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Dr. Gawande

Urologist, Mumbai

500 at clinic
Dr. Gawande Urologist, Mumbai
500 at clinic  ·  ₹ online
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I'm a caring, skilled professional, dedicated to simplifying what is often a very complicated and confusing area of health care....more
I'm a caring, skilled professional, dedicated to simplifying what is often a very complicated and confusing area of health care.
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Dr. Gawande is a popular Urologist in Bhandup West, Mumbai. You can meet Dr. Gawande personally at Bothra's Hospital in Bhandup West, Mumbai. Don’t wait in a queue, book an instant appointment online with Dr. Gawande on Lybrate.com.

Find numerous Urologists in India from the comfort of your home on Lybrate.com. You will find Urologists with more than 42 years of experience on Lybrate.com. You can find Urologists online in Mumbai and from across India. View the profile of medical specialists and their reviews from other patients to make an informed decision.

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Ramkrishna Co-operative Housing Society, Gadav Naka, T.P. Road,Bhandup West. Landmark: Dagwanak TP Road & Near Kamat Hotel, MumbaiMumbai Get Directions
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I have little burning irritation in urethra. And then I am taking 2 time patanjali chanderparbha vati tablet and both I feel very high burning irritation in urethra and stand for toilet for one hour and drink 2 liter water. (After 30 minutes of taking tablet). Why I feel so high pain in urethra after taking tablet if there no side effects of medicine? Why?

BHMS
Homeopath
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I have little burning irritation in urethra. And then I am taking 2 time patanjali chanderparbha vati tablet and both...
Urethritis is the medical terms for inflammation of the urethra, which is a common cause of penile burning sensation. Cystitis (inflammation of the bladder) or prostatitis (prostate inflammation) can also be associated with a burning sensation in the genitals. Sexually transmitted diseases are examples of infections that can cause penile burning sensation. These diseases include herpes, genital warts (human papillomavirus infection), syphilis (sexually transmitted disease caused by bacteria), chlamydia, or gonorrhea. Homoepathic treatment cures it without side effects. Consult me for homoepathic treatment by clicking on consult option.

When Do Kidneys Need Dialysis?

DNB (Nephrology), MD, MBBS
Nephrologist
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Kidneys are a pair of organs that are located on either side of the spine, each about a size of a fist. The kidneys help in purifying blood by removing toxins, waste materials and excess fluids from the human body. Disorders and dysfunctions of the kidney can lead to severe and often fatal consequences. When the kidneys stop functioning as they are supposed to, dialysis is performed to resume normal functioning in the body.

Dialysis is a type of treatment, which filters and purifies the blood with the aid of a machine. It is an artificial way of purifying blood. There are two types of dialysis, namely hemodialysis and peritoneal dialysis. Hemodialysis, the most common form of dialysis, which involves using a manmade kidney called a hemodialyzer, which removes toxins and waste materials from blood.

Peritoneal Dialysis, on the other hand, is a type of treatment which involves implanting a catheter in the stomach. During the procedure, a fluid called dialysate flows into the abdomen that absorbs all the waste material, which is consequently drained out of the body.

You may need a dialysis if:

- Your kidneys are dysfunctional
- When waste materials and toxins start to accumulate in the body
- In an event of an injury or accident to the kidney such as internal lacerations (wound caused by the tearing of a tissue)
- If the creatinine (a type of a chemical waste product) level falls to 10-12 cc/minute
- In an event where the kidneys aren't able to work properly leading to accumulation of toxins, irregular amounts of chemicals in the body and other dysfunctions

Weakening of the abdominal muscles and weight gain are some of the risks involved in dialysis. Dialysis is a temporary treatment and serves to function till the time the actual kidneys get repaired. In chronic cases of kidney disease, kidney transplant may perhaps be the last resort.

'Consult'.

Related Tip: 4 Types of Kidney Stones and Their Common Symptoms

When Do Kidneys Need Dialysis?

I have recently started getting pain while passing stools and sometimes it bleeds as well. The pain remains till first half of the day and subsides by night. The pain is just inside the anus opening and due to which its impossible at times to sit continuously and have to walk to ease out the pain. It feels like as if there is some wound which has come up inside and gets aggravated in morning after passing stools.

FMAS, MS
General Surgeon
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Respected lybrate-user hi it's fissure problem. Avoid all oily spicy nonveg stuffs at all have more liquids, fibers, fruits, curd for better digestion. Take sitz bath (sitting in a tub filled with leuk warm water for 10-10 min mor.

