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

There are many types of cancer that may affect the human body. Bladder cancer is one such cancer that is caused when there is an abnormal growth and accumulation of the cells in the bladder. This kind of growth may cause mutations which can then manifest into tumours that may or may not be malignant. 

Let us find out more about the causes and risk factors of bladder cancer.

Transitional cell carcinoma: In this kind of bladder cancer, the transitional cells that line the inner region of the uterus and urethra will expand when the bladder is full. Further, these cells will end up contracting when the bladder is empty. This will lead to numerous complications which can cause the formation of tumours as an end result.
Squamous cell carcinoma: The squamous cells are those that are usually found in the bladder as a response to any kind of infection or even irritation in the area. These cells become cancerous over a certain period of time. This is also one of the most common types of bladder cancer in the US, as per various medical reports.
Adenocarcinoma: This kind of cancer usually starts in the cells that make mucus and form glands for the production of the same, in the bladder. This is a rather rare form of bladder cancer.
Risk factors: There are a number of risk factors that may affect the manifestation of the abnormal cell growth which can lead to any one of the above types of bladder cancer. Let us learn more about these risk factors.
Smoking: Smoking does not merely cause lung cancer, but it is also capable of causing chemicals from tobacco to accumulate in your urine and lead to several complications, including the increase of abnormal cell growth in the bladder. These chemicals may also cause widespread damage to the lining of your bladder.
Diabetes medication: One of the side effects of taking certain types of diabetes medication may be seen in the bladder and its cells. Pioglitazone is one such medicine which can cause these kinds of complications.
Chronic bladder inflammation: Repeated bladder infections may cause an unhealthy amount of persistent inflammation, which can lead to the growth of cells in an abnormal manner. This can lead to damage of the bladder s inner lining. In such a case, bladder cancer becomes a risk for the patient.
Family history: A family history of the condition also leaves the person susceptible to this disease. Colorectal cancer instances or Lynch syndrome cases in the family can increase the risk of contracting bladder cancer. This is due to the fact that the faulty gene can affect the various organs of the urinary area.

Bladder Cancer - Risk Factors Associated With it!

The bladder is a hollow storage organ that collects urine from the kidneys and stores it until it can be passed out of the body through the urethra during the process of micturition or urination. It has a thin inner lining of cells called urothelial cells and a thick muscular wall, which exerts pressure to push the urine out of the body.

Causes of Bladder Tumors

In most cases, the bladder tumor develops on the inner layer due to a combination of some of the following factors.

1. Hereditary: A strong family history of cancer predisposes a person to cancer.
2. Gender: Men are 3 times more prone for bladder cancer than women.
3. Ethnicity: White people are more prone for bladder cancer black people.
4. Smoking: Smokers develop bladder cancer 2-6 times more frequently than non-smokers. cigarettes contain toxic, carcinogenic substances which reach the kidney and are stored in the bladder, leading to their damage.
5. Occupational hazards: Some workplaces have a higher likelihood of causing bladder cancers, especially dye and rubber industries. The effects can be damaging, and the person may develop cancers years after the exposure has happened.
6. Recurrent bladder infections: In some people, this can also lead to bladder cancer in the long run.

Types of Bladder Tumor

Depending on the extent of the cancerous spread, it can be of two types:

1. Non-muscle-invasive bladder tumors: The tumor spread is limited to the inner part of the bladder (urothelial cells)
2. Muscle-invasive bladder tumor: The tumor has spread to the thick muscular outer layer. This is more advanced and prognosis is poor compared to the noninvasive type.

The most common and diagnostic symptom of bladder cancer is the presence of blood in the urine, known as hematuria. This will be intermittent and happens whenever the tumor bleeding happens. Other symptoms include pain in the lower abdomen and frequent urination.

Diagnosis

From the most noninvasive to the most invasive diagnostic test, these include:

1. Urine microscopy to detect cancer cells in the urine
2. Cystoscopy A tube inserted into the urethra to look into the inner wall of the bladder is highly diagnostic
3. Ultrasound, CT Scan, and biopsy can also be further used to identify severity of the tumor.

