Dr. Shailendra Kumar Goel

Kidney transplantation is the organ transplant of a kidney into a patient with end stage renal disease. You no longer need dialysis post this. Many transplanted kidneys come from donors who have died. Some come from a living family member. One must take drugs for the rest of your life post a transplant.

There is a risk of Urinary Tract Infection in case one does not pee after sexual intercourse. This is mainly a female issue because men’s bodies have a natural mechanism that prevents urination when they have an erection.

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 
8. Blood in urine 

There are medications available to manage this, but offer only temporary and partial relief. Many men therefore prefer the surgery 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. Refractory urinary retention 
3. Presence of blood in the urine 
4. Associated bladder stones or Hernia 
5. Frequent infections of the urinary tract 
6. Associated damage to the kidneys 

Procedure of Surgery 
During the procedure, a tube fitted with camera 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 resect or evaporate 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 vaporized by the laser by using photosensitive vaporization of the prostate. This is also known as Greenlight laser therapy or KTP laser vaporization. Alternately, Diode or Thulium LASER can be used as the source of laser energy to ablate the prostate tissue. 
2. Enucleation: Entire adenomatous prostate tissue is cut and teased out into the bladder by using Holmium laser. Morcellator is used to grind this enucleated 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. Minimal hospitalization: This can be done with minimal one or two days stay at the hospital 
3. Immediate symptom relief: As compared to medications, the relief is felt almost immediately after the surgery 
4. Minimal catheter: With laser surgery, a catheter may be required for less than 24-48 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.

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

Infection caused in the kidneys, ureters, bladder, urethra or prostate gland is known as urinary tract infection(UTI). According to doctors, sexually active women are generally more at risk of suffering from this condition. Females other than sexually active age group and men are otherwise immune for urinary tract infections. If they got UTI, they should be thoroughly investigated for its cause by a urologist. 

Some of the causes which contribute to the development of this infection are: 

1. Females have short urethra: Due to the short length of the urethra, a lot of bacteria got entry into the urinary bladder from the vagina, during sexual intercourse. Therefore, it is wise for females to urinate after intercourse so that bacteria flush out in urine. If not, these bacteria will lead to UTI. 
2. Prostatitis is very common in young males: Infection of the prostate gland is very common in young males. Semen is naturally produced. If a young male does not ejaculate regularly, this stocked up semen leads to prostatitis. That’s why regular ejaculation is very important for males. Therefore, Masturbation is healthy, not harmful. 
3. Urination after ejaculation in males is harmful: If male urinates immediately after ejaculation, then some urine refluxes into the open mouth of prostate glands. Urinary chemicals cause prostatitis. Therefore, males should not void immediately after ejaculation. 
4. Phimosis: In male children, if prepuce does not open properly, it may cause infection. 
5. Unprotected sexual intercourse: Unprotected intercourse may transmit infections to the other partner if one partner has got the infection.

Other common reasons 

1. Uncontrolled diabetes 
2. Kidney, ureteric and bladder stones 
3. Prostate Enlargements 
4. Urethral stricture 
5. Congenital disorders in children 

Some of the symptoms of urinary tract infection are: 

1. A nagging urge to urinate: One of the most predominant symptoms of urinary tract infection is a persistent, nagging urge to urinate.
2. There is a burning sensation when you urinate: If you feel a burning sensation while urinating, chances are extremely high that you are suffering from urinary tract infection. 
3. Red colored urine: Sometimes your urine may contain a perceptible amount of blood in them. 
4. Foul smelled urine: An internal infection in the urinary tract manifests itself in different ways. One of the chief symptoms of this infection is discharging foul smelling urine. 
5. Pain in the pelvic area: Women who suffer from urinary tract infection experience excruciating pain near the pelvic area, sometimes extending to the pubic bone. 
6. Fever with chills: Severe infection may lead to fever with chills and rigors. 
7. Frequent urge for urination: Frequent urination may be a sign of infection.

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

Know more about prostate cancer Prostate Cancer is a form of cancer that affects aging men commonly. The prostate gland is responsible for producing seminal fluid or semen, from its position under the bladder, surrounding the urethra. Its function is under control of testosterone hormone produced by testicles. Prostate cancer refers to the growth of a malignant mass of cells which can also be called a tumour. 

