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Prostate Problems

How are prostate problems characterized?

The prostate is a gland of the male genital system, which lies between the pubis and the rectum. It is about the size of a walnut (or chestnut) and surrounds the urethra, the canal that carries urine from the bladder outward. The prostate participates in the production of seminal fluid, which constitutes the bulk of sperm. The seminal vesicles also secrete part of the seminal fluid.

Several problems can affect the prostate. The most common are:

  • prostatitis, or inflammation of the prostate
  • benign prostatic hypertrophy or prostate adenoma, which is the enlargement of the prostate, which is very common in older men
  • prostate cancer

These three diseases may manifest as similar symptoms, but do not have the same consequences or the same treatments. In the case of genitourinary disorders (pain, increased urge to urinate and frequency, difficulty in urination, etc.), it is imperative to consult your urologist in Indirapuram.

What are the causes of prostate problems?

Although other more rare problems can affect the prostate, the most common are prostatitis, benign prostatic hypertrophy, and cancer.

Prostatitis is an inflammation of the prostate, often due to a bacterial infection. Most often, E. coli is the cause (more than 80% of cases).

The most common symptoms are:

  • fever associated with chills,
  • urinary symptoms such as burning when urinating,
  • too frequent urges to urinate
  • pain in the pubic area, in the urethra, penis, and sometimes the rectum,
  • general discomfort
  • muscle pain
  • a painful prostate during a digital rectal examination

Benign prostatic hyperplasia is a disease that affects about one in two men after 50 years. This “fat” prostate (volume> 20 ml) does not necessarily cause symptoms, and it is benign.

In some cases, however, the increase in the volume of the prostate can cause urinary disorders called obstructive (difficulty to urinate, empty the bladder, decrease in the strength of the jet) and/or irritative (frequent and urgent desires of urinating, pain during urination).

The discomfort felt may be mild, moderate or severe and it is the rectal examination that will help diagnose the adenoma.

Finally, prostate cancer is characterized by the presence of cancer cells in the prostate. In about 95% of cases, it is an adenocarcinoma, a malignant tumor of glandular cells.

What are the consequences of prostate problems?

When they cause symptoms, they are particularly troublesome: very frequent urges to urinate, difficulty urinating, emptying the bladder, pain, etc. It is therefore important to consult a urologist in Noida without delay.

Prostate pathologies are generally treated well, although prostate cancer, like all cancers, can be difficult to eradicate and is at risk of metastasis. Unfortunately, prostate cancer remains the 4th leading cause of cancer deaths. In general, however, these are cancers that evolve slowly and can be diagnosed early.

What are the solutions for prostate problems?

In cases of acute prostatitis, antibiotic treatment is required. One must remain vigilant because prostatitis can, in some cases, become chronic, causing a reappearance at different intervals of infections, pain or discomfort.

On the side of benign prostatic hypertrophy, the treatment aims to improve the quality of life and reduce symptoms by improving urine output.

Surgical treatment may also be proposed in case of failure of medical treatment (10 to 20% of cases) or immediately in case of severe discomfort or complications.

In the case of prostate cancer, several prostate cancer treatment in Delhi may be proposed, depending on the stage and extent of the tumor, the presence or absence of metastases, the type of cancer, etc. Total prostatectomy, consisting of removing the entire prostate, is often proposed.

Pains and Swelling of The Testicles

How to define pain and swelling of the testicles?

The testis is a complex organ, particularly sensitive to minor lesions, and extremely sensitive. Any testicle problem can cause immense pain.

Testicular pain or swelling of the testis are abnormal signs that require consultation with a doctor. The diagnosis cannot be done at home alone. The problem can be mild or sometimes very serious, even requiring the removal of the testicle.

The testicular pain is a scrotal pain, that is to say, that includes the entire scrotum. It is a pain that rises following the anatomical path of the various channels to reach the iliac fossa and even the lumbar fossa.

What are the causes of testicular pain and swelling?

The first diagnosis of testicular pain is testicular torsion: torsion of the spermatic cord containing blood vessels resulting in testicular ischemia and then necrosis (testicular death) if no treatment is given on time :

  • it is a brutal pain, intense, without triggering factor
  • it affects children and young adults and is exceptional in men over 30
  • it is accompanied by swelling and redness
  • the palpation is made impossible so much the pain is great
  • it requires rapid surgical exploration in order to untwist the spermatic cord. Once this step is over, the doctor fixes the testicle to avoid a recurrence.

Pain is considered to be testicular torsion until proven otherwise. Once again, it is necessary to consult a urologist in Ghaziabad as soon as possible.

Other possible causes of testicular pain and swelling are:

  • Orchiepididymitis: inflammation of an epididymis (or epididymitis) and inflammation of a testicle with fever and burning
  • Testicular trauma following a stroke in the testicles: it may be a scrotal hematoma, a contusion or even a “fracture” of the testicle
  • Testicular cancer (possible presence of mass, pain, and swelling)

Note that hydrocele, or accumulation of water around the testicle, causes sometimes impressive swelling of the entire scrotum. But there is most often no associated pain.

Sometimes pain and swelling do not have clear causes, but it is important to proceed by elimination and to oust other potential causes.

It is possible that the pains become chronic. It can then be:

  • varicocele: varicose dilatation (varicose veins) of the spermatic cord veins. The blood circuit is obstructed and the blood circulation slows down. As a result, the production of spermatozoa is reduced.
  • of the presence of cysts on the epididymis (we speak of spermatocele)

What are the consequences of pain and swelling of the testicles?

The pain and swelling of the testicles cause more or less discomfort, yet affect the sex life of the person affected. If these problems are poorly treated or not treated in time, the consequences can be dramatic: sterility, and even removal of a testicle (especially in case of testicular torsion not treated in time).

What are the solutions to relieve pain and swelling of the testicles?

The emergency consultation of a urologist in Vaishali is essential in case of pain and swelling of the testicles. The doctor may, depending on the case:

  • perform a scrotal ultrasound
  • perform surgery
  • propose to wear underwear providing special support, if necessary.

To prevent the occurrence of hydrocele, varicocele, or testicular problems, it is important to perform a regular self-examination.

Testicular cancer

Testicular cancer is one of the cancers that heals best since the cure rate approaches 100% (less than 1% mortality). This testicular cancer is a relatively rare cancer, but it is the most common form of cancer in young men and adolescents, between puberty and 45 years, with a mean age of diagnosis of 37 years. It affects about 1 in 20,000 men. This cancer is increasing steadily, by 2.5% per year between 1980 and 2005 in France. In Canada, the incidence rate of this testicular cancer has increased by about 80% in the last 25 years

Testicular cancers are classified into two broad categories: seminomas and nonseminomas (which include all other forms). Seminomas are more common in older men, while non-seminomas are more common in young men. The only way to confirm the type of cancer is to remove the testicle by surgery to analyze it. This operation is called total orchiectomy. It is done by an incision in the groin.

In almost all cases, only one testicle is reached. Very often, it is the discovery of a suspicious mass during the palpation of the testicles which sounds the alarm. Testicular cancer is cancer that responds well to treatment (95% of men heal). However, treatments, whether by surgery, radiotherapy or chemotherapy, carry risks of infertility.

When to consult

If a man feels a lump or swelling, usually painless and gradually enlarging on one of his testicles, a doctor should be consulted. A small percentage of testicular cancer is likely to lead to early pain. Benign tumors of the testis are rare, and that is why it is necessary to consult quickly.

know-your-kidney

Know Your Kidney

Kidney

The kidneys are organs that are part of the urinary tract. They ensure the filtration of blood by eliminating waste by the production of urine. They also maintain the body’s water and mineral content.

Anatomy of the kidneys

The nothings, two in number, are located in the back part of the abdomen at the last two ribs, on each side of the spine. The right kidney, located under the liver, is a little lower than the left, which lies below the spleen.

