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best urologist in Noida

Swelling of the testicle – after impact and for some other reason

Urologist in Noida, ,

Testicular swelling can be the result of an impact or other mechanical injury, but it can also be caused by one of the male diseases, e.g., inflammation of the testis, hydrocele, testicular torsion, and even testicular cancer. Swelling of the testis or both testicles can also be a symptom of wearing too tight underwear or having a very active sex life. Treatment depends on the factor that causes testicular edema.

What is testicular edema?

The testicles are the even sex organ of a man. They are in the scrotum. The most important task of the testicles is the production of spermatozoa to fertilize the egg. They are a very sensitive organ that can easily be damaged or mechanically injured. Sometimes there are various ailments coming from the testis or both testes. Swollen testicles are one of them.

Swelling of the testicles or one testicle may occur in a child, adolescent, young or mature man. It looks like one or both testicles are clearly enlarged. This image can additionally be accompanied by, for example, testicular pain (or both), redness of the skin in this area, a feeling of pulling or heaviness.

Testicular swelling can be due to a variety of reasons. It can be caused by various diseases, including mumps, testicular cancer, testicular hydrocele, or orchitis. This condition can also be caused by trauma, testicular damage, staying at very high temperatures for a long time, or prolonged and intense sexual intercourse.

How is testicular edema manifested?

Due to the fact that the testicles are very well vascularized and supplied with blood, all changes that occur within them can be quickly noticed and felt in the hands by self-testing the testicles. Of course, not all deviations from the norm will be possible to register from the moment they appear in the organ, but systematic testicular analysis combined with self-examination definitely helps to quickly detect alarming symptoms and diagnose possible diseases of this reproductive organ in a man.

Swelling of the testicle or both caused by inflammation of this organ (s), apart from swelling of the testicles, is also characterized by high pain in the perineum and warming of the scrotum. The swelling and hardness of one testicle not combined with its pain may be symptoms of testicular hydrocele. In turn, the torsion of the spermatic cord can be determined by the growing edema of this organ along with very severe pain, redness, and sometimes also nausea and vomiting. On the other hand, if swelling and testicular pain cease after going to a prone position, this may suggest an inguinal hernia. Symptoms of testicular cancer, in addition to asymmetrical edema, are also nodules or a lump and usually no pain.

Causes of swollen testicles

As already mentioned, swelling of the testicle can be caused by various diseases, which are generally referred to as male.

Swelling of the testicle in a child is very often associated with testicular hydrocele (this is the accumulation of fluid under the skin, between the visceral membrane and the wall membrane) or mumps, in the complication of which may swell this organ together with e.g. severe testicular pain radiating even to the stomach and fever. Both hydrocele and mumps complications can also occur in an adult male.

Pain and swelling of the testicle can result, for example, from inflammation of the testicles or epididymis. The inflammation of the male reproductive organs arises as a result of the action of pathogenic microorganisms, a bacterial infection of the urinary system, or the attack of microorganisms that contribute to infection with gonorrhoea, chlamydia and other sexually transmitted diseases.

What else can cause swollen testicles? The causes of this condition are also testicular torsion, testicular cancer, chronic prostatitis, varicocele, inguinal hernia, or filariosis.

Swollen testicles after surgery

Scrotal edema after a hernia operation is a natural reaction of the body after the procedure. Swelling of the inguinal canal tissues is a symptom resulting from the loss of the possibility of an outflow of blood from the testicle. However, it is enough to apply compresses from the anti-swelling preparation and to lift the scrotum bag to stave off the problem.

Likewise, it may also appear swollen hydrocele after surgery, or after surgery for varicose veins or after a vasectomy. If the symptom does not go away on its own or after symptomatic treatment, seek medical attention.

Injury, pressure on the testicle (caused by wearing too tight underwear), impact on the testicles (e.g. as a result of an accident or kick) can also be causes of edema. Swelling of the testicle after impact can even lead to temporary or complete infertility.

In addition, a large number of sex acts in a short period of time can also cause swelling of the scrotum.

Treatment of swollen testicles

What to do if testicular edema occurs? Treatment is the cause of this organ’s edema. Swelling of the testicles alone is not treated because it is not a symptom that occurs in isolation from the causes of this condition. Hence, the therapeutic method depends on the factor that causes testicular swelling.

In the case of testicular edema, caused by hydrocele of the testis, the therapeutic method chosen most often is urological surgery. Similar procedures are usually used for torsion of the spermatic cord.

Medication, including antibiotic therapy, is the most common treatment for orchitis or epididymitis. Antiparasitic treatment is the choice for filariasis, in difficult cases, surgery is performed.

If testicular swelling is caused by testicular cancer, the treatment depends on the stage of the disease, possible metastases of cancer to further organs and the type of histopathological cancer.

The method of treatment should be decided by the best urologist in Noida caring for the patient. He also makes a diagnosis, which is the basis for choosing the therapeutic method.

Urinary Incontinence And Perineal Rupture

Urinary Incontinence And Perineal Rupture

Urologist in Noida, ,

Urinary incontinence

Urinary incontinence is a fairly common condition among women, but they rarely talk about it on their own initiative, considering it embarrassing, shameful.
Urinary incontinence affects women 5 times more often than men. About 10-25% of women between 25-65 years old suffer from a form of urinary incontinence, the percentage increasing to 40% in women over 65 years old.

Urinary incontinence is defined as the involuntary loss of urine through normal anatomical pathways, due to the bladder and/or sphincter disorders. Loss of urine may occur with exertion (coughing, sneezing) or may be accompanied by other symptoms, such as pollakiuria (frequent urination), nocturia (urination during the night), urinary urgency (urgent need to urinate).

Loss of urine is a symptom that occurs in many diseases: congenital genitourinary malformations, neurological diseases or most commonly (80% of cases), due to insufficient musculoskeletal support – suspension and uterovesis.

The diagnosis of the type of incontinence is made by the urologist in Noida, after the clinical examination and after performing specific urodynamic tests.

Rupture of the perineum

Perineal rupture is a generic, medical term that defines the relaxation of the musculoskeletal system of the perineum and is not mandatory to occur only in women who have given birth vaginally. It can also occur in women who have not given birth or at a long interval from birth to menopause.

Rupture of the perineum may not affect the patient in any way, as well as may cause sexual discomfort, sometimes to the point of frigidity or indifference of the partner; urinary incontinence at lower and lower efforts (sometimes just walking) or lowering of the pelvic organs (uterus, bladder, rectum) through the vulvar cleft, outside, is called prolapse.

The treatment of this condition can only be surgical, the operation being performed most frequently through the vagina, rarely requiring an abdominal approach. Perineal surgery can also be aesthetic: just as many women want more beautiful noses, lips or breasts, some want a more toned perineum, a tighter vaginal lumen, greater sexual satisfaction, sexual comfort as at 20 years old.

Treatment

Both perineal rupture and urinary incontinence are accentuated with age, the symptoms becoming noisier, more annoying. Therefore, it is necessary that the two diseases be diagnosed in time and thus be able to be treated properly, the therapeutic sanction being depending on the indication of the best urologist in Noida: medicinal, surgical or associated.

Cystitis treatment

How to Combat Cystitis?

Urologist in Noida, ,

Have you ever had a promising plan broken because of an uncomfortable or painful sensation in your genital area? Has it happened to you to continually want to pee and feel discomfort when urinating? Don’t worry, it’s more frequent than you might think. Cystitis is a problem that affects a high percentage of the population but has a solution if we team up with an expert urologist in Noida to combat it.

What is cystitis and how does it occur?

Cystitis is an acute inflammation of the urinary bladder due to an infection by the invasion of microorganisms. Normally responsible is the e.coli bacteria, which lives in the guts of humans and is usually harmless in most cases, except for some more dangerous strains. It is usual that the body itself discards these bacteria with urine, so it is essential to drink plenty of water (between 1 litre and a half and 2 litres per day, according to the constitution and food of each person). However, sometimes these bacteria attach to the urethral walls or bladder and multiply so quickly that they cannot all be expelled with urine. That’s when inflammation occurs that leads to cystitis.

What are the symptoms?

The most common are discomfort and pain when urinating, burning sensation or burning in urination, urgent and/or frequent need to urinate, cloudy urine colour and strong urine odour. Other symptoms include pain in the side area, pain or discomfort when having sex and feeling fatigued. However, symptoms may vary by patient.

Are there different types of cystitis?

You can talk about bacterial or infectious cystitis, which is caused by bacterial infection, and non-infectious cystitis, which has no specific cause and is common in women of childbearing age. The latter may arise from the use of feminine hygiene sprays, spermicides or as a result of adverse reactions to certain medicinal products. It may also result from prolonged use of a catheter or complications from other existing pathologies. It is advisable to go to the best urologist in Noida to determine the origin of cystitis and the most appropriate treatment for each case.

On the other hand, sporadic cystitis can be differentiated (there is only one episode on time) or repeat cystitis (there are more than 3 episodes in a 12-month period). According to a research, 37% of women suffer at least one episode of cystitis in their lifetime and 12% suffer from them on a recurring basis.

Is it common?

It is a very common pathology, especially in women. According to the best urologist in Ghaziabad, cystitis especially affects women between the ages of 18 and 39 “coinciding with the age of maximum sexual activity in women”. He also notes that about 50-60% of women in the premenopausal phase suffer from a urinary tract infection and that, of that scale, 90% is cystitis.

However, men also experience episodes of cystitis, sometimes due to an enlarged prostate that, by slowing down urine flow, increases the risk of infection.

Cystitis is common in people who have frequent medical exams with tubes or catheters or those who need tubes. The incidence of this pathology is higher in older patients, as they progressively decrease the faculties of the nervous system to control the bladder. Similarly, in the event of a mismatch of the immune system, there is an increased risk of an episode of cystitis.

People with diabetes, hypercalcemia, or immunosuppression are considered more likely to develop episodes of cystitis.

Having cystitis is very common and can occur to anyone, however, with proper treatment and in the hands of a good urologist in Ghaziabad, it is a risk-free problem.

What treatments are available?

The first and most important thing is to go to the best urologist in Greater Noida to confirm the origin of cystitis and to consider our entire profile with blood and urine tests and any background that can provide more information.

Normally, if it is caused by a bacterium it will prescribe antibiotics and if it is caused by a virus it will prescribe antivirals. As general recommendations, urologist in Greater Noida recommends drinking large amounts of water to clean the urinary ducts well and avoid tobacco, alcohol intake and high-spice meals during episodes of cystitis.

What can I do to avoid getting cystitis or improving symptoms?

Food habits. Some foods and drinks are discouraged when the patient has an episode of cystitis, such as very strong or fermented cheeses, dairy enriched with cream, very fatty meats, sausages, bacon, black pudding, undercooked pasta, candied or frosted fruits, fruits in syrup, alcoholic beverages, coffee or tea with high theine content, confectionery products, chocolates and high fat fries. Instead, it is advisable to add to the diet natural juices, especially American cranberry, vegetables (some of them raw), fish, meats and eggs in the rations that marks a healthy diet.

Hygienic habits. In addition to proper hygiene in the genital area, it is not excessive not to eliminate the genital natural flora, but that does not be in shortening either, in the case of women it is advisable that when urinating they clean from front to back. A safety measure to prevent cystitis is to urinate after sex, eliminating potential toxins that access the urethra and cause infection. Finally add that it is necessary not to stay long periods of time with a wet or damp swimsuit in the genital area, which is a conducive focus to give rise to infections.

urinary incontinence

What Are the Types of Urinary Incontinence And Their Symptoms?

Urologist in Noida,

Types of urinary incontinence

There are mainly two types of urinary incontinence. Stress and urge urinary incontinence. Some women, especially older women, have both.

Stress urinary incontinence occurs when you sneeze, cough, laugh, jog, or do activities that put pressure on your bladder. It is the most common type of urinary incontinence of bladder control problems in women.

The female urinary incontinence emergency occurs when you have a great urge to urinate but cannot reach the bathroom in time. This can happen even when the bladder has only a small amount of urine. Some women may not have any warning before accidental leakage of urine occurs. Other women may leak urine when they drink water or when they hear or touch running water. An overactive bladder is a type of urinary incontinence, but not everyone with an overactive bladder loses urine.

What are the symptoms of different types of urinary incontinence?

Symptoms of stress urinary incontinence:

  • Involuntary release of urine, especially when coughing, sneezing or laughing
  • Leakage of small to moderate amount of urine

Symptoms of urge urinary incontinence:

  • Frequent and sudden uncontrollable need to urinate
  • You may have a moderate to a large amount of urine, although a small amount is possible

It is common for a person to have symptoms of both types of incontinence. This is called mixed incontinence.

What causes the different types of urinary incontinence?

Stress incontinence can be caused by childbirth, weight gain, or other conditions that stretch the muscles of the pelvic floor. When these muscles cannot hold the bladder properly, the bladder falls off and pushes against the vagina. You cannot tighten the muscles that close over the urethra. Therefore, urine can leak due to the extra pressure on the bladder when you cough, sneeze, laugh, exercise, or do other activities.

Urgent incontinence is caused by an overactive bladder muscle that pushes urine out of the bladder. It can be caused by bladder irritation, emotional stress, or brain conditions such as Parkinson’s disease or a stroke. Urologist in Noida often doesn’t know what causes it.

How are the types of urinary incontinence diagnosed?

To diagnose the cause of urinary incontinence, urologist in Ghaziabad asks people about their medical history and perform a physical exam. It may be easier for you to answer questions if you keep avoiding the dairy for 3-4 days before seeing your urologist in Greater Noida.

To check for stress incontinence, your urologist in Vaishali may ask you to cough while standing.

Sometimes urologist in Delhi request these tests:

  • Bladder stress test and Bonney test.
  • Pad test, which can help show how much urine is leaking. They give you an absorbent pad that has been heavy. You use the pad until urine leaks, and then return the pad to weigh yourself again. The increased weight of the pad provides an estimate of the amount of urine that leaked.
  • Urinalysis and urine culture.
  • Urodynamic tests. The urodynamic test is expensive. It is usually only done if you are considering surgery or if treatment has not worked for you and you need to know more about the cause. It provides a more advanced way to check the bladder function.
  • Cystometry, a series of tests to measure bladder pressure at different levels of fullness.
  • Post-emptying residual measures, which measure the amount of urine that remains in the bladder after urinating.
  • X-ray or ultrasound. These are used to examine changes in the position of the bladder and urethra during urination, cough, or straining.

If the cause of the incontinence is not identified by the above tests, more thorough examinations may be required.

prostate cancer treatment in Noida

Prostate Cancer – The Most Common Form of Cancer Among Men

Urologist in Noida, ,

The prostate along with the seminal vesicles are accessory seminal glands that produce seminal plasma from which sperm is formed. The prostate is located below the bladder and in front of the rectum.

Its size changes with age, in younger men being the size of a nut and weighing 15-20g, but maybe much larger in older men.

Prostate cancer is characterized by the uncontrolled growth of cells in the prostate gland.

Types

Almost all prostate cancers are adenocarcinomas (95%), developing from the cells of the gland.

Other types of prostate cancer include sarcomas, small cell carcinomas, transient cell carcinomas; these types being rare.

Some types of prostate cancer can grow and spread quickly, but most grow slowly.

In fact, autopsy studies show that many older men (and even some young people) who died from other causes also had prostate cancer that never affected them in their lifetime.

Precancerous disorders of the prostate

Some urologist in Noida suggests that prostate cancer starts as a precancerous condition, although this is not yet known. These conditions are sometimes discovered during a biopsy.

1. Intraepithelial prostatic neoplasia: there are changes in the way the prostate cells look under the microscope; based on the abnormal appearance of the cell types, they are classified as:

A. Low-grade: patterns of prostate cells that appear almost normal;
B. High-grade: abnormal cell models.

2. Proliferative inflammatory atrophy: the cells look smaller than normal, coexisting with signs of inflammation in the area.

Symptoms

Clinical:

  • Anamnesis: dysuria, pollakiuria, pelvic pain.
  • Clinical examination – local: assessment of the volume of the prostate by rectal cough; general examination.

Laboratory findings:

  • Endorectal prostatic ultrasound; urography iv; Blood PSA (men without prostatic neoplasm have PSA <4ng / ml); prostate biopsy; CT; MRI; lymph node biopsy; the degree of prostate cancer.

The degree of cancer is based on how abnormal the cells look under the microscope. The Gleason score assigns degrees based on how much the tumor resembles normal prostate tissue.

If the tumor closely resembles normal prostate tissue, it is assigned grade 1. If the tumor has abnormal cells it has a grade 5. Grades 2 and 4 have characteristics between these two extremes.

Because prostate cancers often have areas of varying degrees, one degree is attributed to the two areas that make up most of cancer.

These two classes are added to get the Gleason score (also called the Gleason amount). Theoretically, the Gleason score can be between 2 and 10, but scores below 6 are rarely used.

Prostate cancer is often divided into 3 groups, based on the Gleason score:

  • Cancer with Gleason score 6 or lower is called well-differentiated;
  • Cancer with a Gleason score of 7 is called moderately differentiated;
  • Cancer with a Gleason score of 8 to 10 is called poorly differentiated.

Risk factors

  • Age: Prostate cancer is rarely found in men under the age of 40, the risk of developing it increases rapidly after age 50.
  • Ethnicity: Prostate cancer occurs more frequently in African-American men and less frequently in Asian-American and Hispanic / Latino men than in non-Hispanic whites. The reasons for these ethnic-racial differences are unclear.
  • Family history: having a father or brother with prostate cancer, the risk of having this disease is greater than double.
  • Genetic changes: Inherited mutations of BRCA1 or BRCA2 genes increase the risk of breast or ovarian cancer. Mutations in these genes (especially BRCA2) may also increase the risk of prostatic neoplasm in some men.

Staging

A staging system is a standard way for the cancer care team to describe how far cancer has spread.

The most commonly used prostate cancer staging system is the American Joint Committee on Cancer (TNMS) system, which was most recently updated in January 2018.

The TNM system for prostate cancer is based on 5 key elements:

  • The size of the main tumor (category T);
  • If it has spread in the nearby lymph nodes (category N);
  • If it has spread (metastasized) to other parts of the body (category M);
  • PSA level at the time of diagnosis;
  • The grade group (based on the Gleason score), which represents a measure of the probability of rapid growth and spread of cancer. This is determined by the results of a prostate biopsy (or surgery).

Treatment

It is important to discuss all options of prostate cancer treatment in Delhi, including goals and possible side effects. Depending on the age, the stage of cancer and its degree, comorbidities, there are the following treatment options: surgical treatment, radiotherapy, hormone therapy, and chemotherapy.

Surveillance

After radiotherapy and/or radical surgery: general clinical examination: urinary signs, rectal cough; PSA; bone scintigraphy;

Rhythm: At 2-6 months, in the first 3 years;

After hormone therapy: clinical supervision: general condition, urinary signs, rectal cough; biological monitoring: PSA, testosterone, alkaline phosphatase; radiological and/or scintigraphic tracking.

Peyronie's Disease

What Do We Need To Know About Peyronie’s Disease?

Urologist in Noida, , , ,

What is Peyronie’s disease

Peyronie’s disease also called the plastic induration of the penis or the chronic inflammation of the albumin, represents the growth of fibrous plaques in the soft tissue of the penis, respectively in the albuminous tunic, which surrounds as an elastic sheath each of the two cavernous bodies of the penis, located on the lateral parts. and causes an abnormal curvature to occur.

A certain degree of curvature of the penis can be normal and innate, without causing complications, but Peyronie’s disease is a chronic inflammation that can cause pain, hardening, large size lesions and erectile dysfunction with painful erections, painful sexual intercourse, lack of rigidity, distal penis, toward the tip of the fibrous area and abnormal curvature that increases during erection.

Erectile dysfunction can have many causes, Peyronie’s disease being a rare cause, affecting about 4% of men.

Concern about the curvature of the penis can cause stress and anxiety, which also contribute to worsening erectile dysfunction. However, quite a number of men affected by this disorder have a satisfying sex life, says sexologist in Noida.

Signs and Symptoms

The signs and symptoms of Peyronie’s disease may appear suddenly or may develop gradually. The main sign is the curvature of the penis – the penis is curved laterally, up or down, depending on where the fibrous plaques are located.

Other signs and symptoms include the hard plates that feel under the skin of the penis and contain scar tissue in the form of strips or clumps, usually in the upper part of the penis; by accumulating calcium these plaques can become very hard and lead to severe curvature, painful erections or weak erections because the hardened tissue reduces elasticity in that area and makes intercourse difficult. Sometimes, during erection, the penis may shorten or narrow at a certain point. Rarely, the penis can acquire a form of an hourglass.

Curvature and shortening of the penis associated with Peyronie’s disease may worsen over time, but usually, stabilize after 3-12 months after onset. The pain during the erection decreases after 1-2 years.

The disorder occurs rarely in young adults, being more frequent between 40 and 70 years, says sexologist in Ghaziabad.

Causes And Risk Factors

The causes of Peyronie’s disease are not at all known. It can be caused by minor, repeated, penile injuries, either during sexual intercourse or as a result of sports activity or other accidents. After scar tissue is formed, over time, the plaques characteristic of this disease develops.

Genetic factors may be involved because there is an increased risk for men who have relatives suffering from Peyronie’s disease. Also, increased risk exists for those who have connective tissue disorders, such as tympanosclerosis or Dupuytren contracture, which is a thickening and contraction of the tissues of the hand, through which the fingers are drawn inwards.