I am 37 years old, I have had kidney stone 6 mm since 5 years back, right now I don't have any issues, only frequent urination occurring sometimes and I have low body weight only 42 kgs. I am worried about my health. Kindly suitable suggest. thanks.

PG Diploma in Emergency Medicine Services (PGDEMS), Bachelor of Ayurveda, Medicine and Surgery (BAMS), MD - Alternate Medicine
Ayurveda
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I am 37 years old, I have had kidney stone 6 mm since 5 years back, right now I don't have any issues, only frequent ...
take shool gaj kesari ras twice a day..take gokshuradi guggul & punarnavadi mandoor 1-1 tab twice a day...pranacharya U through capsule and syrup twice a day...drink lots of water....avoid spinach...tea and coffee..tomato...lady finger etc....

My brother has kidney stones nearly 8 mm. He is on treatment but not on benefit what to take please tell me.

Certified Diabetes Educator, Registered Dietitian (RD), PGDD, Bachelor of Unani Medicine and Surgery (B.U.M.S), General Physician
Dietitian/Nutritionist
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My brother has kidney stones nearly 8 mm.  He is on treatment but not on benefit what to take please tell me.
Stones treatment depends on the types and size of stone, most kidney stones won't require invasive procedures. You may be able to pass a small stone by: drinking water. Drinking as much as 2 to 3 quarts (1.9 to 2.8 liters) a day may help flush out your urinary system. Unless doctor tells you otherwise, drink enough fluid mostly water to produce clear or nearly clear urine. Passing a small stone can cause some discomfort. To relieve mild pain, according to your medical history I may prescribe pain relievers. I am a doctor and renal (kidney) registered dietitian who will also prescribe a customized diet plan and medications to help pass your kidney stone quickly and with less pain. Do reply back for medication prescriptions. Being also a general physician and registered dietitian, I prescribe both evidence based herbal as well as allopathic medicines complementing with dietary guidelines and home remedies carefully personalized for each individual patient.

I have kidney stone . I am talking medicine since last 6 months but not the expected result. lack of appetite and weight loss , weakness , fatigue , hard pain in abdominal I use to face .please help

MD - Homeopathy, BHMS
Homeopath
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I have kidney stone . I am talking medicine since last 6 months but not the expected result. lack of appetite and wei...
Most of allopathic medicine contains side effects. Take following homoeopathic medicines for just 3 to 5 days. Sure stone will come out. 1. Berberis vulgaris 30 4 pills 3 times 2. Sarsaparilla 30 4 pills 3 times 3. Mag phos 200 4 pills 3 times 4. Lycopodium 200 only 2 dose. No side effects in homoeopathic medicines. 100% rapid and good results from my private practice experience. Drink minimum 3 to 4 litres of water daily. Avoid coffee and soft drinks completely. Let me know the result after 5 days. Please do ultrasound scanning abdomen and pelvis after 5 days after taking homoeopathic medicines.

I am 19 years old girl. I have some burning sensation in my urine.

Fellowship of the Royal College of Surgeons (FRCS), MS - Urology, MBBS
Urologist
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Dear , it happening more towards afternoon and evening? if so you need to increase your fluid intake till color of urine is watery white. If this does not solve the problem then get urine examination done and post the report here.

General Physician (AM)
Alternative Medicine Specialist
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Tips on Treating Urinary Incontinence:

Many people are hesitant to see a doctor for incontinence as they feel embarrassed or believe it can't be treated or that the problem will eventually go away by itself. This may be true in a few cases, but many cases can be successfully treated or managed. The treatment of incontinence will vary according to whether it is faecal or urinary incontinence and will depend on the cause, type and severity of the problem.


1. Stress incontinence

Non-medical treatment

• Weight loss
• Cessation of smoking
• Pelvic floor exercises
• Vaginal weights
• Biofeedback
• Electrical stimulation

Non-medical treatment can be very effective in motivated patients with minor degrees of stress incontinence. The short-term results are often very good, but this isn't always maintained in the long term. Published studies quote cure/improvement rates of 50-80% for pelvic-floor exercises.

Medical treatment

• Oestrogens
• Alpha-agonist
• Combination of the above

Medical treatment doesn't have a great role in stress incontinence. Postmenopausal atrophy affects the closure of the urethra. Oestrogens, which can be taken orally or applied locally, restores the bulk of urethral tissue leading to more effective closure. Alpha-agonist s increase the tone in the bladder neck, thereby increasing outflow resistance. Some studies indicate a beneficial effect using a combination of oestrogen and an alpha-agonist in older post-menopausal women.

