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

Located right under the rib cage, kidneys are a very important organ of the body. They are not only responsible for purifying your blood from wastes and excess fluid but are also involved in maintaining electrolyte balance, regulating blood pressure and producing red blood cell in the body.

In many cases, due to some medical condition, one or both kidneys may stop functioning properly. If not treated in time, it may lead to complete kidney failure and if the kidneys fail completely, dialysis or transplant may be the only treatment options available.

Dialysis is a treatment in which the blood is filtered and purified artificially using machines. This process is beneficial for those whose kidneys are not able to do their job properly.

Need for dialysis

A functioning kidney prevents the accumulation of excess water, impurities, and wastes inside the body. They also work to maintain the blood pressure level and control the presence of certain chemicals like sodium and potassium.

When the kidneys fail to perform these critical functions, maybe because of some disease or injury, dialysis helps to keep up the healthy functioning of the body as much as possible. As without dialysis all the wastes and fluids will accumulate and poison the body, resulting even in death. However, it must be kept in mind that dialysis is not a cure for kidney diseases; it is just an alternative to their functions.

Types of dialysis
Dialysis is an artificial process of purifying your blood using machines. There are two types of dialysis:

Hemodialysis
This is one of the most common types of dialysis, where an artificial kidney, known as a hemodialyzer, is used to remove waste and chemicals from the blood. The doctor surgically creates a vascular access into the blood vessels allowing the artificial kidney to perform.

Peritoneal Dialysis
This is a surgical procedure, where a catheter is implanted in the belly area. The treatment involves a special fluid called dialysate which is flowed into the abdomen to clean the blood. Once the blood is cleaned, the fluid is drained from the abdomen. The benefit of this treatment is that you can perform it in your home, without going to a hospital.

Risks in Dialysis
Even though either of these two treatment procedures is life-saving and there is hardly any alternative, these two can also come with risks. The risks include peritonitis, abdominal muscle weakening, high blood sugar level, weight gain, low blood pressure anemia, muscle cramping, insomnia, itching, depression, increased potassium level and pericarditis. If you experience any of these symptoms of the risks involved, then immediately consult your doctor and explain in details.

A patient who is going through dialysis for a long time also has a chance of succumbing to the medical condition called amyloidosis. When the amyloid proteins, which are produced in bone marrow, collects in kidneys, hearts, liver and other organs, amyloidosis occurs. This results in joint pain, stiffness and even swelling. 

Dialysis May Save Your Life!

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

Diabetes is a lifestyle disease that is very prevalent in the current generation. According to a report by the World Health Organisation (WHO), the number of people with diabetes has risen from 108 million in 1980 to 422 million in 2014. The global prevalence of diabetes among adults over 18 years of age has risen from 4.7% to 8.5% from 1980 to 2014. Diabetes should not be taken lightly as it can affect other body organs besides the pancreas, such as the kidneys. Diabetic nephropathy refers to damage to your kidneys caused by diabetes, and may also lead to kidney failure in various cases.

Causes of diabetic nephropathy
Not everyone who suffers from diabetes will suffer from diabetic nephropathy. The main function of the kidneys is to filter waste from your blood. However, this is not always the case. Due to high a concentration of blood sugar caused by diabetes, several blood vessels in the kidney are destroyed, thereby, preventing the kidneys from carrying out its job. Over time, the kidneys may stop working altogether, resulting in kidney failure. If you are diabetic, the probability of you suffering from diabetic nephropathy will increase if you smoke or have high blood pressure or high cholesterol.

Catching it early
Today, diabetic nephropathy is the leading cause of chronic kidney disease in the US and other western countries. Since the symptoms of this condition aren t visible in its early stages, you need to undergo urine tests on a regular basis. If detected early, the effects of diabetic nephropathy can be reversed. Common symptoms of this disease include the following:

Swelling in legs and feet
Detection of albumin in urine
Decline in glomerular filtration rate (GFR)
Elevated arterial blood pressure
What are the treatment options?
Medication to lower the blood pressure is the most commonly prescribed form of treatment suggested by doctors to prevent or slow the damage to your kidneys. There are other lifestyle changes that you may have to undertake in order to keep a check on the condition:

Limit sugar intake and keep blood sugar levels within the target range
Exercise regularly and work towards keeping your heart healthy
Limit protein intake, as it could put extra pressure on your kidneys
Limit salt intake to control blood pressure
Quit smoking and drinking
Diabetes is an unfortunate condition to have to live with. But don t let it bog you down! With these simple lifestyle changes and taking care of your general well-being, you can beat the disease and emerge a winner!

