Diseases Urological types of diseases

Diseases

Urinary Tract Infection


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.

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, pelvis, or penis Pain circumstances: can occur during sexual intercourse or during urination.

Urinary: bladder discomfort, bladder distention, bladder spasm, cloudy urine, dark urine, dribbling after urination, excessive urination at night, foul smelling urine, frequent urination, inability to control urine, leaking of urine, persistent urge to urinate, sense of incomplete bladder emptying, or blood in urine Whole body: fatigue, fever, or malaise.

Also common: burning sensation, cramping, irritability, recurrent infection, stinging sensation, tenderness, or vaginal irritation.

Diagnosis:

  1. CBC/RFT/RBS/Urine culture
  2. USG-KUB
  3. CECT-KUB-if suspected kidney infection

Treatment:

  1. Mostly medical therapy with culture sensitive antibiotics for 5-7 days and upto 3 weeks for kidney infections.
  2. Self-treatment without urine culture guidance should be avoided as it leads to bacterial resistance
  3. Treatment of cause of infection like urinary tract obstruction or stone disease is mandatory for recurrent infections.

Urinary Incontinence


Urinary incontinence (UI), also known as involuntary urination, is any leakage of urine. It is a common and distressing problem, which may have a large impact on quality of life. Urinary incontinence is often a result of an underlying medical condition but is under-reported to medical practitioners.[ Enuresis is often used to refer to urinary incontinence primarily in children, such as nocturnal enuresis (bed wetting).

There are four main types of incontinence:

  1. Urge incontinence due to an overactive bladder.
  2. Stress incontinence due to poor closure of the bladder.
  3. Overflow incontinence due to either poor bladder contraction or blockage of the urethra.
  4. Functional incontinence due to medications or health problems making it difficult to reach the bathroom.

Cause:

  1. Polyuria (excessive urine production) of which, in turn, the most frequent causes are: uncontrolled diabetes mellitus, primary polydipsia (excessive fluid drinking), central diabetes insipidus and nephrogenic diabetes insipidus. Polyuria generally causes urinary urgency and frequency, but doesn't necessarily lead to incontinence.
  2. Enlarged prostate is the most common cause of incontinence in men after the age of 40; sometimes prostate cancer may also be associated with urinary incontinence. Moreover, drugs or radiation used to treat prostate cancer can also cause incontinence.
  3. Disorders like multiple sclerosis, spina bifida, Parkinson's disease, strokes and spinal cord injury can all interfere with nerve function of the bladder.
  4. Urinary incontinence is a likely outcome following a radical prostatectomy procedure.
  5. About 33% of all women experience UI after giving birth; women who deliver vaginally are about twice as likely to have urinary incontinence as women who give birth via a cesarean.

Diagnosis:

  1. Stress test – the patient relaxes, then coughs vigorously as the doctor watches for loss of urine.

  2. Urinalysis – urine is tested for evidence of infection, urinary stones, or other contributing causes.

  3. Blood tests – blood is taken, sent to a laboratory, and examined for substances related to causes of incontinence.
  4. Ultrasound – sound waves are used to visualize the kidneys, ureters, bladder, and urethra.

  5. Cystoscopy – a thin tube with a tiny camera is inserted in the urethra and used to see the inside of the urethra and bladder.
  6. Urodynamics – various techniques measure pressure in the bladder and the flow of urine.

Treatment:

  1. Exercise: Pelvic floor muscle training.
  2. Medications: for mild incontinence.
  3. Devices: urine collecting systems for men.
  4. Surgery: Artificial urinary sphincter for Men.
  5. Surgery: Mid Urethral Slings for females.

Kidney Stone


Also called: nephrolithiasis.

Kidney stones are hard deposits of minerals and acid salts that stick together in concentrated urine. They can be painful when passing through the urinary tract, but usually don't cause permanent damage.The most common symptom is severe pain, usually in the side of the abdomen, that's often associated with nausea.Treatment includes pain relievers and drinking lots of water to help pass the stone. Medical procedures may be needed to remove or break up larger stones.

Symptoms:

  1. The most common symptom is severe pain, usually in the side of the abdomen, that's often associated with nausea.
  2. People may experience:
    1. Pain areas: in the back or side part of the body
    2. Pain types: can be severe, sharp, or sudden in the abdomen
    3. Pain circumstances: can occur during urination
    4. Gastrointestinal: nausea or vomiting
    5. Urinary: blood in urine or frequent urination
    6. Also common: sweating

Diagnosis:

Lab tests or imaging often required (CBC RFT RBS Urine C/S, USG KUB NCCT KUB)

Treatment:

  • Medications:
    1. Tamsulosin (@Blockers): Relaxes Urinary tract to ease passage of stone
    2. Nonsteroidal anti-Inflammatory drug: Diclofenac/ Ketorolac: Relieves pain, decreases inflammation, and reduces fever.
  • Surgical procedure:
    1. Extracorporeal shockwave therapy: Using shock waves to break up kidney stones and gallstones so they pass more easily.
    2. Ureteroscopic stone removal: Using a small camera inserted into the urethra to remove a kidney stone.
    3. Laser lithotripsy: Using heat from a laser to break up and remove stones in the kidney, gallbladder, and urinary tract.
  • Specialists:
    1. Emergency medicine doctor: Treats patients in the emergency department for relief of symptoms
    2. Urologist: Final treatment of stone Kidney stone.
Note:

The information you see describes what usually happens with a medical condition, but doesn't apply to everyone. This information isn't medical advice, so make sure to contact a healthcare provider if you have a medical problem. If you think you may have a medical emergency, call your doctor or a emergency number immediately.


Erectile Dysfunction


Erectile dysfunction (ED) or impotence is sexual dysfunction characterized by the inability to develop or maintain an erection of the penis during sexual activity in humans.


A penile erection is the hydraulic effect of blood entering and being retained in sponge-like bodies within the penis. The process is most often initiated as a result of sexual arousal, when signals are transmitted from the brain to nerves in the penis. The most important organic causes of impotence are cardiovascular disease and diabetes, neurological problems (for example, trauma from prostatectomy surgery), hormonal insufficiencies (hypogonadism) and drug side effects.

Psychological impotence is where erection or penetration fails due to thoughts or feelings (psychological reasons) rather than physical impossibility; this is somewhat less frequent but can often be helped. Notably in psychological impotence, there is a strong response to placebo treatment. Erectile dysfunction can have severe psychological consequences as it can be tied to relationship difficulties and masculine self-image.

Besides treating the underlying causes such as potassium deficiency or arsenic contamination of drinking water, the first line treatment of erectile dysfunction consists of a trial of PDE5 inhibitor drugs (the first of which was sildenafil or Viagra). In some cases, treatment can involve prostaglandin tablets in the urethra, injections into the penis, a penile prosthesis, a penis pump or vascular reconstructive surgery.

Cause:

  1. Drugs (anti-depressants (SSRIs) and nicotine are most common)
  2. Neurogenic disorders
  3. Cavernosal disorders (Peyronie's disease)
  4. Psychological causes: performance anxiety, stress, and mental disorders
  5. Aging. It is four times more common in men aged in their 60s than those in their 40s.
  6. Kidney failure
  7. Diseases such as diabetes mellitus and multiple sclerosis (MS).
  8. Lifestyle: Smoking causes impotence because it promotes arterial narrowing.
  9. Pelvic Surgery
  10. Prolonged bicycling due to both neurological and vascular problems due to compression.
  11. PIED (Pornography Induces Erectile Dysfunction) common in young males due to excess exposure to sexually explicit content. No organic defect, mostly psychological.

Diagnosis:

Involves examination and evaluation by experienced urologist


Treatment:

  • Counselling and behavioural therapy.
  • Medical management.
  • Surgical treatment.


Benign Prostatic Hyperplasia


Also called: BPH

With this condition, the urinary stream may be weak, or stop and start. In some cases, it can lead to infection, bladder stones, and reduced kidney function. This type of prostate enlargement isn't thought to be a precursor to prostate cancer.


Cause:

  1. Age: associated prostate gland enlargement that can cause urination difficulty
  2. Frequency: Very common
  3. Ages affected: 50 and above

Symptoms:

  1. Urinary: dribbling after urination, excessive urination at night, frequent urination, sense of incomplete bladder emptying, urge to urinate and leaking, or weak urinary stream.
  2. Also common: incontinence or sexual dysfunction.

Treatment:

  • include medications that relax the bladder or shrink the prostate, surgery, and minimally invasive surgery.
  • Medications:
    1. include medications that relax the bladder or shrink the prostate, surgery, and minimally invasive surgery.
    2. @ Blockers: Tamsulosin/ Alfuzosin /Silodosin
    3. 5@Reductase Inhibitor: Finasteride/ Dutasteride
    4. PDE5 Inhibitors: Tadalafil
    5. Ant muscarinic: Solifinacin/ Darifinacin/ Toterodine/ Trospium Chloride
  • Surgical Treatment:
    1. TURP/BNI: Endoscopic surgical removal of Prostate
      Usual hospital stay 2-3 days
      Duration of catheter 1-2 days

    2. Laser Prostatectomy: Specially indicated for large prostates and elderly patients and patients on blood thinners.
      Relatively shorter stay in hospital with lesser blood loss.

Note:

The information you see describes what usually happens with a medical condition, but doesn't apply to everyone. This information isn't medical advice, so make sure to contact a healthcare provider if you have a medical problem. If you think you may have a medical emergency, call your doctor or a emergency number immediately.


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