Each kidney, shaped like a bean, measures on average 12 cm long, 6 cm wide and 3 cm thick. They are surmounted by an adrenal gland, organ belonging to the endocrine system and not involved in the urinary function. They are each surrounded by an outer protective envelope, the fibrous capsule.

The inside of the kidneys is divided into three parts (from the outside to the inside):

  • The cortex, the outermost part. Pale color and about 1 cm thick, it covers the medulla.
  • The medulla, in the center, is reddish brown. It contains millions of filtration units, the nephrons. These structures are equipped with a glomerulus, a small sphere where the filtration of the blood and the elaboration of the urine take place. They also consist of tubules directly involved in the modification of the composition of the urine.
  • The chalices and the pelvis are collector cavities of urine. The calyxes receive urine from the nephrons which are then dumped into the pelvis. The urine then flows through the ureters to the bladder, where it will be stored before being evacuated.

The inner edge of the kidneys is marked by a notch, the renal hilum where the blood vessels and renal nerves and the ureters end. “Used” blood reaches the kidneys through the renal artery, which is an offshoot of the abdominal aorta. This renal artery then divides inside the kidney. The resulting blood is delivered to the inferior vena cava through the renal vein. The kidneys receive 1.2 liters of blood per minute, which is about a quarter of the total blood volume.

In the case of pathologies, only one kidney can fulfill the renal functions.

Physiology of the kidneys

The kidneys have four major functions:

  • The development of urine from the filtration of blood. When the blood reaches the kidneys through the renal artery, it passes through the nephrons where it is freed of certain substances. Waste (urea, uric acid or creatinine, and drug residues) and excess elements are eliminated in the urine. At the same time, this filtration makes it possible to control the water and ion content (sodium, potassium, calcium, etc.) of the blood and to keep it in equilibrium. In 24 hours, 150 to 180 liters of blood plasma is filtered to produce about 1 liter to 1.8 liters of urine. The urine is ultimately composed of water and solutes (sodium, potassium, urea, creatinine …). Certain substances are not present in a healthy patient in the urine (glucose, proteins, red blood cells, white blood cells, bile).
  • The secretion of renin, an enzyme that participates in the regulation of blood pressure.
  • The secretion of erythropoietin (EPO), a hormone that stimulates the formation of red blood cells in the bone marrow.
  • The transformation of vitamin D into its active form.

Diseases and diseases of the kidneys

Kidney stones (renal lithiasis): commonly known as “kidney stones”, they are hard crystals that form in the kidneys and can cause severe pain. In nearly 90% of cases, urinary stones from inside a kidney. Their size is very variable, ranging from a few millimeters to several centimeters in diameter. A calculus formed in the kidney and in transit to the bladder can easily block a ureter and cause severe pain. This is called renal colic.

Malformations:

Renal malrotation: Congenital abnormality that can affect only one kidney or both. During embryonic development, the kidney rises along the column to its final location and rotates. In the case of this pathology, the rotation is not done correctly. As a result, the pelvis, normally located on the inner edge of nothing, is found on its anterior face. The abnormality being benign, the renal function is intact.

Renal duplication: rare congenital anomaly, it corresponds to the presence of an extra kidney on one side of the body. This kidney is independent, with its own vascularization and it’s own a ureter that leads directly to the bladder or joins the ureter of the kidney on the same side.

Hydronephrosis: it is a dilation of the calices and the pelvis. This increase in the volume of these cavities is due to a narrowing or obstruction of the ureter (malformation, lithiasis …) that prevents urine from flowing.

Horseshoe kidney: malformation resulting from the union of the two kidneys, usually by their lower pole. This kidney is located lower than the normal kidneys and the ureters are not affected. This condition has no pathological consequence, it is usually highlighted by chance during a radiological examination.

Anomaly of renal function:

Acute and chronic renal failure: Gradual and irreversible deterioration of the kidneys’ ability to filter blood and excrete certain hormones. The products of metabolism and the excess water pass less and less into the urine and accumulate in the body. Chronic kidney failure results from complications of diabetes, hypertension or other diseases. Acute renal failure, on the other hand, occurs suddenly. It often occurs as a result of a reversible decrease in renal blood flow (dehydration, severe infection). Patients may benefit from hemodialysis using an artificial kidney.

