Dr. Saurabh

Kidney stones are one of the most common urinary tract disorders. These stones are the result of an abnormal concentration of urine. The stones might get unnoticed, till it moves around the kidney or passes into the ureter. The stones are basically small deposits of calcium that can cause excruciating pain.

Here is a list of signs that can indicate that a person might be suffering from kidney stone disorder:

1. Painful Urination: The most common sign of kidney stones is a sudden urge to urinate. The urination occurs even though an individual has maintained the normal rate of fluid intake. When an individual does try to urinate, the amount of urine expelled is less than normal. In case of a normal volume of urine, an individual might experience extreme pain. The pain is the result of kidney stones travelling from the bladder to the urethra.
2. Back Pain: People suffering from kidney stones often suffer from localized back pain in the early stages. The pain initiates at the side and back, just near the kidney area. As the condition worsens, the pain might spread to the groin, lower abdomen and lower back area. The waves of pain might last from a few minutes to few hours, depending on the number and size of the stones. For men, the pain might also be felt in the testicles and scrotum area.
3. Blood In Urine: Apart from pain and discoloration, visible signs of blood in the urine are seen in patients who have kidney stones. The color of urine might vary from brown, pink to slightly red with stains of blood. With kidney stones increasing in size, it blocks the urethra, thereby ticking blood along with urine. This condition is referred to as hematuria.
4. Vomiting and Nausea: People suffering from kidney stones often complain of nausea. It can become so severe that can lead to vomiting. Some other complications related to this condition include dehydration, nutritional deficiency etc. Another theory suggests that, throwing up is the result of body’s endeavor of clearing the toxic material from the body.
5. Pungent Smell: It is quite common among patients suffering from kidney stones to have a pungent smelling urine. The smell is foul and sticks for a long time. The smell is the result of creatinine waste being accumulated and slowly passing through the urine from time to time.
6. Difficulty in Sitting: Once the kidney stones gain in size, it becomes increasingly difficult for a patient to sit or lie down for a longer duration. Sitting or lying down puts pressure in the kidney area thereby causing intense pain. People try to combat this condition, by frequently standing up or by having a small walk.

In case you have a concern or query you can always consult an expert & get answers to your questions!

Urological problems such as urinary tract infection, urinary incontinence, and kidney stones are highly prevalent across gender and age groups. But there are several simple measures you may undertake to improve urological health and prevent such problems.

Read on to know how to go about it.

1. Drinking adequate amount of fluids: Waste products are mostly eliminated through urine, and when you drink more water, you will be able to remove more toxins from the body. The general recommendation is having 8 glasses of water in a day even though this varies on an individual basis. You must also consider drinking cranberry juice which offers protection from various types of infections of the urinary tract. And you should drink an extra amount of water while exercising and when you are spending a lot of time outside as you might excrete more water through perspiration.
2. Cutting down the intake of caffeine and alcohol: Both alcohol and caffeine act as a diuretic and they irritate the lining of the urinary bladder. This causes frequent urge to urinate.
3. Avoid holding urine: You should never practice holding the urine for a long span of time but try going to the toilet whenever you feel the urge.
4. Controlling the daily intake of salt: When you consume too much of salt, the sodium in the body increases and it causes retention of fluids in the body. This is invariably linked with high blood pressure which can cause damage to the kidneys and formation of kidney stones. Thus, it is essential to reduce the intake of canned foods, fried stuff, and processed foods.
5. Keeping the genital area clean: You should always aim to keep the genital area clean by washing it with plain water or some mild cleanser once in a day. Also, while indulging in sexual intercourse, bacteria along with other micro-organisms can enter into the urinary tract causing infection. Women are at a higher risk of developing urinary tract infections since they have a shorter urethra. Male groins and female vaginas are considered breeding grounds for different pathogens which can transfer from one partner to another during intercourse hence care should be taken.
6. Preventing urological problems in women: Once you use the washroom, you should wipe the genital area from the front part to back. You should not use perfumed soaps and cleansers in the vaginal areas. Wearing cotton panties is always a healthier option than other fabrics. One should also avoid using vaginal deodorants and spermicidal creams to prevent infections.

