India's one of the leading Urology centre and No.1 Urology centre in Tamilnadu.
CARE & CURE & CONFIDENCE
Indira Nursing Home(INH), the brain work of Dr.P.shankar is one of the leading proctology centres in Tamilnadu. This hospital has a benchmark in the field of Laser Proctology, Introducing the latest Innovation and advanced Surgical Procedures for Piles, Fissure, Fistula and PNS(Pilonidal Sinus) in India.
INH Ensures the excellent treatment & the latest laser facilities in proctology. Where the new invention of laser technology has been introduced over a period of 16 Years. INH has done more than 25,000 Surgeries. And is one among the largest wide speciality centre in proctology.
Urinary Tract Infection
A) Burning Sensation when passing urine
B) Frequent urination
C) Pain or pressure in the lower abdomen
D) Dark / Cloudy Urine
E) Fever/ chills
2. Risk Factors
A) Obstruction in the urinary tract- stones/enlarged prostate
C) Postmenopausal women due to hormonal changes
D) Elderly men due to poor bladder emptying
E) Immunocompromised state
Urinary Tract Infection
A) Urine analysis
B) Urine culture
C) Imaging of urinary tract - Ultrasound
D) Cystoscopy in case of recurrent UTI
E) Rule out diabetes
C) