UROLOGY AND ANDROLOGY

Dr. Gautam Banga
Senior Consultant (UROLOGY)
MBBS,MS, M.Ch
Dr. Sarwar Eqbal
Consultant Urologist
MBBS, MS-General Surgery,
DNB, MCH (Urology)
Dr. Satish Gunawant
Consultant Urologist
Dip.Urology (London) 2002,
MS, FAIS, Dip.Urology (London)
       








Dr. Gautam Banga,Book Appointment With Dr. Gautam Banga,Urologist Dr. Sarwar Eqbal,
Book Appointment With Dr. Sarwar Eqbal,Urologist
Dr. Satish Gunawant,
Book Appointment With Dr. Satish Gunawant,Urologist



URINARY STONES

Urinary stones are in fact, a congregation of chemical substances present within the body. Normally, urine contains many dissolved chemical substances at a specific concentration. Conditions leading to increased concentration of these chemicals in urine cause them to crystallize, thus leading to the formation of stone. The urinary stone size varies from that of a grain of sand to that of a golf ball. They may be smooth, jagged or spiky and can be single or multiple. Commonly urinary stones are made up of Calcium oxalate monohydrate/ dihydrate, Uric Acid, Calcium Magnesium Phosphate and uncommonly Cystelne and Xanthene.

Treatment options for kidney stone:
• Ureteroscopic (urs) stone removal
• Percutaneous nephrolithotomy (pcnl)
• Laser for stone treatment
• Open surgery
• Lithotripsy (eswl)

What Is Benign Prostatic Hyperplasia? (BPH )

Benign Prostatic Hyperplasia (BPH) is a condition that affects the prostate gland in men. The prostate is a gland found between the bladder (where urine is stored) and the urethra (the tube through which the urine passes). As men age, the prostate gland slowly grows bigger (or enlarges). As the prostate gets bigger, it may pass on the urethra and cause the flow of urine to be slower and less forceful. The word "benign" means the enlargement isn't caused by cane or infection. The word "hyperplasia" means enlargement.

What are the treatment options?
There are a number of treatment options. These include
• Watchful Waiting
• Medical therapy with drugs such as Alpha Blockers, Finasteride/Duasteride
• Various surgical procedures – the many options of surgical intervention are Holmium Laser Enucleation of Prostate, Transurethral Incision of the Prostate (TUIP), Transurethral resection of the Prostate (TURP), and Open Prostatectomy.

Treatment Preference
BPH affects the quality rather than the quantity of life. It is therefore the degree to which the patient's symptoms bother him will determine the need for therapy; the relative benefits and harms of each treatment option will help to determine their therapeutic preference.

EXPERTS SPEAK ON WHEN TO GET PROSTATE SURGERY DONE

While medications help many men with an enlarged prostate ( also called benign prostatic hyperplasia : BPH) they may not always be effective in relieving symptoms. The Next Step in treating enlarged Prostate is minimally invasive surgical procedures. These are available to treat moderate-to-severe enlarged prostate symptoms that are bothersome. These procedures are also used if tests show that urinary function is seriously affected.

Surgery is usually recommended in treating BPH-related complications, such as:
• Urinary retention
• Failure to respond to medical or minimally invasive treatments.
• Blood in the urine that is not getting better
• Bladder stones formation
• Frequent urinary tract infections because of BPH
• Kidney function damage

'When to get the surgery for enlarged prostate done' is the question most seniors face. As you discuss the options, ask your doctor these five questions:
1. Is there a good chance my condition will improve?
2. How much will it improve?
3. What are the complications or limitations of these surgical options?
4. Is there any long term effects?
5. Will I need to have this treatment repeated in future?

There are many minimally invasive options available e.g. TURP/ HoLEP / KTP Laser / Diode Laser / TUIP etc.

PROSTATIC CANCER

Prostate cancer is the 2nd most common cancer in males. With newer modalities like Screening by PSA and Transrectal Ultrasound Examination along with DRE cancer prostate can be diagnosed in early organ confined stage which has a very high rate of cancer free survival after appropriate treatment. Radical prostatectomy is a hugely successful treatment option for organ confined prostate cancer.

Urology department at Adiva has facility for Ca Prostate Screening, TRUS and Nerve Sparing Radical Prostatectomy. Continence and Potency are sustained in the majority of patients.

EXPERSTS SPEAK ON EARLY DETECTION OF PROSTATE CANCER

Prostate cancer that is detected early when it's still confined to the prostate gland — has a better chance of successful treatment. Prostate cancer occurs in a man's prostate — (a small walnut-shaped gland) that produces the seminal fluid that nourishes and transports sperm. This is one of the most common cancer in men. Prostate cancer usually grows slowly and initially remains confined to the prostate gland, where it may not cause serious harm and symptoms. While some types of prostate cancer grow slowly and may need minimal or no treatment, other types are aggressive and can spread quickly.