Surgical treatment

• Periurethral injections of bulking agents
• Suspension operations
• Sling operations
• Artificial urinary sphincters

Periurethral injections involve the injection of bulking agents into the urethra to improve effective urethral closure. Commonly used agents include fat, collagen, Teflon paste and silicon particles. Injection therapy is suitable for women with intrinsic sphincter deficiency rather than hyper mobility, as well as for men with post-prostatectomy incontinence. The major advantage of injection therapy is that it's a minor procedure. Short-term results are good, but often not maintained long-term.

The various suspension operations restore the normal anatomy in patients with hyper mobility and improve the support of the urethra and the bladder neck. Open suspension operations like the Burch copo suspension provide the best long-term results. The various needle suspensions have fallen into disuse due to high failure rates.

Urethral slings can be used in people with intrinsic sphincter deficiency as well as those with hyper mobility. It involves the placement of a strip of tissue or artificial substance that supports the urethra and bladder neck like a hammock. It increases outflow resistance and improves urethral closure by supporting the mid urethra. The vast majority of patients can be rendered dry in this way, but the operation does carry the risk of difficulty with passing urine afterwards. Other complications include infection or erosion of the synthetic sling material which then has to be removed.

An artificial urinary sphincter (AUS) made of silicone can be used in someone with total incontinence resulting from irreparable damage to the sphincter. The AUS consists of a small cuff that is placed around the urethra (bladder tube), with a reservoir (balloon) that is placed in the lower belly next to the bladder. Both of these are connected with a small tube to a valve placed in the scrotum, which the person then uses to inflate or deflate the cuff. An AUS is very effective, but it is quite expensive, and there is a risk of infection or erosion of the synthetic material.

2. Urge incontinence

Non-medical treatment

• Bladder training
• Biofeedback
• Pelvic floor exercises

Voiding by the clock and progressively increasing the time between voids can improve the symptoms of patients with urge incontinence and otherwise normal bladders. This can be combined with biofeedback and pelvic floor exercises.

Medical treatment

• Oxybutynin
• Tolterodine
• Imipramine

Drug therapy forms the mainstay of treatment for patients with urge incontinence due to bladder instability. These anti cholinergic agents relax the bladder muscle and increase bladder capacity. Side effects include a dry mouth, constipation and blurred vision.

Surgical treatment

Injection of botulinum A toxin (Botox) into the bladder muscle (detrusor) can be used if the urge incontinence is due to a neurological disease causing overactive bladder contractions.

Tiny bladders due to radiation or tuberculosis can be enlarged surgically. A segment of intestine is patched onto the opened bladder, thereby increasing the capacity. Patients with intractable bladder instability who have failed medical treatment can also be treated in this way.

3. Overflow incontinence

Overflow incontinence due to bladder outflow obstruction is treated by surgically alleviating the obstruction. The most common example would be a man with prostatic enlargement treated by resection of the prostate gland. If the incontinence is due to failure of the bladder to contract then intermittent clean self-catheterisation is the most appropriate treatment. Permanent indwelling catheters should be avoided if at all possible.

4. Total incontinence

Total incontinence due to a vesico vaginal fistula or auretero vaginal fistula is treated by surgical repair of the defect.

Treating faecal incontinence

Once your doctor has established the underlying cause of faecal incontinence, they will decide on the most suitable treatment, which could involve a combination of medication, exercise and other methods.

Let’s look at some of the treatment options available for FI:

Dietary changes: If your FI is caused by diarrhoea or constipation, making changes to your diet may sometimes help to normalize and regulate bowel movements. Your doctor may ask you to keep a food diary to monitor the impact of dietary changes. For example, he or she may suggest increasing your intake of high-fibre foods and fluids, or to eliminate foods that may exacerbate the problem.

Medications: Your doctor may recommend specific medication or bulking agents such as fibre supplements to change stool consistency, depending on whether you suffer from diarrhoea or constipation. Another option is Solesta, an injectable FDA-approved gel that's injected into the anus and effectively reduces or completely treats FI in some people. This gel narrows the anal opening by increasing the growth of rectal tissue and helping it to remain tightly closed.

Bowel retraining: This routine encourages normal bowel movements and helps you achieve greater control by becoming more aware of the need to use the toilet. It may incorporate various aspects such as making a conscious effort to have a bowel movement at a specific time of day and using suppositories to stimulate bowel movements.

Biofeedback: This improves the strength and coordination of the anal muscles that help control bowel movements, and heightens the sensation related to the rectum filling with stool. It usually involves a specially trained physiotherapist teaching you simple exercises to strengthen your pelvic-floor muscles, sense when stool is ready to be released and contract the muscles if it's not appropriate to have a bowel movement at a specific time.