Though numerous treatment options are available for these disorders since prevention is always better than cure, adopt these practices to steer clear of these common problems. Further, incorporating lifestyle changes such as eating a balanced diet coupled with exercise and leading a stress-free routine can pave the way for general good health.

Staying hydrated and consuming plenty of fluid is the key to manage kidney stone. Fluid can help the stone pass through the urinary tract, as well as refrain the body from forming new stones. While drinking water itself is good, adding certain ingredients with water can improvise flushing of stones and managing the pain. It’s recommended that every person with kidney stone should drink at least 2 litres of water every day. .

Apart from consuming 12 glasses of water every day, here is a list of alternative methods to manage kidney stones:

1. Lemon juice: Consuming 2-4 glasses of lemon juice can do wonders to reduce the symptoms of kidney stones. Lemon contains citrate, a chemical ingredient that prevents calcium formation inside the body. Citrate is also capable of breaking smaller calcium crystals and flushing them through the urinary tract. Apart from this, lemon contains vitamin C and is immensely beneficial for the body.
2. Basil juice: Basil comprises of acetic acid that has the capability to break down kidney stones and reduce pain. Furthermore, basil juice can lower the uric acid level and reduce the chances of future kidney stone formation. Basil leaves can be consumed with water, tea or a smoothie. However, a person should refrain from consuming basil leaves, if he is suffering from low blood sugar, low pressure and increased bleeding.
3. Apple cider vinegar: Apple cider vinegar is yet another agent that is immensely beneficial to get rid of kidney stones. Being alkaline in nature, it can increase the acidic level of the stomach and prevent stone formation. Apple cider vinegar has citric properties that can dissolve smaller stones of the kidney and flush them through the urinary tract. This should not be consumed if a person is suffering from diuretics, undertaking insulin and have digoxin.
4. Celery juice: Celery juice can be consumed twice or thrice a day to get rid of kidney stones. It can also be used in salads or dishes for flavour and taste. It regulate urine flow, reduce pain and clear toxins from the body. People suffering from blood disorder problems should not consume celery.
5. Pomegranate juice: Pomegranate juice can improve the overall function of the kidney. It can successfully lower the acidic level of the urine and reduce the chances of kidney stone formation in future. . People suffering from liver diseases and blood pressure should refrain from having this juice.
6. Kidney beans: As its name indicates, the kidney bean broth can improve the overall health of the kidney and the urinary function. It can flush out kidney stones. Kidney beans soaked in water and 2-3 glasses consumed in a day can do wonders in removing the kidney stone. In case you have a concern or query you can always consult an expert & get answers to your questions!

Kidney stones are one of the most common urinary tract disorders. These stones are the result of an abnormal concentration of urine. The stones might get unnoticed, till it moves around the kidney or passes into the ureter. The stones are basically small deposits of calcium that can cause excruciating pain.

Here is a list of signs that can indicate that a person might be suffering from kidney stone disorder:

