Minimally Invasive Urology Surgery
Reconstructive Urology Surgery
Reconstructive Surgery Procedures
Treatment Of Male Sexual Problems
Transurethral Resection Of The Prostate (Turp) Pro
Transurethral Incision Of The Prostate (Tuip) Proc
Urology Minimally Invasive Surgery
Urinary Incontinence (Ui) Treatment
Kidney Transplant Treatment
Treatment Of Erectile Dysfunction
Blood In Urine (Hematuria) Treatment
Open Prostatectomy Surgery
Hydrocele Treatment (Surgical)
Treatment of H.I.V
Patient Review Highlights
Lower Urinary tract obstruction refers to a condition of hindrance to urinary flow from bladder outwards. This can occur in all the age groups and affect either sex. The symptoms can be poor urine flow, intermittent flow, straining to pass urine or empty bladder, sense of incomplete emptying of bladder, difficulty in starting urination. Other problems can be increased urine frequency and difficulty to hold on with or without occasional urine leak in clothes. The cause and treatment vary in different age groups.
Few common reasons behind Lower urinary Tract Obstruction:
Congenital Urethral Stricture and PUV: These defects can be detected either before or after birth and need correction at earliest to avoid long-term complications. It is usually brought to attention by parents who observe abnormal urine flow pattern of their child OR found out during evaluation for repeated urinary tract infections.
Neurogenic Bladder: This is caused due to defects of nerves that are responsible for controlling bladder function. This can be due to diseases of brain, spinal cord or peripheral nerves. These defects can occur by birth or later in life. It is very important to take early consult to avoid long-term complications and progression to renal failure.
Urethral Stricture: This is narrowing in a long tube that starts from bladder to the external urinary opening. It can be idiopathic, post-traumatic, or due to urethral infections. Usually, a person is able to recognise poor urine flow and bring it to the attention of urologist. Treatment for stricture depends on various factors and range from simple endoscopic surgery to open surgeries.
Bladder Neck Obstruction: Bladder neck is a network or a group of muscles that connect the bladder to the urethra. The muscles tighten to hold urine in the bladder, and relax as they release it through the urethra. Urinary tract obstruction occurs when there are abnormalities blocking the bladder neck that restricts its opening during urination.
BPH: This occurs due to enlarged prostate obstruction urine flow out of bladder. Prostate enlargement is mostly age-related and rarely due to prostatic tumors. Urinary stones. This can be usually recognized by sudden obstruction to urine flow in person who was voiding normally. These episodes might be recurrent due to movement of stone in between bladder and urethra.
Bladder Tumors: The are mostly characterized by blood in urine. Sometimes there might be blood clots that obstruct the urine flow. Phimosis: Usually occurring post-puberty, it is referred to as the inability to retract the glans (the sensitive structure at the end of the penis). It is a condition in which the distal foreskin, which was previously retractable, is unable to retract anymore.
Phimosis: Phimosis is another major reason behind urinary tract obstructions.
Bladder cancer can be caused by a variety of factors, which include genetic factors, inheritance, drugs, chemicals, environment related factors and smoking. In fact, smoking tobacco is one of the major causes of bladder cancer around the world. The chemicals present in tobacco can irritate the bladder lining which ultimately leads to bladder cancer. Besides smoking other important environmental factors might be chemotherapy, exposure to chemicals from newspaper, dye, leather, paints industries.
Symptoms of bladder cancer are as follows:
Most often it occurs in people more than 50 years of age. It can present in different ways, but common symptoms being :
- Painless hematuria - reddish or brownish colored urine with or without clots Increased frequency of urination Pain while passing urine .
- Difficulty in passing urine
The diagnosis requires a proper imaging workup including ultrasound, CT scan and urine examinations. Following the initial imaging, a biopsy is required to confirm the diagnosis and stage the disease. This is done by cystoscopy under anesthesia.
Treatments for bladder cancer depend on the stage of cancer. Broadly bladder cancers can be categorised into Non-invasive and Invasive cancers.
- For non-invasive cancers: It requires recurrent cystoscopic surveillance and resection. For those with high risk of tumor recurrence or progression, intravesical chemotherapy or immunotherapy might be required.
- For invasive cancers the various treatment choices are:
- Surgery: For localised tumor which are amenable to resection perhaps surgery is the best possible treatment. This is a major undertaking where in whole of bladder along with accessory organs is removed. The surgeon may offer choices for reconstruction between neobladder (refashioning bladder with patient's gut) or ileal conduit (fashioning a stoma over which bag can be worn to collect urine). Following surgery a regular follow up is required and the prognosis is good.
- Chemotherapy: This modality is reserved for patient's where surgery is not possible or they have metastatic disease (disease spread to other body parts).In this method, medications are used to target and destroy cancer cells.
- Radiation Therapy: This might be and option for patient's that are not suitable for surgery. Radiation therapy uses gamma rays to destroy cancer cells in the body The key to good prognosis in bladder cancers is early detection timely intervention and good follow up.
Prostatitis is a very common infection of the prostate. However, it is worth to note that prostatitis can also be an inflammation of the prostate without infection. Only 5 to 10 percent of prostatitis is caused by bacterial infection. Prostate cancer does not normally have its chances increased by prostatitis. There are several forms of prostatitis, including acute bacterial prostatitis, chronic bacterial prostatitis and chronic nonbacterial prostatitis (which is also known as chronic pelvic pain syndrome ).
The exact cause for prostatitis is not known, but here are some factors which increase its risk, particularly acute bacterial prostatitis.
- Medical instrumentation: Putting an instrument like a urinary catheter may well cause prostatitis.
- Rectal intercourse: This is basically another name for anal sex.
- Abnormal urinary tract: The urinary tract comprises of the bladders, kidneys, ureters and urethra. If any one of these organs gets infected, then prostatitis is much more likely.
- Bladder infection: A bladder infection may well spread to the prostate.
Prostatitis has a variety of symptoms. Here are the most common symptoms of prostatitis.
- Constant need of urination: This is one of the most common symptoms of prostatitis.
- Difficulty when urinating: Just like the constant need of urination, difficulty urinating is also a sign that you may have prostatitis.
- Pain while urinating: This is because the prostate gland is a part of your urinary tract and if it does not work properly, there will be pain.
- Chills and fever: This is a rarer symptom, but may indicate prostatitis if it is coupled with the other symptoms.
- Pain in perineal area and genital organs: If you are experiencing pain in genital organs, than it may indicate prostatitis.
- Painful ejaculations or relief of perineal pain after ejaculations: If you are having painful ejaculation or the pain arises after ejaculation, then it may be due to prostatitis.
- Hematospermia: Pinkish or brownish semen.
If these symptoms are persistent or bothersome, then a proper consultation is required. Evaluation includes physical examination along with few simple tests. This can be followed by proper treatment for cure or relief of symptoms.