A readily available blood test called prostate-specific antigen (PSA) is used for the early detection of prostate cancer. Total PSA, free PSA and their ratio is used to increase the sensitivity of this test. Although prostatic inflection and very large benign prostate gland can also increase the value of PSA, careful analysis by digital rectal examination, urine examination and ultrasound especially transrectal ultrasound can also increase its sensitivity. Periodic assessment of PSA also helps in measuring the velocity of increase of PSA and indicate abnormality. If PSA is high (>4.0 ng/dl) and your doctor suspects the cancer then a Trans rectal Ultrasound (TRUS) guided Prostatic biopsy is done form at least 12 regions of prostate to confirm or rule out the malignancy so that specific treatment can be planned.

STRICTURE URETHRA

Stricture urethra is narrowing of Urethra (urinary passage from prostate to urethral opening on the penis. Our urologists have been regularly managing various types of Stricture Urethra including inflammatory traumatic or other origin.

URODYNAMICS

The highly automated Urodynamic machinery for cystometrogram and uroflometry at Adiva Urology centre assists in the all-inclusive management of neurogenic bladder and incontinence. Patients with SUI (stress Urinary Incontinence), bladder instability and Hypocontractile bladder are isolated and accordingly managed.

EXPERTS SPEAK ON HOW TO TACKLE URINARY LEAKAGE

Urinary incontinence is a fact of life for many people. It can happen as we get older, and for women during pregnancy or after birth, even as the result of a persistent cough.

What can you do to take control?
Here are some tips on how to take matters into your own hands -- and make living with urinary incontinence a lot easier.

Which Type of Urinary Incontinence Do You Have?
Urinary incontinence (UI) is the involuntary loss of urine and "it's a common condition" in men and women of all ages. The two main types of urinary incontinence are:
• Stress incontinence, which can cause leakage when you cough, sneeze, exercise, laugh, or strain to lift something heavy.
• Urge incontinence, which is an unexpected, sudden urge to urinate, one that's so strong it can be hard to reach the bathroom in time.
No matter which type of urinary incontinence you have, simple behavioral tips can help you deal day to day.

8 Quick Tips for Coping With Urinary Incontinence

1. Do Kegel Exercises. An important urinary incontinence treatment, Kegels are especially effective for women with mild symptoms. Kegels are simple to do: Simply clench and unclench your pelvic floor muscles. Which muscles are those? Next time you pee, stop the stream of urine midway. Presto! You've just found your pelvic floor muscles and done your first Kegel. But don't make a habit of stopping your urine when you pee, as it can actually weaken muscles. Do Kegels anywhere and everywhere else, though: while online, on hold, or in the car. Start by clenching your pelvic floor muscles for three seconds, then release for three. Repeat ten times. As you develop strength over time, aim to hold the muscles for ten seconds and release for ten.

2. Stick to a Pee Schedule. Don't feel like you need to go? Head to the bathroom anyway. Why? Timed urination helps keep the bladder empty.

3. Fill the Void. And don't be in a hurry when you're in the bathroom. Take your time in there and after you've finished urinating, relax a bit and then urinate again -- this practice, called double voiding, helps really empty the bladder.

4. Keep the Path Clear. Having accidents before you make it to the bathroom? It's time to clear your path of obstacles so you can get there faster. And then help yourself once you're there by wearing easy-to-release clothes -- think elastic waistbands and Velcro closures.

5. Consume less Caffeine. As much as you may love your cup of coffee, or crave a cola come 3 p.m., you're doing yourself no favor by drinking caffeine-rich beverages like coffee, tea, and carbonated drinks. To help control urinary incontinence, eliminate these diuretics -- or at least cut back.

6. Drink Up, But Not Too Much. Your body needs fluids, so be sure to drink enough to stay well hydrated. Drink about two quarts (eight cups) to keep your bladder and kidneys healthy.

7. Watch for Medication Side Effects. Talk with your physician to make sure you're not taking any prescription or over-the-counter drugs that could be making your urinary incontinence worse. If you are -- and need those medicines -- Comiter suggests you "stay close to home (near a bathroom) for a few hours after taking a diuretic" drug.

8. The Tampon Tip. Women can try wearing a tampon to help control leaks when they jog, run, dance or do other energetic activities. The tampon puts a bit of pressure on your urethra, helping to prevent leakage.

ERECTILE DYSFUNCTION

Andrology is the discipline of malfunctions of the Male Reproductive System, also referred to as "impotence" or "erectile dysfunction." Sexual Impotency or Erectile Dysfunction result from:

• DIABETES MELLITUS
• HYPERTENSION
• NEUROLOGICAL DISORDER
• PELVIC OR PERINEAL INJURIES
• SPINAL INJUREIES
• PSYCHOGENIC DISORDERS

At Adiva, facilities like Penile Doppler imaging and Pharmacological Penile Erection Induction, Vaccum Erection Devices are available. We also provide sage and confidential counseling sessions by experienced psychologists on our panel, In addition, an expertise for medical and surgical treatment for erectile dysfunction is also available including Penile Prosthesis.

MALE INFERTILITY

Recently, the number of infertile couples has been increasing. Male factors are equally responsible for the infertility in these couples. At Adiva speciality centre male infertility is explored thoroughly. Various diagnostic procedures Like Scrotal Doppler Ultrasound / Testicular FNAC / Vasogram are available. Our team has been regularly performing V TURED / Vasovasostom, TESA for managing these patients.

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