More about this cancer: 

Risk Factors: The various risk factors are studied for the development this cancer. Advancing age, a family history of the same disease, obesity, western diet and black race are the risk factor for the development of this cancer. 

Types: There are basically two types of prostate cancer, including fast growing or aggressive, and slow growing or non-aggressive. Yet, it is also important to remember that not every abnormal growth in this gland can be termed as a tumour, or is a sign of prostate cancer. A malignant growth signifies prostate cancer. This tumour can grow at a fast pace for aggressive prostate cancer, while it can grow and spread slowly for the non-aggressive type. 

Symptoms: It is possible not to have any kind of obvious symptoms when suffering from this kind of cancer at early stage. The symptoms usually begin to show up when cancer has reached a more advanced stage. These include urinary problems, like poor flow, frequency, frequent need to wake up for urination during the night time. The patient may go through pain and difficulty when it comes to urinating. This pain may also occur during ejaculation. The patient may also find blood discharge in the semen upon ejaculation. Pain in the back bone and pelvic are also common symptoms of prostate cancer when it spread into bones. Spine involvement may gradually turn into numbness in lower limbs with paralysis. Blockage of ureters may lead to kidney failure. 

Diagnosis: The diagnosis of prostate cancer is suspected by digital rectal examination and PSA blood test. If any nodule or hard area is suspected on digital rectal examination or PSA is high, then prostate biopsy is done to confirm the cancer. When in doubt, Multiparametric MRI of prostate may guide the necessity of biopsy. 

Treatment: Early cancer limited to prostate can be cured by surgery (Radical Prostatectomy) or Radiotherapy. Advancement in surgical techniques due to robotics and laparoscopy, has made Robotic radical prostatectomy as the first choice of treatment for localized prostate cancer. The advance cancer is treated by hormonal manipulation of testosterone blockade. It can be achieved medically by various injections or surgically by removing both testes. If cancer still grows despite hormonal manipulations, chemotherapy helps in rescue. 

Prostate cancer is a treatable disease. We should not fear with it rather fight with it. Ultimately, we can win over cancer.

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

The urinary bladder is a hollow purse like storage organ which 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 / Tobacco use: Smokers develop bladder cancer 2-6 times more frequently than non-smokers. Tobacco contain toxic, carcinogenic substances which reach the kidney and are stored in the bladder, leading to cancerous changes in bladder.
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 without pain in abdomen, known as painless hematuria. This is usually intermittent and stops on its own. Therefore any person who is more than 40 year old, has blood in urine, must be checked to rule out bladder tumor. If you miss these early warning symptoms by just thinking simple infection, you may miss the tumor and will be diagnosed later when tumor is advanced. Other symptoms include pain in the lower abdomen and frequent urination. 

Diagnosis 

From the most non-invasive to the most invasive diagnostic test, these include:

1. Urine microscopy and cytology to detect blood and cancer cells in the urine 
2. Ultrasound and CT Scan can define the bladder tumor, its size and spread. 
3. Cystoscopy and biopsy is when a is tube inserted into the urethra to look into the inner wall of the bladder and biopsy is taken from lesion. It is highly diagnostic and confirmatory. 

Treatment TURBT

Once the tumor is diagnosed, first step of the treatment is endoscopic surgery known as transurethral resection of the bladder tumor (TURBT). The cancerous bladder lesion is resected and removed through a cystoscope. Muscle tissue from the base of tumor is also resected to check the spread of tumor in the muscle. The bladder is then flushed with chemotherapy agent to kill any residual cancer cells in the bladder.

