Bombay Hospital

Urinary incontinence is the inability to hold urine in the bladder because of loss of control of the bladder. The severity may range from temporary to chronic, depending on the cause of this disease. Urinary incontinence is more common in women than men and can be categorized into three types.

Types and symptoms of urinary incontinence

Stress incontinence: this incontinence may occur while participating in any physical activity such as a sudden cough, laugh, sneezing or exercising. The stress here refers to the sudden physical pressure that a person experiences, leading him/her to urinate involuntarily.

Urge incontinence: a sudden, involuntary contraction of the muscular wall of the bladder causes an urgency to urinate. This urgency can be formed by a sudden change in position or sex.

Overflow incontinence: this is more common in men with prostate gland problems, damaged bladder or blocked urethra. The person has an urge to urinate frequently but in small amounts.

Causes of urinary incontinence

There are a number of causes of urinary incontinence ranging from aging to cancer and physical damage to the neurological disorder.

1. Aging: with age, the bladder muscle weakens and the chances of incontinence increases.

Damage: since the pelvic muscles support the bladder any damage to it (surgery or any procedure to remove the uterus) can lead to urinary incontinence.

2. Enlarged prostate: enlargement of the prostate gland in older men may give rise to this condition.

Cancer: urinary incontinence may be associated with untreated prostate cancer, which is a side effect of treatments for it.

3. Menopause: estrogen is a hormone that keeps the lining of bladder and urethra healthy. After menopause the production of estrogen is decreased, increasing the chances of urinary incontinence.

4. Prevention: urinary incontinence is not preventable but some steps can be taken to reduce the risk of it. Maintaining a healthy lifestyle, avoiding smoking, practicing pelvic floor exercises, avoiding caffeine and acidic foods and eating more fiber to prevent constipation can help decreasing the risk of it.

The problem of an enlarged prostate or benign prostate hyperplasia is a very common occurrence as you grow older. It's known to strike men above the age of 50, with more than 50% of men after the age of 60, having this complaint.

Causes of enlarged prostate

A non-cancerous condition, enlarged prostate makes the passing of urine from the bladder through the urethra difficult. The multiplication of the prostate cells causes an enlargement of the gland, leading to a buildup of pressure on the urethra, affecting the discharge of urine from the body. The narrowing of the urethra, due to this benign condition, forces the bladder to contract more vigorously so as to push urine out of the body.

As time passes, the muscles of the bladder get significantly affected, causing them to become extremely sensitive, thicker and stronger. As a consequence, the bladder begins to contract, even if the amount of urine in the organ is negligible, causing episodes of frequent urination. Gradually, the bladder fails to completely empty itself of urine due to the constriction of the urethra. This can give rise to a number of health problems including the formation of bladder stones, urinary tract infections, blood in the urine and so on.

How can you identify the signs of the condition?

Signs of enlarged prostate are very easy to identify and include:

- A slow or weak urine flow
- Difficulty in initiating urination
- Instances of frequent urination
- A feeling of not completely emptying one's bladder
- Frequent urination during the night
- Exerting a lot to urinate
- Instances of dribbling
- Urgency to pass urine
- A feeling of urinating again minutes after doing so
- Urination that starts and stops. If you wish to discuss about any specific problem, you can consult a Urologist.

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 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. If you wish to discuss about any specific problem, you can consult an urologist.

It may sound queer, but it is true, testicular trauma is a condition wherein one or both the testicles experience an injury. Any kind of accident can lead to testicular injuries. Although some common ones include:

1. Bicycle or motorbike injuries
2. Being hit by a football or a cricket ball
3. Being kicked

Other few and severe causes of injury include bullet wounds, animal bites, injuries or accidents because of the wrong usage of tools or machinery. Not surprisingly, it can happen during sexual intercourse too.

The types of testicular injuries
Testicular trauma can be of various types. Some typical ones include:

1. Rupture: Also known as testicular rupture, such injuries involve tearing of the coarse, protective layer around the testicles.
2. Fracture: In such cases, the testicular tissue breaks down, causing excruciating pain.
3. Contusion: When an accident causes an injury to the blood vessels, it can lead to contusion.
4. Infection: Insect bites to the scrotum can cause infections.

Symptoms of testicular injuries
As you might recall from prior experience, a testicular injury causes crunching pain within the scrotum. Pain in the abdomen might also accompany the above mentioned symptom. Some further symptoms include:

1. Feeling nauseated
2. Sustaining bruises or swelling of the scrotum
3. Experiencing difficulty while urinating (although this is not common)
4. Fever (this is uncommon as well)

Some serious injuries can also cause sexual problems and even fertility issues.

Diagnosis and treatment
Most minor injuries get healed within minutes or hours. But for any serious injury sustained, you have to consult a doctor. The doctor would ask you questions regarding how and when it occurred after which you could be advised to go through imaging and ultrasound tests. After diagnosing the extent of the condition, the doctor may prescribe antibiotics or other medications. Although home remedies such as applying ice packs on the affected area also helps.

Reproductive medicine has gained a lot of attention recently with its increasing scope and opportunity. This branch of medicine is concerned with improving reproductive health, preventing reproductive disorders, diagnosis of infertility issues and allowing couples to have children when they choose to be parents. The scope of reproductive medicine is based on endocrinology, anatomy and physiology. Here are some things you need to know about reproductive medicine:

Scope

Reproductive medicine includes many aspects of human health and other factors. Sexual dysfunction, puberty, birth control, sex education, family planning are some of the factors that it is concerned with it. In women, issues such as ovulation, menstruation, menopause and pregnancy are of immense importance in reproductive medicine.

Methods and techniques

Methods to assess any reproductive abnormality include reproductive surgery, laboratory methods while methods of treatment are prescription of fertility medication, counseling and surgery. In vitro fertilization or ivf has become one of the most effective treatments to enable pregnancy. This treatment allows the examination of the embryo before implementation.

Training

Specialists in reproductive medicine are trained in gynecology and obstetrics which is followed by infertility and reproductive endocrinology. Some of them specialize in urology followed by andrology. Training is also provided for contraception specialization. Usually, specialists in this branch of medicine receive education in particular organizations that deal with only human reproductive disorders. If you wish to discuss about any specific problem, you can consult a Urologist.