Treatment

Once the tumor is diagnosed, treatment would depend on the severity of the tumor. For both invasive and noninvasive tumors, definitive therapy is surgery, known as transurethral resection of the bladder tumor (TURBT). The cancerous bladder tissue is removed through a cystoscope as done for diagnosis. The bladder is then flushed with chemotherapy agent to kill any residual cancer cells in the bladder. This is then followed by BCG vaccine, which is again done 1 to 4 weeks for several months to avoid recurrence. In some cases, radiotherapy may also be included.

Bladder Tumor and Its Common Causes

5 reasons you will see blood in urine

The condition in which blood appears in the urine is known as hematuria. The loss of blood in this condition could be gross or microscopic depending on the cause of the condition. There are several causes why blood may appear in the urine. Whatever the cause may be, hematuria is mostly indicative of a serious medical condition.

Here are 5 reasons that cause blood to appear in the urine.

1. Infection

Infections like urethritis, pyelonephritis, cystitis or infection in any other body organ along the urinary tract is one of the most common causes of hematuria. Such bacterial infection in the urethra can also infect the kidneys and the urinary bladder. It results in the urge to urinate frequently and also causes blood to appear in the urine.

2. Kidney stones and bladder stones

Another reason that can cause blood to appear in the urine is the presence of stones in the kidney or bladder. These stones are crystallized minerals that are formed in the kidney or the bladder but fail to pass through the urinary tract. They cause blockage and pain and result in hematuria.

3. An enlarged prostate

An enlarged prostate is a common cause of the appearance of blood in the urine in men who are in their middle ages or older. Enlargement of the prostate gland causes the urethra to be compressed. This prevents the urethra from getting fully emptied while urination.

4. Polycystic kidney disease

PKD is a kidney disorder in which cysts filled with fluid form in the kidneys and impair the kidneys, causing them to fail entirely at times. It is an inherited disease and causes blood to appear in the urine.

In children who are between 6-10 years of age, kidney disorder after streptococcal glomerulonephritis can be a possible cause of hematuria.

5. Cancer

A cancerous kidney, bladder or prostate gland can also cause blood to appear in the urine. It is another major cause of hematuria but usually occurs in older patients.




5 Reasons You Will See Blood in Urine

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?

What are kidney stones?
The primary function of the kidney is to filter the blood and eliminate the waste products through urine. The waste deposition is sometimes in the form of excessive calcium, uric acid and other undesirable contents. It may cause the urine to get highly saturated. This is when stone like formations take place inside the kidneys. Kidney stones are also termed renal lithiasis or calculi. There are different kinds of kidney stones, which are differentiated based on its varied constituents. Kidney stones cause excruciating pain and uneasiness. Frequent urination, extreme discomfort during urinating and presence of blood in the urine are some of the major signs of kidney stones. The symptoms are not evident if the stones are very small in size.

Causes of kidney stones:

Incorrect calcium intake: High amounts of calcium can lead to high calcium depositions in the kidneys. It is important to keep the calcium intake moderate. Calcium supplements must be checked if you have already included dairy products in your diet.
Abnormal rates of sodium in the body: Sodium, just like calcium, gets deposited in the kidneys.
Excessive animal protein intake: Too much of animal protein intake can make the urine turn acidic, leading to uric acid depositions in the kidneys.
Sugary, aerated drinks: These lead to undesirable waste deposition in the blood stream and eventually in the kidneys.
Inadequate water intake: Not keeping the body well hydrated can cause the urine to turn acidic and increase waste deposition.
Potential risks and complications of kidney stones:

Kidney stones may cause an infection in the kidneys which may eventually spread to the other internal organs and surrounding tissues.
Kidney stones block the ureter and cause severe pain and discomfort that make sitting, standing or any other posture difficult.
Kidney stones rarely cause kidney failures but the severe blockage and infection may cause such detrimental results in the human body.

Kidney Stones - 5 Causes Behind It!

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