Kalyani Clinic

Andrology is the male equivalent of gynecology, which refers to the study of the female reproductive system and sexual health. Unlike its female counterpart, andrology is not very widely used. Urology is a more popular known specialty for male urinary and reproductive issues.

Read on to understand some of the common issues and procedures that come under the purview of andrology.

1. Vasectomy: One of the most effective methods of birth control, vasectomy is ligating the tubes so that the sperm does not enter the urethra. It is a definitive surgical contraceptive technique and is very simple, as compared to the other contraceptive measures.
2. Circumcision: Surgical method of removing the foreskin, which may be done for medical or elective reasons, at birth or later in life. This is one of the most widely performed surgical procedures across the world.
3. Prostatitis: The prostate gland is a walnut-sized gland located between the bladder and the penis. It can get inflamed as a result of infection, often bacterial. This can be acute or chronic and presents with painful urination and change in color of urine. The patient never has the feeling of having emptied the bladder fully, and there is a constant fullness. Urge to urinate is increased, especially at night. A course of antibiotics often helps in treatment.
4. Impotence: The most common reproductive problem in males, impotence or erectile dysfunction is now known to have strong psychological and physiological components. In addition to male organ problems, there can be unhealthy relationships and performance anxiety which also could lead to impotence. In most cases, counseling will help in managing impotence.
5. Epididymitis: In sexually active males, the epididymis which is located behind the testicles can get inflamed as a complication of gonorrhea or chlamydia. There can also be swelling of the testicles, frequent urination, and a burning sensation when urinating. Treatment includes pain killers and antibiotics.
6. Phimosis: In a patient with phimosis, the foreskin cannot be pulled back beyond the glans. There could be a balloon-like swelling with urination under the foreskin. It is often painless, but with the erection, may be slightly painful. Seen in young children, usually resolves by the age of 7 years.
7. Peyronie's disease: This is a connective tissue disorder, where fibrous plaques form in the soft areas of the penis. The penis develops a curvature which does not easily go away. It becomes common with age and interferes with urination and sexual intercourse. Though it resolves with time, there is no definitive treatment for this condition.

These are the major conditions encountered by andrologists. This specialty has gained popularity over the last few decades and is only set to get more popular in the coming years.

The body’s reacts to anything suspicious by developing an allergic reaction. Some of the common substances inducing this reaction include certain food substances, pollen, insect bites and certain metals. This body recognises these suspicious substances as antigens and produces what is known as antibodies. These produce various allergic reactions in the body ranging from something as minor as a skin rash to something drastically fatal as respiratory distress and even death.

Features:

1. Angioedema is one of the most severe forms of allergic reactions.
2. Translated literally as swelling of the blood vessels, angioedema causes swelling of the blood vessels in the underlying layers and this can lead to the formation of giant hives.
3. The hives or rashes are extremely itchy, reddish, and can vary in shape (oval or circular). The hives also are warm and painful when touched.
4. Angioedema usually affects the skin but can have more severe effects like blocking the airway and leading to respiratory distress

Causes: Angioedema is usually caused by one of the following:

1. Insect bites or stings
2. People with allergies to foods like peanuts, eggs, milk, shellfish, chocolates, tree nuts, etc.
3. Pollen, animal dander, latex, poison ivy, and other common allergens
4. Medicines like penicillin, aspirin, ibuprofen, and some anti-hypertensives
5. Autoimmune skin disorders like lupus
6. Reaction to incompatible blood transfusions
7. Weather conditions like extremes of cold, heat, or pressure
8. Infections like hepatitis, cytomegalovirus infections, Epstein-Barr infections, etc.
9. Conditions like leukaemia and thyroid disorders
10. Extreme emotional stress
11. Genetic angioedema, inherited from parents by children, which can last forever

Risk factors: Though hives usually develop without any warning signs, the following are some risk factors for developing angioedema.

1. Previous history of allergies
2. Predisposition to develop allergic reactions (overactive immune system)
3. Genetic history of allergies, especially of angioedema

Diagnosis:

1. In first-time patients, a detailed history with deep dive into similar instances in the past will be done
2. A physical exam to check for missed hives (like the back) is then done
3. Allergy testing may also be required to test if a person has a high predisposition to allergies
4. Blood testing to check for eosinophils, which is usually high in patients with allergies, is done.
5. Allergy testing to identify the trigger agent may be done if trigger is not known. This will help in preventing further attacks.
6. If genetic angioedema is suspected, C1 esterase inhibitor test and complement particles are also checked.

Treatment:
Non-medical treatment including loose clothing, cool compresses, and copiously moisturizing to reduce dryness and itching. This is usually sufficient in majority of the cases.
Medical: Antihistamines like cetirizine and loratadine are the next line of treatment. Very severe cases may require steroids like prednisone. In case you have a concern or query you can always consult an expert & get answers to your questions!

PCOD or polycystic Ovary Disorder is one of the most common disorders of hormones among women in the age of reproduction. It is yet not discovered why some women become susceptible to this disease and it is believed to be a genetic disorder. The word “polycystic” refers to multiple cysts and a woman suffering from PCOD has multiple cysts in her ovary. This is due to the imbalance of hormones, which don’t allow the ovary to release eggs every month and these numerous unreleased eggs present in the ovary cause it to become polycystic.

What are the symptoms of PCOD?
The regular release of eggs from the ovaries directs a woman’s fertility and allows her to have a normal menstrual cycle. Therefore, women with PCOD face difficulty in conceiving along with irregular, low and absent periods. Some of the most common symptoms of PCOD include infertility and even miscarriage, elevated insulin levels, high blood pressure, diabetes, acne, unhealthy weight gain and obesity. It also leads to loss of hair from the scalp and excessive growth of hair on the body. This is due to over production of male hormones that lead to male pattern of growth of hair, such as on chest, cheek, chin and inner thighs. The hormonal imbalance leads to weight gain and obesity makes the hormonal imbalance even worse, turning it into a vicious cycle.

How is PCOD diagnosed and treated?
Your gynaecologist would be able to determine whether you have PCOD by checking your symptoms. Then she would recommend you to do a few blood tests along with a pelvic ultrasound scan to confirm whether you have PCOD. Though this disease is not reversible, its symptoms may be reduced or minimised. Most women can lead a trouble-free and healthy life if they take proper precautions at the right time.

It has been pointed in several studies that reduction in weight can help in the improvement of most PCOD symptoms because fat contributes to the production of certain hormones. Your doctor will prepare a treatment plan depending on the aspect from which you are suffering. For instance, if you are suffering from irregular periods, your doctor may prescribe you some contraceptives which can help in restoring normal menstrual cycle. But this treatment is definitely unsuitable for those who are trying to conceive. The infrequent and irregular ovulation can make it difficult to conceive and it can be artificially induced with the aid of medications. So, you must consult a gynaecologist to help your situation. In case you have a concern or query you can always consult an expert & get answers to your questions!

One of the common complaints associated with sexual intercourse, is vaginal bleeding. This bleeding can occur during the course of intimacy or after it. Post intercourse bleeding is also termed as post-coitus bleeding. This is known as post costal bleeding. Doctor should be consulted immediately as it may be a sign of hidden cervical cancer.

Reasons behind vaginal bleeding

1. In most cases, the bleeding is risk free. It could be due to extreme friction, causing damage to superficial blood vessels in the cervix. It is important to use adequate lubrication; otherwise the consequences could be annoyingly painful.
2. If your period dates are nearby, the source of the blood could be from your uterus.
3. Benign growths, cysts, polyps on the cervix can cause bleeding. They are small fragile growths that rupture easily.
4. There can also be bleeding due to inflammations that occur as a reaction to a condom or a diaphragm.

When can vaginal bleeding be difficult?

1. Vaginal bleeding after sex can often be a warning sign of ectopic pregnancy. Ectopic pregnancy is when implantation of an embryo takes place outside the uterus, commonly inside the fallopian tubes.
2. Bleeding every time after intercourse is also a common symptom of endometriosis. It occurs when the inner lining of the uterus, called the endometrial tissue, appears outside it. Endometrial tissue can attach itself to other surrounding organs in the pelvic region, generally, the abdomen, causing searing pain. It is also a major cause of infertility.
3. Another cause of vaginal bleeding is atrophic vaginitis, a health condition mostly affecting older women, especially those who have reached menopausal age. This is due to the massive decline in the levels of estrogen that causes vaginal dryness and irritation.
4. Sexually transmitted diseases could be a serious cause of vaginal bleeding. It is generally accompanied by several other symptoms such as vaginal odour, discharge, pelvic pain, inflammations. It should receive immediate medical attention.
5. Vaginal bleeding could be a sign of cancer. It could be vaginal, ovarian, uterine or cervical cancer. It requires medical attention without any delay.

