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Male Urinary Incontinence

Urinary incontinence is a health condition in men, which is caused by loss of bladder control. Urinary incontinence usually occurs in cases of medical conditions such as an enlarged prostate, Parkinson’s disease and diabetes, and may also occur after a prostate surgery. Urinary incontinence is an irritating and embarrassing condition, but with proper treatment, it can be cured. There are several ways to treat this condition which include home remedies as well as medications and surgery.

Here are several methods used to treat urinary incontinence:

  1. Caffeine, soda and carbonated drinks cause irritation in the bladder and worsen the symptoms of urinary incontinence. Alcohol is a diuretic and increases the amount of urine too. So abstain from coffee, alcohol and soft drinks to make a difference.
  2. Dietary adjustments are required for the treatment of urinary incontinence. Several spicy and acidic food items can make urinary incontinence worse. Hence, you should avoid having such foods for some time.
  3. Urinary incontinence can lead to stress and you must get rid of it for better health. You can try relaxation techniques, such as meditation and breathing exercises. Biofeedback is another option by which you can observe your bladder muscle contractions on a monitor.
  4. You should try a behavioral technique known as bladder training. This would require you to urinate every half hour, in spite of not having the urge. Slowly try to increase the time in between the bathroom breaks.
  5. You need to flex your muscles to gain control over urinary incontinence. Kegel exercises can be practiced as they boost the strength of your pelvic muscles.
  6. You should find the right muscles that are required to stop the passing of gas.
  7. Pads and disposable undergarments can be used by men. These help in containing leaks and also protect the skin from irritation and odor.

There are several medicines, which help in the treatment of urinary incontinence in men. Some of these work to relax muscles for preventing unwanted bladder contractions, while others help in blocking the nerve signals to the bladder. Drugs used for the shrinking and treatment of an enlarged prostate are also used as blocked by prostate lead to bladder irritation. Now-a-days, more than 80% cases of incontinence in males respond well to medications.

Surgery may be the ultimate option for the treatment of urinary incontinence. Options depend on the cause of incontinence. If it is because of obstructing prostate, prostate surgery by TURP / HOLEP is curative. If it is because of bladder overactivity, BOTOX injection in bladder is useful. If it is TRUE incontinence after radical prostate surgery then treatment include a male sling or artificial urinary sphincter implantation. In sling operations, a type of material is wrapped around the urethra for compressing it. In Artificial sphincter implantation, a cuff is used in order to close the urethra. Urine is released by squeezing the pump to open the cuff. A Interstim device similar to a pacemaker is used to stimulate nerves, which help in relaxing the bladder and pelvic floor.

Laser prostate surgery

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

Prostate Treatment in Noida
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 urologist in Ghaziabad, Noida to identify if you are a suitable candidate for laser surgery.

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 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 the cancer has reached a more advanced stage. These include urinary problems, like poor flow, frequency, frequent need to wake up for urination in night. 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. Bloked 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 first choice of treatment for localized prostate cancer. 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 treatable disease. We should not fear with it rather fight with it. Ultimately, we can win over the cancer.

Kidney Stones – Causes and Treatment

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 by urologist in Vaishali, Ghaziabad, Noida.

HoLEP Removes Enlarged Prostate Gland

Enlarged Prostate Gland, Watch Out!

The Holmium Laser Enucleation of the prostate (HoLEP) is an advanced endoscopic surgical procedure that is done to remove the enlarged prostate gland. As laser seals blood vessels accurately, there is little or no bleeding, thereby making the entire procedure a lot safer.

How does HoLEP work?

The HoLEP surgery is a state-of-the-art minimally invasive surgery that removes the enlarged prostate gland tissue without any incision.

The goal of the HoLEP surgery is to relieve pressure on the tube (urethra) through which the urine drains, by anatomically enucleating the prostate adenoma. This is done under a regional anaesthesia with the help of a telescopic camera inserted through the penis. The three lobes of the prostate that are cored out intact are pushed into the bladder before being churned &sucked up (morcellated) by a special instrument inserted through the same telescopic camera.

A catheter is placed into the bladder to drain the urine while the raw surface heals for next 48 to 72 hours. Sterile saline fluid is also irrigated into the bladder through the catheter to dilute any blood in the urine and prevent clots formatio. It is normal to have some blood in the urine after this operation, so it is advisable to drink plenty of water for a few days while it clears.

Who are the right candidates?

HoLEP can be performed on men of any age with urinary outflow obstruction caused by an enlarged prostate. It is particularly useful in men with very large prostates (over 80 ml in size).

What are the advantages of HoLEP?

  • Safe , even in elderly individual
  • Safe in patients with low sodium level
  • Less bleeding
  • Perfect for small to very large prostates
  • No blood transfusion required
  • Safe even for cardiac patients and those on anticoagulants
  • Minimal catheterization
  • Early return to work
  • No chances of recurrence
  • Immediate relief of symptoms
  • Ability to destroy bladder stones if present
  • Lower complication rate