere to your treatment plans and follow the guidelines that have been given to you.

Intensive control over blood pressure
Hypertension is common in patients who are diabetic. Hypertension alone can result in end-organ damage due to excess pressure build up in the blood vessels. Hypertension associated with hyperglycaemia (diabetes) is a ticking bomb for your kidneys. Hence it is advised to keep your blood pressure under control as well to prevent diabetic kidney disease.

Diabetic nephropathy is not something that happens to every individual with diabetes, so if you follow the above simple tips, the chances of the same reduce, and thus the quality of your life goes up. Many diabetics will get kidney failure due to causes other than diabetes and that may be treatable. Hence early consult with nephrologist is a must.

Diabetic Kidney Disease - How It Can Be Prevented?

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