Most of the time, the reasons for post coitus bleeding is harmless. However, if it persists, you must pay a visit to your gynaecologist as soon as possible and get a thorough evaluation done. This could save the condition from worsening and also diagnose any other underlying medical condition at an early, curable stage.  In case you have a concern or query you can always consult an expert & get answers to your questions!

Colored marks which are present on the skin since birth or develop soon after birth are called birthmarks. They can be of many sizes, colors and shapes. Some of them are present on the surface, while a few of them are raised over the skin surface.

Here are some common types of birthmarks:

1.        Salmon patches
These birthmarks are most commonly found. They are flat and thin, and are mostly present on the back of the neck, the upper lips, eyelids and in some cases, between the eyebrows. They are usually pale pink or reddish in colour and fade within a year. However, those which are on the nape of the neck might stay and become permanent marks.

2.        Congenital moles
Congenital moles appear at birth. They are usually brown in colour and can be of different sizes. While some moles appear as a single mark, others can appear clustered in groups. The moles which become larger, however, need close observation because there remains a possibility of them becoming cancerous later on in life.

3.        Cafe-au-lait spots
They are smoother than other types of patches. They are present from birth and may develop more during childhood. Usually, these spots are not found in the neck or shoulders, but rather at the legs or torso. It is generally not a health scare. However, if these spots appear in clusters and occur in the armpits accompanied with freckles, they might be suggestive of neurofibromatosis later in life.

4.        Mongolian Spots
They are usually present in babies who are born with darker skins. Mongolian spots usually fade by the time the baby has reached school-going age.

5.        Venous Malformations
These are very rare birthmarks which are formed because of the abnormalities in the veins. These are usually bigger than other birthmarks and need to be treated by a process which is known as "embolization". This involves treating the malformation with a solution, thus putting a clog in the blood vessels and shrinking the mark. In case you have a concern or query you can always consult an expert & get answers to your questions!

Yoga is a great way to get rid of diseases and health conditions from heart problems to back pain, sciatica and depression. There exists a body of research suggesting that yoga is the best healing therapy for improving spine alignment and joint health. But on the flip side, research also suggests that yoga can’t cure cancers though it can help one deal with chemotherapy.

But you can certainly try yoga for these diseases and conditions

1. Digestive disorders: There are a number of asanas and pranayamas like the child pose or bala asana and kapalbhati pranayama, which can alleviate indigestion, gas and flatulence. These also help in bowel movement. The Boat pose which is done by stretching your legs and arms straight out parallel in front of you and then raising legs so toes are above eye level is very good for stomach disorders and so is the downward dog pose.
2. Back pain: More than 50 percent adults will face back pain due to a number of reasons in their lifetime. Simple stretching or yoga stretches can both help in the prevention of back pain. Tadasana is very good for aligning the vertebral column and getting rid of back pain. Surya namaskar stretches are very helpful too. You can also try Jatara Parivartanasana, Upavista Konasana or forward bends, Paschimottanasana or seated forward bend and Bhujangasana or cobra pose for back pain.
3. Heart disease: Bhujangasana or cobra pose stretches the chest, massaging organs inside, including heart, and allowing more blood flow to it, thus stimulating and strengthening heart muscle. Kapalbhati pranayama is also very good for the heart since it increases the absorption of oxygen in the blood. Yoga is proven to be an excellent heart risk improvement practice according to current research too.
4. Depression: Anulom vilom pranayama is extremely effective in tackling anxiety and depression. It slows down breathing and is effective against hypertension too when done regularly over a long time. The deep breathing done while doing this pranayama helps slow heart rate and allows the lungs to absorb more oxygen.
5. Diabetes: Surya namaskar or the twelve sun salutation poses help control diabetes as it promotes the production of insulin. The corpse pose is good too.
6. Headaches: Migraines and headaches are common problems that can be handled using yoga. Poses like Sirsasana that increase the flow of oxygen to the brain can alleviate migraines easily.
7. Thyroid disorders: Yoga asanas like shoulder stand, inverted pose, plough pose and the fish pose all help in making the thyroid gland work optimally again. The cobra pose and Ujjayi pranayama also work wonders by re-balancing metabolism and working on the throat reflex pathways to cure thyroid imbalance.

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

Spots on a men private part 

Men are often very worried when they find spots on their penises. In this article, we'll describe the different types of penile spots and their colors that you might find. Penile spots are not usually a sign of anything very serious. But nearly always, it's a good idea to show the spots to your sexologist. Please bear in mind that most penile spots that you might find there are likely to be completely harmless. But some aren't! It's understandable that men can be very concerned if they notice spots on their penis.