1. Painful Urination: The most common sign of kidney stones is a sudden urge to urinate. The urination occurs even though an individual has maintained the normal rate of fluid intake. When an individual does try to urinate, the amount of urine expelled is less than normal. In case of a normal volume of urine, an individual might experience extreme pain. The pain is the result of kidney stones travelling from the bladder to the urethra.
2. Back Pain: People suffering from kidney stones often suffer from localized back pain in the early stages. The pain initiates at the side and back, just near the kidney area. As the condition worsens, the pain might spread to the groin, lower abdomen and lower back area. The waves of pain might last from a few minutes to few hours, depending on the number and size of the stones. For men, the pain might also be felt in the testicles and scrotum area.
3. Blood In Urine: Apart from pain and discoloration, visible signs of blood in the urine are seen in patients who have kidney stones. The color of urine might vary from brown, pink to slightly red with stains of blood. With kidney stones increasing in size, it blocks the urethra, thereby ticking blood along with urine. This condition is referred to as hematuria.
4. Vomiting and Nausea: People suffering from kidney stones often complain of nausea. It can become so severe that can lead to vomiting. Some other complications related to this condition include dehydration, nutritional deficiency etc. Another theory suggests that, throwing up is the result of body’s endeavor of clearing the toxic material from the body.
5. Pungent Smell: It is quite common among patients suffering from kidney stones to have a pungent smelling urine. The smell is foul and sticks for a long time. The smell is the result of creatinine waste being accumulated and slowly passing through the urine from time to time.
6. Difficulty in Sitting: Once the kidney stones gain in size, it becomes increasingly difficult for a patient to sit or lie down for a longer duration. Sitting or lying down puts pressure in the kidney area thereby causing intense pain. People try to combat this condition, by frequently standing up or by having a small walk.

In case you have a concern or query you can always consult an expert & get answers to your questions!

Hello friends. I am Dr Saurabh Mishra. I am a senior consultant in Urology in Lajpat Nagar, New Delhi. Now I am going to discuss something about Prostate. As you know prostate is a very common problem and it is not only seen by the urologist but so many other colleagues in the medical specialities, specially the physician. There are lot of myths and confusions about the Prostate in patients as well as the health care professionals. So, I would like to simplify the treatment methods for the prostate specially from the patient's point of view.

For the treatment protocol, we keep the patients into three categories;

• Those patients who are asymptomatic and incidently been detected an emlarged prostate. Anything above 20g prostate, we call it as enlarged prostate. So, suppose a patient have some symptoms, he has undergone ultarsound and enlarged prostate was picked up. Such patients lie in Group-1. They do not need any treatment and kept under observation. Once they face any problem, they are given appropriate treatment.
• Group-2 are those patients who suffer some urinary problems. Most commonly, they face frequent urine at night. In this category, they can have some obstructive features also. For example, they take long time to pass urine, the last part of the utine comes slowly that is called dribbling of urine. If these symptoms are present, the patient goes to the doctor and doctor evaluates and if no complicated factors are found then the medical treatment is started. So many medicines are available for the medical treatment of the Prostate. But unfortunately, most of them belong to same family. Due to this, if one drug fails to work then the options are least.
• Group-3 patients are those who have complications. The complication may include the recurrent urinary tract infection, recurrent blood in urine, either of the kidney or both the kidneys are enlarged, bladder stones etc. If these symptoms are present, then it becomes the complicated factor. If any of tehse factors or all of these are present in the patient, then these patients may directly be planned for the surgery and no medical treatment is incorporated in such patients.

Few things we come to know. I have never dicussed about the size of the prostate. That means the size of the prostate will not tell about the treatment. There are so many patients who took treatment from the physician also. So, to such patients, I want to clarify the thing that the treatment is not that complicated but the treatment should be incorporated. The patient should be clarifies about the problem and the treatment and the group should be evaluated for the patient.

Thank you so much.

The condition of enlarged prostate occurs due to the enlargement of a man’s prostate gland, with the passage in time. Also known as benign prostatic hyperplasia (BPH), it is more common in men over the age of 60. Some cases might have symptoms and others may be symptomless. Although the causes are relatively unknown, it is evident that BPH is not a form of cancer, neither does it cause cancer. The prostate is located below the bladder and is responsible for producing the fluid needed by semen. The growth of the prostate tissue that is associated with benign prostatic hyperplasia begins near the inner prostate which is a tissue ring around the urethra. Its growth is generally inward.