It appears especially in older men with weak erections and frequent sexual intercourse. It is also associated with diabetes, high blood pressure, hyperlipidemia, surgical treatment of the prostate and occurs more frequently in smokers. Occasionally, it is associated with fibromatous degeneration of the outer cartilage.

The disease has two phases – acute and chronic. In the acute phase, which lasts 6-18 months, there is penile pain, curvature, and nodules, and in the chronic phase the fibrous plates do not increase and the curvature of the penis does not worsen anymore, and the pain during the erection disappears.

The diagnosis can be made by the urologist in Noida by palpation and discussion with the patient. Simple ultrasound and duplex Doppler scanning can also be used.

In this way, a possible arterial insufficiency or veno-occlusive dysfunction can be observed, which can result from the fibrous plaque influencing the blood circulation and which are also causes of erectile dysfunction. Radiographically, cleavages can be observed, these being an indication for surgery

Treatment of Peyronie’s Disease

In mild cases, when there is no pain or the pain is mild, when the curvature does not accentuate and the sex life is satisfactory, the urologist in Ghaziabad will recommend the evolution of the disease.

In more severe cases treatment is prescribed. Injections can be made with collagen products (collagenase) if the curvature of the penis forms an angle greater than 30 degrees. It is also prescribed injections with interferon or oral verapamil.

Some techniques are still in the experimental phase. Thus, some patients may benefit from iontophoresis, a technique by which a weak electrical current passes through the skin, favoring the absorption of drugs in the affected area. Another option is extracorporeal shock wave therapy. Radiation therapy was also experienced.

The administration of vitamin E has doubtful effects. The administration of the vitamin B complex also does not guarantee positive effects. As well as some anti-estrogenic, antioxidant or anti-inflammatory drugs.

Sometimes easy exercises for stretching the penis manually or with special devices – stretching the penis when it is not erect, for 30 seconds, three times a day, for 6 weeks after treatment with collagen products and straightening it for 30 seconds once a day, during spontaneous erection.

Surgical treatment is generally prescribed by sexologist in Delhi in cases of severe deformity and only in the chronic phase of the disease, after the degree of curvature and the size of the plates have stabilized for at least 3-6 months.

Surgical techniques include elongation of the lateral penis by incision, excision of the plates and skin graft, when the curvature is over 60 degrees, shortening of the lateral penis when the disease is less serious and the penis rather long, penile prosthesis or implant (flexible or inflatable cylinders inserted into the cavernous bodies).

The implant can be permanent, giving the penis a semi-rigid character, sufficient for sexual intercourse, or activated by a pump located in the scrotum, which produces a stronger erection.

Patients suffering from Peyronie’s Disease are better off changing their lifestyle – quitting smoking, doing gymnastics, reducing alcohol use and not taking drugs. The urologist in Delhi should be consulted when pain occurs, with or without an erection, and when priapism occurs – unwanted and persistent erection for more than 30 minutes, sometimes accompanied by pain.

Testicular Disorders

Disorders of The Male Reproductive System: Testicular Disorders

Urologist in Noida, , , , , ,

There are two major primary disorders affecting the male external reproductive organs. These include penile dysfunction and testicular disorders. Penile and testicular dysfunctions can affect male fertility and sexual function.

The testes are part of the male reproductive system. The testicles are two oval-shaped organs, the size of two larger olives. They are located inside the scrotum, the free sac of the skin that hangs behind the penis.

The testes secrete male hormones, including testosterone, and produce sperm, the male reproductive cells. Testicular disorders can cause severe disorders, including hormonal imbalances, impaired sex life, and infertility.

Testicular trauma, testicular torsion, testicular cancer, epididymitis, and hypogonadism are among the most common testicular disorders.

Testicular trauma

Because the testes are located at the scrotum, which hangs on the outside of the body, they have no muscle and bone protection. This makes them more likely to hit, kick or crush, which occurs more frequently during contact sports. Men can protect their testicles by wearing athletic cup-shaped devices during sports.

Testicular trauma can cause severe pain, bruising and / or swelling. In most cases, the testicles – which are made of spongy material – can absorb the shock of trauma, without serious injury.

A rare form of testicular trauma, called testicular rupture, occurs when the testicle receives a direct hit or is crushed by the large bones of the pelvis. This type of trauma can cause bleeding in the scrotum. In severe cases, surgery is needed to repair the rupture, thus saving the testicle.

Testicular torsion

Inside the scrotum, the testicles are fixed at each end by a structure called spermatic cord. Sometimes, this cord twists around the testicle, thus disrupting the blood supply to the testicle. Symptoms of testicular torsion include sudden and severe pain, enlargement of the affected testicle and swelling.

This condition, which occurs mainly in men younger than 25 years, can occur due to a testicular or secondary impairment to an activity that requires a great deal of effort. It can also occur without an obvious cause.

Treatment

Testicular torsion requires emergency treatment. Usually, the treatment consists in correcting the condition through surgery. Testicular function can be saved if the disorder is diagnosed and treated immediately. If the blood supply to the testicle is interrupted for a long time, the testicle may be permanently damaged and may require surgical removal.

Testicular cancer

Testicular cancer occurs when the cells in the testis divide and grow uncontrolled. In some cases, certain benign (non-cancerous) tumors can progress and turn into cancer. Testicular cancer can develop in one or both testes in men or adolescents.