Kegel exercises: Also called pelvic-floor exercises, these focus on strengthening the muscles of the anus, buttocks and pelvis. When done correctly, they can be effective in improving or resolving FI. They involve a routine of repeatedly contracting muscles used when making a bowel movement. Hold these muscles as if you're trying to stop the flow of stool or passing gas for a slow count of five, and then relax. Kegel exercises should be done in a series of 30 contractions three times a day. They usually strengthen the pelvic-floor muscles within a few weeks.

Surgery: In some cases, surgery may help people with severe FI who haven't responded to other treatments or people with an underlying condition causing incontinence that need surgery to regain control. There are various surgical options and your doctor will probably refer you to a specialist.

The treatment of piles is available in Ayurveda or not ? I am suffering from piles and my skin come out from anus I have consulted with Ayurveda doctors and he said there is no treatment available in Ayurveda and he advised me to consultant with surgeon only surgery is the treatment of this. But I do not want to surgery. Please give me suitable advice for the treatment of this decease.

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The treatment of piles is available in Ayurveda or not ? I am suffering from piles and my skin come out from anus I h...
Hi, Please follow these tips: 1. Drink 2-3 lts of water per day. 2. Consume lot of fibre in your diet like raw vegetabes, fruits, whole grains, oats. Etc. 3. Eat one fully ripe big banana at bed time. 4. Drink one glass of hot milk with one spoon of ghee in it at bedtime. 5. Take your food at regular intervals. Avoid spicy and oil fried food. 6. Never curb the urge to pass stools. \ 7. Never put in lot of pressure to pass stools. 8. Add 2tsf of sugar to 4 tsf of oinon juice, mix it well and take it in the morning on empty stomach for 1-2 weeks, which cures piles. 9. Add 1tsf of sugar and 1 tsf of butter to 1 tsf of powdered seeds of wild basil plant, take this twice daily for 2-3 weeks. 10. Mix 1/2 a glass of raddish juice with 1/2 a glassof buttermilk and drink it in the morning for 1-2 weeks to cure pile 11. Add1 tsf of ghee and 1tsf of sugar to 4 tsf of onion juice, mix it and take it twice daily daily to cure bleeding piles. 12. Mix curds to grated onion and take it twice daily with food to arrest bleeding piles.

I have pain in lower abdomen and my urine burn also in last ten days I take kracxit sy and pain killer.

Bachelor of Ayurveda, Medicine and Surgery (BAMS)
Ayurveda
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I have pain in lower abdomen and my urine burn also in last ten days I take kracxit sy and pain killer.
First of all you should follow some basic thing 1. Avoid=hot and cold at time 2. Less the sugar as much as possible if you want to eat sweet take juggery which is black 3. Do not drink water after meal drink at the time of meal sip by sip up to 150 ml 4. Avoid late night sleep 5. Avoid to eat spicy food, besan, bekary food, overeating, junk food. 6. Every 3 day in month eat mung dal and rice for whole day. 7. Chadrakala ras vati 2 tab twice a day 8. Chandanasav 4 tsp before lunch and dinner.

I am suffering from stones having on my both kidneys what is the treatment for that explain.

BHMS
Homeopath
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I am suffering from stones having on my both kidneys what is the treatment for that explain.
Avoid milk and tomato in diet, because these contain calcium which increases chance of stones, and drink lots of water (at least 10-12 glass in a day). For medical treatment of removal of stones and stop the recurrence you can consult me.

I have kidney stones how to get rid of them Stone size is 4mm 3-4 stones are there.

BAMS
Ayurveda
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I have kidney stones how to get rid of them Stone size is 4mm 3-4 stones are there.
Dear, causes of kidney stones are * urinary infections * intake of less quantity of fluids & water * high intake of non vegetarian diets like eggs, red meat, fish. * high intake of calcium rich diet like milk tomatoes, spinach. * hormonal disorders (hyperparathyroidism) you should follow these very important and simple things to prevent stone formation & to get sure treatment of kidney stones: 1. First take a lot of fluid daily. The more you drink water and fluid, the less amount of deposit accumulate in kidney. So you have to make your kidneys healthy just only by drinking 2-3 liters (10-12 glasses) of water. 2. Stones are mainly formed of calcium and oxalate. So take very low quantity of milk, cheese, cream and dairy products. 3. Do not take strawberry, plum, spinach and tomatoes. These fruits and vegetables are rich in oxalate. So avoid them to prevent from kidney stones. 3. Stop taking supplementary vitamin d and calcium medication. 4. Avoid animal protein diet- eggs, red meat, fish in diet. 5. Take less amount of salt, pickle and western foods. They have high amount of sodium. So avoid it. 6. Urinary infection are also one of the cause of stone. So take proper antibiotic treatment of urinary infection on time. Even when you feelburning sensation or pain during urination, don't avoid it. Take medication as soon as possible. I hope you follow them in your life andstay healthy. 7. You can take gokshur tablets of himalaya for 3 months. It definitely get relief from kidney stones.