• Intravesical BCG Therapy: If muscle is not involved with tumor, this is called superficial tumor. As there is high chance that this tumor may recur or progress, bladder is treated with BCG injection therapy repeatedly for at least 6 weeks to many months. Check cystoscopy is usually done thereafter to check for any recurrence at frequent intervals.
• Radical Cystectomy with Ileal conduit or Neo-Bladder: If tumor is involving muscle layer of bladder then whole urinary bladder is removed surgically and urine passage is made at abdominal wall using part of intestine called Ileal conduit. Patient has to wear a bag on abdomen to urine collection and discharge. Now-a-days, artificial bladder is made by patients own intestine which functions like normal bladder and patient passes urine per urethra.
• Radical Radiotherapy: This is also an alternative treatment for muscle invasive bladder cancer where bladder is preserved and treated by radiotherapy. Repeated check cystoscopy is required thereafter to check for recurrence.
• Chemotherpy: If tumor has advanced to lymph nodes and other body organs, then treatment is chemotherapy where anticancer drugs are injected into veins. In Summary, Bladder cancer is usually caused by Tobacco consumption. Blood in urine even if it stops on its own or by medications, in person over 40 years of age must be evaluated for bladder cancer. In early stage it can be treated by cystoscopy. If it involved muscle, bladder is removed and neo-bladder is made.

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

What menstrual problems are to women, prostate problems are to men. The prostate is a gland in the lower abdomen that aids in the production of semen. The prostate is walnut sized in a young man, but can get enlarged with age. As it grows bigger, it can cause a number of problems. These are commonly seen after a man celebrates his 50th birthday.

There are three common prostate problems faced by men. Some of the symptoms that can tell if a man has a prostate problem are:

1. Difficulty faced while urinating.
2. The urge to urinate frequently at night.
3. Constant feeling of a full bladder.
4. Pain while urinating.
5. Blood in urine.

Prostatitis

This can be defined as inflammation of the prostate gland. In most cases the cause of this inflammation is unknown. However, there are two types of prostatitis; bacterial and nonbacterial. While the former reacts well to antibiotics, the latter is more difficult to control. Symptoms of this disease vary from one person to the next. Some of the factors that could trigger this disease are:

1. Chemical irritants
2. Past bacterial infection
3. Dysfunctional pelvic floor muscles
4. Sexual abuse
5. Chronic anxiety

Enlarged prostate

As mentioned earlier, as men get older, the prostate gland tends to grow in size. This growth is benign, but can block the bladder neck and prostatic urethra. This can cause problems urinating and lead to acute urinary retention. This can be very painful. Inserting a catheter can provide temporary relief and help release stored urine. Chronic retention is much less common and is associated with high bladder pressure and can damage the kidneys.

Prostate cancer

Advancing age and family genetic history are said to be the main triggers of prostate cancer. This type of cancer can remain restricted to the prostate gland in its early stages but may spread to the other glands as the cancer advances. This can also cause the growth of secondary tumors in the bones.

The only way to correctly diagnose a prostate problem is with a thorough physical examination. This includes a digital rectal exam where the doctor will insert a gloved finger into your rectum to check the size of your prostate, a blood test, mid stream urine tests and ultrasounds. In some cases a biopsy of the prostate may also be required. Depending on the diagnosis, your doctor may prescribe antibiotics, surgery, radiotherapy or hormone therapy to manage your prostate.  If you wish to discuss about any specific problem, you can consult a Urologist.

Our kidneys are an important organ in the body and are responsible for the filtration of blood and creation of urine. Sometimes, during this process salt and other chemicals get stuck together to form small crystals also known as kidney stones. The size of a kidney stone can range from the size of a sugar crystal to the size of a ping pong ball. However, it is noticed only if it is large enough to cause a blockage. Smaller stones may pass out of the body without you realizing it.

Kidney stones can be a very painful experience. Some of the symptoms exhibited by patients suffering from kidney stones are:

1. Severe back pain
2. Pain in the belly or groin
3. Painful urination
4. Frequent urination
5. Nausea and vomiting
6. Blood in the urine

Excruciating pain is usually the symptom that makes a patient consult a doctor in cases of kidney stone problems. A confirmed diagnosis can then be made by using a series of tests that include an X-ray, ultrasound, CT scan and urine analysis. A blood test may also be conducted to check the mineral levels in the body.