Symptoms

Symptoms of testicular cancer include:

– a swelling, an irregular area or enlargement at the level of each testicle;

– a sensation of traction or unusual weight at scrotal level;

– a pain that can be sustained at the groin or lower abdominal level;

– pain or discomfort (which may appear and disappear) at the testicular or scrotal level.

Etiology

The exact etiology of testicular cancer is unknown, but there are a number of risk factors for the disease. Risk factor is considered anything that increases a person’s chances of contracting a disease. The risk factors for testicular cancer are:

– age: testicular cancer can occur at any age, but most commonly it occurs in men between the ages of 15 and 40

– the unobstructed testicle: this is a condition in which the testicle does not descend from the abdomen, where it is located during the fetal development period, at the scrotum level, shortly before birth

– family history: a family history of testicular cancer increases the risk of cancer

– race and ethnicity: the risk of testicular cancer in white men is five times higher than in black men and twice as high as in Asian and American men.

Treatment

Testicular cancer is a rare form of cancer, with effective treatments being usually curable. Surgery is the most common form of testicular cancer treatment in Noida. Surgery involves the removal of one or both testicles by an incision (cut) at the groin level. In some cases, the urologist in Noida may also remove lymph nodes from the abdomen.

Radiation therapy, which uses high-energy rays to destroy cancer, and chemotherapy, which uses cancer cell-destroying drugs, are other therapeutic options.

The removal of a testicle does not lead to problems of conception or sexual activity. The remaining testicle will continue to secrete sperm and male sex hormones. In order to return to the normal appearance, a testicular prosthesis can be fitted, which is surgically implanted at the scrotal level, which looks and feels like a normal testicle.

Prognosis

The success of testicular cancer treatment in Noida depends on the stage of the disease at the time of diagnosis and treatment. If the cancer is detected and treated before spreading to the lymph nodes, the cure rate is very high, greater than 98%.

Even after testicular cancer has spread to the lymph nodes, the treatment is very effective, the cure rate is more than 90%.

Prophylaxis

In order to prevent testicular cancer, men should be familiar with the size and sensation of the testes, in order to detect any type of change. Most doctors believe that early recognition of swelling is an important factor in the success of testicular cancer treatment and recommends monthly testicular self-examination, associated with a routine physical examination, in all men after puberty.

Epididymitis

Epididymitis is an inflammation of the epididymis. The epididymis is the groove wrapped around and around each testicle. It has the function of transport, storage and maturation of the sperm cells, which are produced at the testicular level. The epididymis provides a connection between the testes and the deferential channels (the channels that carry sperm).

Etiology

Epididymitis commonly occurs due to infections or infections with Chlamydia, a sexually transmitted disease. In men over 40, the most common cause is the bacteria that exist in the urinary tract.

Symptoms

The symptoms of epididymitis are scrotal pain and swelling. Penile secretion, pain in the urine and sexual contact or painful ejaculation may also be present. In severe cases, the infection can spread to the adjacent testicle, producing fever and abscesses (pus collections).

Treatment

Treatment of epididymitis include antibiotics (drugs that kill the bacterium that caused the infection), physical rest, application of ice bag to reduce swelling, use of a device to support the testicles and anti-inflammatory drugs. The partner should also be treated, if the epididymitis is secondary to a sexually transmitted infection, to prevent re-infection.

If left untreated, epididymitis can cause scar tissue damage, thus blocking normal sperm leakage at the testicular level. This can lead to fertility problems, especially if both testicles are involved or if the man has recurrent infections.

Prophylaxis

Condom use during sexual contact can prevent epididymitis secondary to chlamydia or gonococcal infection.

Hypogonadism

One of the testicular functions is the secretion of testosterone. This hormone plays an important role in developing and maintaining the majority of male physical characteristics. These include strength and muscle mass, fat distribution, bone mass, sperm production, and sexual behavior.

Hypogonadism in men is a condition that occurs when the testicles (gonads) do not produce enough testosterone. Primary hypogonadism occurs when there is a disorder or anomaly in the testis itself. Secondary hypogonadism occurs when there is a disorder in the pituitary gland of the brain, which transmits chemical impulses to the testicles to stimulate testosterone secretion.

Hypogonadism can occur during the fetal period, at puberty or during adulthood.

Signs and symptoms

If it occurs in adult men, hypogonadism can produce the following:
– erectile dysfunction (inability to obtain or maintain an erection);
– infertility ;
– decrease in sexual activity;
– reduction of hair or body hair;
– decrease in size or firmness of the testes;
– decreased muscle mass and increased fat deposition;
– decrease in bone mass (osteoporosis);
– enlargement of the male breast tissue (gynecomastia);
– emotional and mental symptomatology similar to that seen in menopausal women (profuse sweating, changes in mood, irritability, depression, fatigue ).

Etiology

There are various causes of hypogonadism:

– Klinefelter syndrome: This syndrome involves the presence of abnormal sex chromosomes. Men usually have an X chromosome and a Y chromosome. The Y chromosome contains the genetic material in coded form, which determines the male sex, as well as the development and specific male characteristics. Men with Klinefelter syndrome have an additional X chromosome, which results in abnormal testicular development.

– unobstructed testicles

– Hemochromatosis: this condition consists of excess iron in the blood, which can cause disorders of the testicular function or the pituitary gland.

