General Urology

General urology is a very important part of urology, More than 75% of patients whom we see in our daily urology practice have one of these below-mentioned urological problems. It is very impportant for the patient to see if they have any of these urology problems and understand about their disease.


Prostate enlargement

Prostate is an accessory reproductive organ that is exclusively present in males. It is not present in females. Enlargement of the prostate gland is seen in most males, as a process of ageing. The imbalance in hormone levels with increasing age causes this enlargement. Beyond 50 years of age, with a decline in male hormone levels, the glandular enlargement commences. It grows faster in some and slower in others. Let us remember that one should not panic about prostate enlargement. It is a universal phenomenon and is part of normal ageing process.

Prostate enlargement can be treated medically or by endoscopic approach. Transurethral resection of prostate is a gold standard procedure. Recent advances include application of Laser to enucleate the gland and remove it in toto.


Kidney stones

Kidney stones are a common occurrence in young adults. Various factors play a role in stone formation. Patients present with severe pain in the loin. They may also present with vomiting, fever chills or rigor.

Treatment depends on the size, location and number of stones. Stones located in the kidney can be removed either by Shock waves transmitted from externally or by application of Laser endoscopically. Larger stones in the kidney can be removed by a Key hole surgery. Stones in the ureter (tube draining urine from the kidney to bladder) can be removed ureteroscopically.


Erectile dysfunction

Erectile dysfunction is one of the common conditions that we come across in andrological practice. Young males about to get married and anxious about marriage, recently married couple with inability to perform and elderly males in the age group of 40 to 60 years with co-morbidities like diabetes or high blood pressure present with difficulty in achieving adequate erection.

Many patients with difficulty in achieving satisfactory erection may also have pre-mature ejaculation. Most of such conditions can be treated with adequate counselling. Few patients need medical management and very few need surgical repair.


Kidney transplant

End stage kidney disease is a not-so-uncommon problem that we come across these days. Kidney transplant refers to transplanting a healthy kidney from one donor to the patient with kidney failure. The donor kidney may be from a live related donor or from the brain dead unrelated individuals.

Patients who undergo kidney transplantation need to be on immune-suppressive medicines. A thorough medical check up is mandatory before transplantation to ensure that the individual is healthy enough to withstand the procedure and also to make sure that the patient would otherwise live long enough to reap the maximum benefits of such major surgical procedure.


Stricture urethra

The urethra is a tube that carries urine from the bladder so it can be expelled from the body. Usually the urethra is wide enough for urine to flow freely through it. When the urethra narrows, it can restrict urinary flow. This is known as a urethral stricture. Urethral stricture is a medical condition that mainly affects men.

Urethral stricture involves constriction of the urethra. This is usually due to tissue inflammation or the presence of scar tissue. Scar tissue can be a result of many factors. Young boys who have had a hypospadias surgery (a procedure to correct an underdeveloped urethra) and men who have penile implants have a higher chance of developing urethral stricture.

A straddle injury is a common type of trauma that can lead to urethral stricture. Examples of straddle injuries include falling on a bicycle bar or getting hit in the area close to the scrotum.

Other possible causes of urethral stricture include:

· pelvic fractures

· catheter insertion

· radiation

· surgery performed on the prostate

· benign prostatic hyperplasia

Rare causes include:

· a tumor located in close proximity to the urethra

· untreated or repetitive urinary tract infections

· the sexually transmitted infections (STIs) gonorrhea or chlamydia

Strictures can be treated by endoscopic procedures (optical internal urethrotomy OIU) or by urethroplasty.


Tuberculosis of urinary tract

What causes urinary tract tuberculosis?

Tuberculosis of the kidney and urinary tract is, like other forms of the disease, caused by members of the Mycobacterium tuberculosis complex. By far the most common causative organism is the human tubercle bacillus, M. tuberculosis, but the bovine tubercle bacillus, M. bovis, occasionally can be responsible.

What are the symptoms of urinary TB?

Symptoms of genitourinary TB may include flank pain, dysuria, and frequent urination. In men, genital TB may manifest as a painful scrotal mass, prostatitis, orchitis, or epididymitis. In women, genital TB may mimic pelvic inflammatory disease.

How is urinary TB treated?

Urogenital tuberculosis (UGTB) should in general be treated as pulmonary TB with a four-drug regimen of Isoniazid, Rifampicin, Ethambutol and Pyrazinamide for a total of 6 months, Ethambutol and Pyrazinamide only the first two months.

Is bladder TB curable?

As with any other infection, UGTB should be cured by antibacterial therapy, but because of late diagnosis it may often require surgery.


Urinary tract infections

An infection in any part of the urinary system, the kidneys, bladder or urethra.

Urinary tract infections are more common in women. They usually occur in the bladder or urethra, but more serious infections involve the kidney. A bladder infection may cause pelvic pain, increased urge to urinate, pain with urination and blood in the urine. A kidney infection may cause back pain, nausea, vomiting and fever. Common treatment is with antibiotics.

Symptoms

Usually self-diagnosable. A bladder infection may cause pelvic pain, increased urge to urinate, pain with urination and blood in the urine. A kidney infection may cause back pain, nausea, vomiting and fever. People may experience:

Pain areas: in the bladder, groin, lower abdomen, or pelvis

Pain circumstances: can occur during urination or during sexual intercourse

Urinary: foul smelling urine, frequent urination, bladder spasm, cloudy urine, dark urine, persistent urge to urinate, sense of incomplete bladder emptying, or blood in urine

Whole body: fatigue, fever, or malaise

Also common: cramping or vaginal irritation

Common symptoms include a strong, frequent urge to urinate and a painful and burning sensation when urinating. A UTI is usually diagnosed based on symptoms and testing of a urine sample. UTIs can be cured with 2 to 3 days of treatment. Cranberry extracts do not treat UTIs but may help reduce the risk of recurrent UTI.


Urine leakage in women


Urine leak in woman is one of the most distressing complaints that a woman can ever have. The smell of urine on her garments would not allow her to participate in public gatherings. Fear of urine leak would not allow her to react emotionally (cry/Laugh) wherever needed.

The two most common types of urinary incontinence that affect women are stress incontinence and urge incontinence, also called overactive bladder. Incontinence affects twice as many women as men. This may be because pregnancy, childbirth, and menopause may make urinary incontinence more likely. Such urine leakages restrict their activities and prevent a woman from social gatherings.

The following self-help tips and lifestyle changes may offer relief of symptoms.

  1. Regular pelvic floor exercises.

  2. Stop smoking.

  3. Avoid lifting.

  4. Lose excess weight.

  5. Regular bowel habits.

  6. Cut down on caffeine/Tea.

  7. Stop alcohol consumption.


Blood in urine

Hematuria (blood in urine) is a condition that has a wide range of presentations from microscopic to being seen with naked eye to gross frank blood in urine.

Several different conditions and diseases can cause hematuria. These include infections, kidney disease, cancer, and rare blood disorders. The blood may be visible or in such small quantities that it can’t be seen with the naked eye.

Hematuria cannot be taken lightly. Any blood in the urine can be a sign of a serious health problem, even if it happens only once. Ignoring hematuria can lead to the worsening of serious conditions like cancer and kidney disease, so you should talk to your doctor as soon as possible.

Please consult your family doctor who can analyze your urine and order imaging tests to determine the cause of the hematuria and suggest the correct plan of treatment.