Kidney stones are a common condition faced by many people, but some people are at a higher risk of suffering from this than others. Some of these factors are:

1. Family history of kidney stones
2. High uric acid levels in the blood
3. Being between 20-50 years of age
4. A previous kidney stone
5. Chronic diseases such as diabetes and high blood pressure
6. Some medication such as diuretics and antacids with calcium
7. Inadequate fluid intake

Between men and women, the former are at a higher risk of suffering from kidney stones. Asians and Caucasians also suffer from this condition more than people from other races. Hormone changes during pregnancy can also trigger the formation of kidney stones.

The first thing to do if you suffer from a kidney stone is to increase your water intake. This can help dissolve some of the minerals in the stone and make it a small enough to pass through the urethra. Injectable anti-inflammatory drugs and pain relievers may be used to ease the pain caused by kidney stones.

If the kidney stone does not pass on its own, a process known as lithotripsy may also be used. This involves the administration of shock waves that can break a large stone into smaller pieces. In extreme cases, surgical techniques may also be used. 

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

Urology is a branch of medicine that focuses on the diseases affecting the urinary tract system and male reproductive organs. The organs that come under the scanner here are the kidneys, adrenal glands, ureters, urinary bladder, urethra, and the male reproductive organs (testes, epididymis, vas deferens, seminal vesicles, prostate, and penis). Though there is a prevalent misconception that gynecologists are for women what urologists are for men, urology also deals with certain women urinary tract related health issues. These include overactive bladder, pelvic organ prolapse, and urinary incontinence. 

In fact, doctors who specialize in female urology gain detailed knowledge of the female pelvic floor together with intimate understanding of the physiology and pathology. So for woman, gynaecologist is the doctor for menstrual, genital and pregnancy related troubles but UROLOGIST is the doctor who treats urinary problems. Here are 9 things you should know as a woman: 

1. Age related factors affect both men and women: However, women do not have prostate but they suffer similar urinary problems as men at growing age. Right around the time when menopause and andropause strike, changing hormone levels affect the pelvic floor, bladder, urethra and vagina in women causing problems like recurrent urinary tract infection, frequency, nocturia and urinary incontinence. These conditions are effectively treated by a urologist who can also probe for underlying conditions like urethral stenosis, overactive bladder, stone, polyp, or tumor in severe cases. 
2. An overactive bladder is more common than you think: Around 40% women have to hit the bathroom every hour or so owing to this. Simple lifestyle changes like lowering the intake of caffeine and alcohol, in combination with pelvic floor exercises can decrease the problem. However, a urologist can help you to diagnose and treat this condition successfully. 
3. Women must go for urination after sex: Urinary tract infections are very common in sexually active females. During intercourse lot of vaginal bacteria gets entry into urinary bladder. If woman voids after sex, majority of bacteria are thrown out and rest are handled by body immunity. But if you sleep over with all these bacteria, you are more likely to suffer with UTI. 
4. Women sometimes pee in their pants too: A majority of the female population between 40 and 60 suffer from either stress incontinence (when you cough, sneeze or laugh) or urgency incontinence (leaking when you want to go badly). Urologists can help you to know that there are minimal invasive options and medications available to treat this problem. 
5. Pelvic pain: If it is not gynecology then it is urology. A general pain in the pelvic region triggers a visit to the gynecologist first for most women. From menstrual cramps to ovarian cysts, all of this may well be taken care of by your gynecologist. But when the usual culprits are not the cause for your discomfort, it's time you get the urological aspect examined thoroughly too by a urologist. 
6. Know the difference between UTI and STI: Because of cross symptoms, one often gets mistaken for the other. So check with your urologist to understand the cause and cure of your particular problem. 
7. Recognize pelvic organ prolapse: This condition is defined by a bit of bladder, rectal, or uterine tissue bulging out of your vagina. An urologist can provide minimal invasive options to deal with this. 
8. Women can get kidney stones too: This is true, especially when you forget to hydrate yourself in hot climates or high temperature situations. 
9. Urology can solve some sexual problems too: Whether it's sexual dysfunction, low libido or trouble reaching orgasm, urologist can play its part to help you out. If you wish to discuss about any specific problem, you can consult a Urologist.

How to prevent kidney stones?