– Testicular trauma: testicular trauma can affect testosterone production

– Anticancer treatments: chemotherapy or radiotherapy, treatments frequently applied in cancer, may interfere with testicular production of testosterone and sperm

– Normal aging process: older men have lower levels of testosterone, although the rate of decrease of this secretion varies greatly from man to man

– Disorders of the pituitary gland: disorders of the pituitary gland (a small organ located in the middle of the brain), including either trauma or a tumor, may interfere with the ability of the gland to send hormonal signals to the testes to stimulate testosterone synthesis.

– Medicines: certain drugs may affect the production of testosterone; these are some commonly used antipsychotic drugs.

Treatment

The treatment of hypogonadism is different depending on the etiology. For the treatment of testicular disorders, hormone replacement treatment (testosterone replacement therapy) is used.

If the etiology is a condition of the pituitary gland, pituitary hormones can be used to increase testosterone levels and sperm production.

penis fact

17 questions everyone has about the penis

Urologist in Noida

“Size does not matter,” said Dr. Shailendra Goyal, a urologist and sexologist in Noida. “You know why size doesn’t matter? Because the top one-inch of the penis and first inch of the vagina (which includes the clitoris and G-spot) is where we are most sensitive – this is where sexual pleasure comes from,” he added.

Over his 23-year practice, Dr. Goyal has repeatedly answered this question and others about erection, masturbation and sexual pleasure.

Representational image. Image by Gerd Altmann from Pixabay

We asked Dr. Goyal to answer the most frequently asked questions about the penis; as well as a bunch of questions he wants more people to ask him:

Penis FAQs

Q1: What is the average penis size for Indian males?

A: It depends on where you start measuring!

A section of the penis (about half of it) isn’t visible; the correct way to measure the penis is from the pubic bone. If you measure it right, the average Indian penis is seven to eight inches. (Remember, some of it is inside the body. You can’t see it.)

The part that’s visible outside is three to five inches on average.

Q2: What is the average girth?

A: The short answer is that it doesn’t matter.

Q3: Can I do something to increase penis size?

A: Quacks will tell you yes; I say no. Drugs won’t work, home remedies definitely won’t work. There are surgical options. Remember how I said that a part of the penis is inside the body. Surgeons can draw some of it out. But I wouldn’t recommend that surgery.

Q4: Does penis size matter?

A: Nope. Not unless the penis is so big, it causes the woman in the relationship discomfort or actual pain during sex. And that’s definitely not a good thing.

Barring extreme cases, each couple has to explore to find sexual pleasure. That’s what matters – your personal chemistry and the right amount of preparation.

Q5: How long does it take the average Indian man to get an erection?

A: Depends on the man. It depends on his mood. It depends on the chemistry between partners.

Q6: How long should sex last?

A: Just the sex part? That’s 2-5 minutes. Anyone who tells you otherwise has been watching too much porn or is a braggart with not a leg to stand on. The foreplay and after-sex intimacy, now that is entirely up to the couple.

Q7: Is a bent penis normal?

A: A little bit, sure.

Q8: Do height or race affect penis size?

A: Based on ethnicity, height, and overall health, the penis size can vary somewhat. But there’s no guarantee that a tall, broad Afghan man in good health will have a larger penis or a short, stout Indian man will have a smaller one. At the risk of repeating myself, size doesn’t matter. Girth doesn’t matter.

Q9: Can I accidentally bend or break my penis?

A: It’s like any other part of the body; if you’re rough with it, you can hurt it.

Q10: Can my penis become thin if I masturbate?

A: First, masturbation is healthy. When the body makes semen, it has to come out some way – whether it is during intercourse or masturbation or through night-time emissions.

Second, no, you can’t make it thin.

Third, girth doesn’t matter.

Fourth, remember what we discussed in the last question – be gentle with yourself.

Q11: Does shoe size or length of the forearm indicate the size of the penis?

A: Your race and body contour – height, breadth, health – have something to do with penis size. But there are no guarantees, and definitely no reliable correlation.

Q12: Should I shave or trim my pubic hair?

A: Your pubic hair is there for a reason. You can trim it or cut it to make it neat if you like.

Q13: Can I do something about the penis smell?

A: Penis hygiene – finally something that does matter a great deal! 

The penis smell is because of this natural lubricant called smegma. When we don’t pull the foreskin back to clean it, this smegma gathers under it and can smell a bit. If we ignore the smell and let the smegma gather, it can cause balanitis.

Questions Dr. Goyal wishes you would ask

Q14: What’s the right way to clean my penis?

A: Most men don’t know how to clean their penis: when you’re in the bath, gently pull back the foreskin, pour a steady stream of room temperature water on the penis head and shaft. Pull the skin back over the penis when you’re done. Don’t use any soap, wipes or deodorizers.

Q15: What is balanitis?

A: It’s an inflammation. The skin over the penis head can become irritated, and even infected if you don’t clean the penis properly or if you clean with harsh soaps. This is known as balanitis. Ask your doctor about medication to fight the infection. As a rule, consult your doctor if you feel pain while peeing.

Q16: Should I pee after sex?

A: No, not for the next 10-15 minutes. It’s ridiculous that men who have been married, divorced and married again don’t know this.

The penis does three important things: you have sex with it, pee with it and make babies with it. But the penis is rubbish at multitasking. It’s not alone. Think about other parts of your body that do multiple things – just not all at the same time. You don’t swallow and sneeze at the same time, though there is the involvement of the throat in both.

Peeing after sex helps women avoid urinary tract infections. But it is a significant cause of UTIs in men.

Before sex, roll the foreskin back. After, gently roll it back to the front. And wash under the foreskin.

Q17: Do I need to teach penis hygiene to my two-year-old?