Causes
It is of common knowledge that in males, the urine originates from the bladder and flows through the urethra. BPH is a condition where the prostate experiences a benign i.e. non cancerous enlargement which leads to blockage of urine flow through the urethra (the urinary duct). The resultant enlargement, caused due to the gradual multiplication of cells, subjects the urethra to extra pressure. Further narrowing of the urethra causes more contraction of the bladder, resulting in the urine being forcefully pushed out of the body.

With time, the condition leads to the bladder muscles gradually becoming thicker, stronger and oversensitive. Contraction occurs even due to the presence of small amounts of urine, giving rise to frequent needs of urination. At one point, the bladder muscle is unable to overcome the effects of the narrowed urethra. Due to this, urine does not pass properly and the urethra is not emptied.

Some of the common symptoms of enlarged prostate include:
1. Frequent urination
2. Urgency to urinate
3. Difficulty during urination
4. A slow or weak urinary stream
5. Requirement of extra effort to urinate
6. Interrupted sleep due to need of urination

Further risks
Sometimes, when the bladder is not emptied completely, a risk of urinary tract infections develops. Some other serious problems which can be a result of enlarged prostate include blood in urine, bladder stones as well as acute urinary retention (inability to urinate). In some rare cases, kidney and/or bladder damage might also result from such a condition. If you wish to discuss about any specific problem, you can consult a Urologist.

There is a rich concentration of minerals in the kidneys, and when there is no sufficient medium to clear it out, these can form small crystals within the urinary tract and can settle anywhere along the urinary tract. Stones can, therefore, be found in any part of the kidney and the ureters, which connect the kidney to the bladder.

The pain that is associated with kidney stones is very diagnostic. It includes a sharp shooting pain in the back of the abdomen, on either side of the spine. Kidney stones tend to be recurrent, and so patients who have had an episode would be able to tell when they have kidney stone pain.

When the size of the stone is less than 4 mm, it is usually passed through urine and eliminated from the system. However, if it is more than that, shock waves are used from an external source to break the bigger stones into smaller ones, which then get eliminated from the body through the kidneys on their own.

Ways to manage kidney stones
Immediate relief measures would include intravenous injections of pain relievers, which will help in getting rid of the pain. An additional shot may be required after a while for people suffering from severe pain. Also most people present with severe nausea and vomiting may require anti-emetics for the same. When being sent home, they may be given these medications to be continued at home.

Once you are home, the doctor may ask you to drink lots of water (up to 3 liters of water) and strain the urine to collect the stone as it is passed. The urine turning colourless is an indication that the water intake is adequate. If there is any colour in the urine, water intake should be increased.

Immediate admission to the hospital may be required in the following conditions:

1. In people with one kidney where the stone has already come down to the ureter
2. Pregnancy
3. Persistently high fever of up to 104 with shaking and chills
4. Elderly people, greater than 60 years of age
5. Severe dehydration and vomiting
6. No improvement of symptoms after an hour of treatment

Larger kidney stones would be removed by one of the following methods:

1. Extracorporeal shock wave lithotripsy (ESWL): This is the most common mode of treatment, where shock waves are used to break down the stones into smaller segments, which are then passed out through the urine.
2. Ureteroscopy: This involves passing a tube from the urethra all the way up to the bladder to retrieve the stone.

Open surgery in people where the above measures are not feasible. If you wish to discuss about any specific problem, you can ask a free question.

Blood in urine, medically known as Hematuria is not usually a cause of concern, but it can translate into an adverse condition if left unevaluated. The kidneys and other structures in the urinary tracts such as urethra (tube connecting the bladder to the outer part of the body); bladder (that stores the urine) and ureters (tube joining the bladder to the kidney) are the sources of blood flow to the urine. Hematuria can be accompanied by symptoms such as discharge of tea-colored, brownish-red or pink colored urine due to the presence of red blood cells, traces of which can only be detected under the microscope.

Blood in urine should be taken lightly especially in elderly because the commonest cause of Hematuria after 60 years is urinary bladder cancer.