Men also get alarmed about the sometimes rather unpleasant physical appearance of a spotty' penis, and what their sexual partner or partners might think of it. This is quite understandable. However, very tiny and harmless bumps' and spots on the penis, alarming though they may be, they are unlikely to be noticed by a sex partner.

Where could one seek medical help?

If you're concerned about a spot (or spots) on your penis, please ask a sexual medicine specialist doctor to have a look at it.

Now let's look at some really common penile spots:

• Fordyce spots
• White or yellow spots on your penis

These are tiny white or yellowish spots, found on the head of the penis or the shaft. If your skin is brown or black, they may look more prominent. They are normal. They're minute sebaceous glands and are just part of the natural structure of many penises. Many men also have them around their lips. Fordyce spots are not sexually transmitted and they don't do any harm. There's absolutely no need for any treatment.

Hair follicles
As you know, virtually all men have quite a few hairs growing around the base of the penis. And often, the hairs extend some distance up the underside of the organ. Human hairs grow out of a tiny'pit, which is called a follicle. And very frequently, the follicles on the penis may be quite prominent. This is nothing to worry about and no treatment is needed.

Septic spots (Pimples on your penis)
Obviously, people do often get pimples, or'septic spots' on their faces and on other parts of the body. They're particularly common in young adults. Sometimes a small pimple appears on the penis. This is not a serious matter and no treatment is needed. Do not squeeze the spot, because you may spread infection. Don't have sex with anyone till it's completely gone. However, if something that you think is a pimple hasn't gone away within a week, ask a doctor to check it out.

Genital warts
Pink, brown or black spots on your penis
In contrast, genital warts do need treatment. And they are transmitted by sexual contact. They are pink, brown, ivory-coloured or black. Occasionally, they grow out of the opening at the tip of the organ. They are caused by one of the human papilloma viruses (hpv), which like living in warm, moist parts of the human body. Genital warts are easily passed on during vaginal, oral or anal sex.

It is strongly recommended that you go to a sexologist if you suspect you have genital warts, partly to make sure that your diagnosis is correct.

Treatment is either by application of special creams, or else by removing the wart altogether – for instance with an electric probe or laser. This is virtually painless.

Do not have sex until the doctor says that you are completely cured.

The final step of the IVF treatment process, the retrieval and implantation of the developed embryo can be an exciting but stressful milestone in the journey of many couples undergoing fertility treatment. The successful implantation depends on mostly two major factors – the quality of the embryo and the receptiveness of the uterus. But apart from this, there are several things that you can do to increase the chance of a successful implantation. Here are some tips to help you:

1. Request the most experienced doctor
Most clinics will tell you that the embryo transfer is routine and not really a risky step. But it is always good to ensure that you’re getting the best care. Therefore, insist that the senior doctor or consultant in the team carries out your embryo transfer so that you can have the peace of mind that he or she has a steady hand and won’t accidentally nick something in the process.

2. Take folic acid, along with multivitamins
Folic acid has been known to reduce the risk of birth defects, in both natural pregnancies and ones through IVF. It is advisable to take one tablet of folic acid a day from at least 3 months before you start IVF treatment. Talk to your doctor about the dosage and also consider taking a multivitamin which combines folic acid, vitamin D and all the B vitamins.

3. If you are over 40, consider transferring 2 embryos
The chances of implantation can be reduced after the age of 35. Thus, research suggests that it may be advisable for women above the age of 40 to transfer more than one embryo to ensure success of the treatment.

4. Don’t take bed rest after your embryo transfer
It is a myth that bed rest helps in successful embryo transfer. In reality, relaxing and staying upright can be much more helpful. On the contrary, strenuous exercise, heavy lifting and extremes of temperatures should be avoided as they may cause uterine contractions and can cause failure of implantation. Instead, consider taking a walk or have a good meal instead.

5. Eat as if you are already pregnant
There are several misconceptions on the internet about what you should or should not eat before and after your IVF treatment. However, such “implantation diets” or “miracle diets” can be nothing more than a myth. The best thing you can do is to have the same balanced diet during treatment and throughout your pregnancy – nutritionally balanced with necessary protein, fiber and vegetables.

Every woman’s body is different; therefore what may work for someone else may not work for you. However, you can implement these tips which are based on medical facts to ensure that your embryo transplant and subsequent pregnancy goes smoothly, without any complications. In case you have a concern or query you can always consult an expert & get answers to your questions!