A: Absolutely. When children are born, the foreskin is usually very tight. Don’t force it back. As your baby grows up, try to gently roll the foreskin back to wash under. As the child grows up and learns how to bathe, teach him to do this on his own.

Varicocele

Health Tips: Varicocele

Urologist in Noida

Varicocele is the tortuous enlargement of the veins in the scrotum above and around the testis. It is the most common cause of low sperm count and low motility of sperms leading to infertility. It may cause pain in the scrotum and may lead to shrinkage testicles.

What are the symptoms to watch out for?

Varicoceles rarely cause severe pain but when it does, the pain is :

  • Usually dull aching
    • Increase with high exertion or strenuous exercise or when standing for a long time
    • Worsens with time
    • Relieved on lying down

When Varicocele is large, it is felt and sometimes visible as “BAG OF WORMS” above the testicle.

It mostly occurs on the left side, but some time may be on both sides of the scrotum.

How is it caused?

Testes hang in the scrotum by their stalk called spermatic cord. It contains Arteries, veins, lymphatics, and nerves of testes. Arteries bring fresh blood with nutrients to testes and veins clear bad blood and excreta of testes. Blood travels in veins against the gravity toward the heart but valves in veins prevent backflow. When valves in veins got damaged, blood backflows and veins in scrotum swell up. Veins no longer able to clear bad blood and excreta of testicles. Hence, testicles do not get proper nutrition and temperature for the growth of sperms. Therefore, a patient develops low sperm count and weak sperms. Lack of proper nutrition causes mild pain and ultimately may lead to shrinkage of testicles.

How is the condition diagnosed?

Examination by Urologist in Ghaziabad in lying down and standing condition while the patient holds his breath and strain for stool reveal dilated veins.

Diagnosis can be confirmed by Doppler Ultrasound of Scrotum.

Treatment is necessary only when the varicocele causes the following-

  • Pain
    • Infertility
    •Testicular Atrophy

Treatment options –

Treatment involves tying up of abnormal veins, so that blood flow normalizes. It can be achieved by following methods but Microscopic microsurgical method is best –

  • Conventional Open Surgical Varicocelectomy – It is usually done by a cut in the abdomen. But this method is not accurate as lots of lymphatics are also tied which causes hydrocele. Some dilated veins may be left leading to recurrence or persistence of the problem.
  • Laparoscopic Varicocelectomy –By making 3-4 holes in the abdomen main testicular vein is ligated. It is less painful but is associated with high recurrence rates due to patency of other veins of the scrotum.
  • Angio-embolization- A small catheter is inserted into the abnormal veins through the groin area. The main testicular vein is blocked by sclerosant or coil. It is a convenient daycare procedure but is associated with high recurrence rates due to patency of other veins of the scrotum.
  • Microscopic Microsurgical Varicocelectomy – It is done by small cut just above the scrotum. All the dilated veins are ligated by examining under a microscope and dissecting finely by the microsurgical method. All types of dilated veins are tied leaving lymphatics & arteries unhurt. This method gives almost 99% success and a minimum chance of recurrence or complication.
renal-transplantation

Understanding Renal Transplantation

Urologist in Noida,

Renal transplantation is the definitive treatment for patients with end-stage renal disease (ESRD). ESRD can be defined as patients who are suffering from chronic kidney disease (CKD) and require regular dialysis or possibility of permanent dialysis requirement is imminent. Renal transplantation is regularly been done at Max Super Speciality Hospital, Vaishali, by an expert team under Dr Shailendra Goel, Urologist in Noida, Ghaziabad, Vaishali. In a Kidney transplant, donated Kidney is implanted in the lower abdomen of the patient (Recipient).

How can a patient of ESRD get a kidney?

ESRD patient can get a kidney from either any of his relative (voluntary living kidney donation) or brain dead cadaver. Any relative of a patient can donate his/ her one kidney to the patient. The donor is medically screened for any disease and fitness for donation. Donor surgery is now routinely been done by Laparoscopy at Max Super Speciality Hospital, Vaishali.

What is Cadaveric Donation?

Braindead donors are considered dead but the donor’s heart continues to beat and maintain circulation to organs. When the team of experts declare any hospitalised patient as brain dead, his / her family member can decide to donate his organs (Heart, Liver, Kidneys, Eyes) to patients suffering from end-organ damage.

How can any patient opt for Cadaveric Transplantation?

If any patient is not having a suitable living donor in his/ her family, he can opt for cadaveric transplantation. Every transplant hospital maintains a waiting list of suitable end-stage organ disease patients. We at Max Super Speciality Hospital, Vaishali, maintain a waiting list for kidney transplantation from Cadaver. We have done many cadaveric transplantations recently.

What if the patient does not have a matching donor in the family?

Kidney transplantation is usually done with blood group matching donor and recipient. If matching donor is not available in the family or near relatives, then ABO-incompatible transplant can be done. In this scenario, the recipient’s blood is washed off for antibodies against opposite blood group by plasmapheresis and some medications are given for desensitization. At Max Super Speciality Hospital, Vaishali, we have the facility of ABO-incompatible renal transplantation.

What is swap kidney transplantation?

If any two ESRD patients, whose Donors do not have matching blood groups but one patient’s donor blood group matches with other patient’s blood group and other patient’s donor blood group matches with first patient’s blood group. In this scenario, donor’s kidneys are exchanged among two recipients.

We at Max Super Speciality Hospital, Vaishali are usually doing swap renal transplantation.