Glomerulonephritis: inflammation or lesions of kidney glomeruli. The filtration of blood does not work properly, proteins and red blood cells are then found in the urine. Primary glomerulonephritis (only unaffected) is distinguished from secondary glomerulonephritis (a consequence of another disease). Generally, of unknown cause, it has been demonstrated that glomerulonephritis may, for example, appear following an infection, the taking of certain drugs (eg non-steroidal anti-inflammatory drugs such as ibuprofen) or a genetic predisposition.

infections

Pyelonephritis: infection of the kidneys by a bacterium. In most cases, it is Escherichia Coli, responsible for 75 to 90% of cystitis (urinary tract infection), which proliferates in the bladder and rises to the kidneys through the ureters. Women, especially pregnant women, are the most at risk. The symptoms are the same as for cystitis associated with fever and pain in the lower back. Treatment is by taking antibiotics.

Benign tumors

Cyst: A renal cyst is a pocket of fluid that forms in the kidneys. The most common are simple (or solitary) cysts. They cause no complications or symptoms. The vast majority is not cancerous, but some can disrupt the functioning of the organ and cause pain.

Polycystic disease: an inherited disease characterized by the development of a multitude of renal cysts. This condition can lead to increased blood pressure and kidney failure.

Malignant neoplasms 

Kidney cancer: It accounts for about 3% of cancers and affects twice as many men as women. Cancer appears when certain kidney cells transform, multiply in an exaggerated and uncontrolled way and form a malignant tumor. In the majority of cases, kidney cancer is detected incidentally during an abdominal examination.

Treatments and kidney prevention

Prevention. Protecting your kidneys is essential. Although it is impossible to completely prevent certain diseases, healthy lifestyle habits can nevertheless reduce the risks. In general, well hydrated (at least 2 liters per day) and control its salt intake (through diet and sports) are beneficial for kidney function.

Other more specific measures are recommended to reduce the risks or prevent recurrence of kidney stones.
In the case of kidney failure, the two main causes are diabetes (type 1 and 2) as well as high blood pressure. Good control of these diseases greatly reduces the risk of progression to a case of insufficiency. Other behaviors, such as avoiding alcohol, drug, and drug abuse, can keep the disease away.

Kidney cancer. The main risk factors are smoking, overweight or obesity, and non-dialysis treatment for more than three years. These conditions can promote the development of cancer.

Examinations of the kidneys

Laboratory tests: the determination of certain substances in the blood and urine allow evaluation of renal function. This is the case, for example, for creatinine, urea, and proteins. In the case of pyelonephritis, a cytobacteriological examination of the urine (ECBU) is prescribed to determine the germs involved in the infection and thus adapt the treatment.

Biopsy: an examination that involves taking a sample of the kidney with a needle. The removed piece is examined microscopically and/or biochemically for cancer.

imagery 

Ultrasound: an imaging technique that relies on the use of ultrasound to visualize the internal structure of an organ. The ultrasound of the urinary system allows visualizing the kidneys but also the ureters and the bladder. It is used to highlight, among other things, renal malformation, insufficiency, pyelonephritis (associated with ECBU) or renal calculus.

MRI (Magnetic Resonance Imaging): a diagnostic medical examination performed using a large cylindrical device in which a magnetic field and radio waves are produced. It provides very accurate images in all dimensions of the urinary tract in the case of an MRI of the abdominopelvic area. It is especially used to characterize a tumor or to make a diagnosis of cancer.

Intravenous Urography: A radiological examination that visualizes the entire urinary tract (kidneys, bladder, ureters, and urethra) after injecting an opaque X-ray product that concentrates in the urine. This technique can be used especially in cases of lithiasis or to compare the functioning of the kidneys.

Renal scintigraphy: This is an imaging technique that involves administering to the patient a radioactive tracer, which spreads in the kidneys. This test is used to measure the renal function of the kidneys, to visualize the morphology or to evaluate the sequelae of pyelonephritis.