Underlying causes behind this disorder might be

1. Urinary tract infections is where the bacteria enter the body through the urethra and begin to proliferate in the bladder.
2. Kidney infections (pyelonephritis) is when bacteria infiltrate into the kidneys from the bloodstream or travel up from the uterus to the kidneys.
3. A kidney or a bladder stone is marked by the minerals in the concentrated urine precipitating out and molding into crystals that deposit on the bladder or kidney walls.
4. Enlarged prostate is a condition in which the prostate gland, that is situated just below the bladder surrounding the upper part of the urethra, starts growing as males head towards their middle age.
5. Kidney disease such as glomerulonephritis causes swelling of the kidneys, thus disrupting the filtering system.
6. Bladder, kidney and prostate cancer are also possible causes.
7. Hereditary disorders such as sickle cell anemia (a hereditary disease of the red blood cells in the hemoglobin) can also pose as a cause behind this disorder.
8. Kidney injury as a result of heavy blows, accidents or injuries sustained while playing a spot can also contribute to this condition.
9. Medications such as penicillin or the anti-cancer drug ‘cyclophosphamide’
10. Strenuous physical exercises like intense workout or running may also result in Hematuria.

Treatments
There is no fixed cure for Hematuria; instead, the doctor would work on treating the repressed conditions behind the symptoms, such as prescribing antibiotics to heal the urinary tract infection or a medicine to shrink and normalize the enlarged prostate or administer a shock wave therapy to destroy the kidney or bladder stones. If you wish to discuss about any specific problem, you can consult a Urologist.

It is an extremely embarrassing situation to have a bladder leakage. Social life could be altered, with reduced socialising for fear of losing control in the presence of others. Though not discussed frankly, it is an extremely common issue and about 25 million people in the United States suffer from this, with 75% of these being women.

Treatment depends on the type of incontinence, such as stress, urge, overflow, functional, or mixed. It starts with least invasive methods like lifestyle changes moving over to surgical approaches.

Ways to manage it

With trips to the toilet increasing considerably when you have urinary incontinence, simple measures can help manage leakage.

1. Bladder training: Train your bladder to control the urge for another 10 minutes. This happens by voluntarily contracting the muscles and holding up the urge to go to the toilet. Gradually, it will help increase the frequency of the visit to 4 to 6 hours.
2. Scheduled toilet trips: Whether or not there is an urge, visit the toilet every 4 to 6 hours.
3. Double emptying: Even after you have voided, force yourself to void one more time. The residual urine, which is almost always present in the bladder, also gets emptied.
4. Food/diet modifications: Stress incontinence is worsened by alcohol, spicy foods, acidic foods, and caffeine. Avoiding these can help reduce bladder leakage.
5. Kegel exercises: The simple repetition of contracting the pelvic floor muscles, holding it in place, and releasing it can do wonders for strengthening the pelvic floor. This can be done anywhere and any time of the day and is very effective for improving bladder control.
6. Catheters: These can be used if the incontinence is short-lived; the person would need to learn how to safely insert and remove it.
7. Absorbent pads and medical devices: The absorbent pads are helpful in preventing embarrassment during social situations. On the other hand, medical devices like pessary are inserted into the vagina to support the bladder neck and thereby prevent leakage from the bladder.
8. Drugs: Anticholinergics/antimuscarinics are useful to control a leaking bladder. Botox injections can help paralyse the overactive bladder muscles and provide a solution. Topical oestrogen may be used in small amounts to improve tone and reduce incontinence. Alpha blockers are also used in some people with good results. There are muscles that relax the bladder and increase the amount of urine it can contain.
9. Surgery: In the event that all these measures are not useful, surgical correction is possible. Sling procedure where an artificial mesh is used to support the urethra. Bladder neck suspension is where the bladder neck is given support to prevent leakage. If there is a pelvic organ prolapse, that is corrected to rectify the bladder leakage. If you wish to discuss about any specific problem, you can consult a Urologist.