Every time I eat something I have to go to washroom, for toilet, even when I go to toilet twice a day. I feel a disturbed bowel. Will you please suggest me something.

MBBS, MD - Community Medicine
General Physician
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Every time I eat something I have to go to washroom, for toilet, even when I go to toilet twice a day. I feel a distu...
Identify the food item, there may be particular food item which may cause this problem. Write things in detail, then discuss it.

I am 21years of age and I am suffering with stone problem from last 2 months. I have used medicines but it didn't effected that well. So what should I do now?

PG Diploma in Emergency Medicine Services (PGDEMS), Bachelor of Ayurveda, Medicine and Surgery (BAMS), MD - Alternate Medicine
Ayurveda
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I am 21years of age and I am suffering with stone problem from last 2 months. I have used medicines but it didn't eff...
Take shool gaj kesari ras twice a day..take gokshuradi guggul & punarnavadi mandoor 1-1 tab twice a day...pranacharya U through capsule and syrup twice a day...drink lots of water....avoid spinach...tea and coffee..tomato...lady finger etc....

I have got evidence of 5.2mms calculus at mid pole calyx of left kidney in USG compare to 5mms size in last report 4 months back. It started with 4.5 mm in 9 months back. Is it advisable to tale himalaya cystone to cure my stone problem.

Diploma In Anesthesiologist, MBBS
Anesthesiologist
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I have got evidence of 5.2mms calculus at mid pole calyx of left kidney in USG compare to 5mms size in last report 4 ...
Hey don't treat your self kindly consultant a Urologist and have lot of water 4-5 liter daily avoid meat tomatoe review back.

Dr. I feel tense while I mingle with new people and frequently feel like urine but if I go only small amount of urine I go. please help me sir.

Ex Sen.V.Surgeon/Research Scientist, M.D.(Alternative Medicine/tibetan/chinese/acupuncture), Vaida/ Unani, Homeopath
Unani Specialist
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Dr. I feel tense while I mingle with new people and frequently feel like urine but if I go only small amount of urine...
hi dear - it is bcz of hormonal disturbances/ imbalance -for this u can do yoga - also learn social atticates from elders/ seniors - take plenty of fruits/ juices/ water -u can consult me for yoga learning privately

A swelling on my anus sphincter area, which is paining and bleeding while I go for loo. And I am feeling tired and thirsty too.

MBBS, MD - Internal Medicine
Internal Medicine Specialist
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Apply anovate cream at anus twice a day. Take syp. Livluk 10 ml at night before meals. Eat fiber rich meals. Eat 200 gm papaya at night daily. Eat salaad with meals. Avoid spicy and oily foods. Drink 8 glass of water in a day.

I am 26 yrs/47 kg/m. 1 years ago I suffered from b/l mild hydronephrosis, 4 mm stone and cystitis, which was cured. But then onwards I am suffering from recurring urine infection, every time using an antibiotics course, till now used for 12 times, occuing infection after masturbation now my serum creatinine raised from 0.7 mg to 1.2 mg, now its 1.3 mg, having flank to groin pain, burning sensation due to infection in urine (pus cells: 10hpf, color: S.Hazy, protein:trace). Ct scan plain is normal, Kindly tell me is there any problem, what solution for my problem .

Bachelor of Ayurveda, Medicine and Surgery (BAMS), MD - Ayurveda
Sexologist
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I am 26 yrs/47 kg/m. 1 years ago I suffered from b/l mild hydronephrosis, 4 mm stone and cystitis, which was cured. B...
Hello- urinary system and reproductive systems are linked to each other according to ayurveda. Masturbation leads of loss of semen (vital element of the body) which leads to urinary diseases like infection, stone formation, etc. Antibiotics provide only symptomatic relief. Due to this recurrent infection your kidney function is also degraded (rise in serum creatinine). I personally suggest you to start our ayurvedic medicines, it will not only improve your kidney function but also will prevent you from discomfort completely.

Frequent night fall in sleeping, and one type of aromatic smell is in urine what is my problems how to cure?

MBBS
General Physician
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Frequent night fall in sleeping, and one type of aromatic smell is in urine what is my problems how to cure?
Night fall is very normal you need not worry but if you are finding some abnormal smell in urine then consult a good physician and get tested
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