Diabetic Nephropathy - Who is at Risk of Acquiring it?

The ideal diet after a kidney transplant

A kidney transplant is a surgical procedure where your kidneys are cleansed and rebuild using the kidneys of a deceased person, in order to flush out the excessive waste fluids from the kidneys. It is of paramount importance and your dietary patterns and lifestyle should be altered after you go through a kidney transplant. Your dietician will help you out by preparing your diet chart to clearly list out the foods that you should consume and those which you should avoid after the surgery. The diet chart that would be prepared for you would be highly subjective and it would totally depend  on your lifestyle, medical history, family health records, genetically transmitted conditions and such others. Apart from improving the condition of your kidney and assisting your transplant, the diet chart will also help you to lose weight, boost your metabolism and enhance your immune system. Some of the most common recommendations that your dietician may give you are as follows:

-Eating at least 5 full servings of fresh fruits and vegetables each day as both are an important part of a healthy diet for a person who has just undergone a kidney transplant. The vegetables should mostly be eaten after cooking/boiling as per the suggestions of your dietician.
-Having enough of fiber rich foods in your daily diet is essential as it speeds up the process of digestion and prevents constipation by promoting frequent and easy bowel movements.
-If you are a non-vegetarian, then you should be going for lean meat alternatives which are low on fat and high on nutritional value. -Examples of such meat are fishes and poultry. Additionally, you should also avoid all kinds of red meat as it is high on fat.
-Consume low-fat milk and dairy products as they help to prevent the fat accumulation inside the body and also maintain an acceptable level of calcium and phosphorus inside your body.
-Maintain a low level of iodized salt in your meals, as it helps to keep your blood pressure under control.
Over the counter health supplements like vitamins and proteins can also be taken, if recommended by your dietician.

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The Ideal Diet after a Kidney Transplant

The general perception that hereditary diseases cannot be prevented is changing. Polycystic kidney disease (PKD) is one such hereditary condition. The kidneys are the body's detox machine, which remove all impurities and flush it out of the system through urine. PKD is a condition where there are multiple, fluid-filled cysts which develop in the kidneys. These can vary in size and though noncancerous, can grow to a very large extent, producing severe symptoms including extremely high blood pressures and kidney failure.

In the recent past, however, there have been various theories that put forth how a modified and healthy lifestyle can prevent PKD. A child with a parent who suffers from PKD has 50% likelihood to develop the same. That cannot be prevented; however, changes can be made which can delay the onset and reduce the severity of symptoms of PKD, most notably high blood pressure and kidney failure which may require lifelong dialysis.

Symptoms and complications: The most common symptoms include high blood pressure, kidney pain (behind the back above the buttocks), infections of the kidneys or the bladder, bloody urine, kidney failure, headache, bloated abdomen due to the fluid-filled cysts, frequent urination, and kidney stones. There could be impact on pregnancy plans, with high blood pressure complicating the pregnancy. This needs extra care in management and is not life-threatening in most cases.

Prevention: The kidneys take the brunt of all the toxins that a body is subjected to. It is therefore, very important to reduce the exposure of body, especially kidneys to toxins. One of the best ways to keep the kidneys in good health is to control blood pressure. Some of the ways to do this include:

    Following a low-sodium diet with a good amount of hydration
    Reduce fat in the diet as much as possible
    Include a lot of berries, broccoli and apples
    Be diligent in taking your blood pressure medications as directed
    Ensure that your weight is within the prescribed limits for you
    Quit smoking and drinking
    At least 30 minutes of moderate physical activity should be included in your daily regimen

Read up on symptoms of PKD and keep an eye on them. If you are having a bloated feeling or pain in the kidneys or blood in the urine, consult a doctor. If you are planning on having a baby, genetic counseling may be useful to see if there is a risk of passing on the genes to the baby. Keep a positive outlook and have a frank discussion with family and friends on your overall condition. So, as much as PKD is a hereditary disease, there are ways to manage it and improve the quality of life.

Is Polycystic Kidney Disease Preventable?

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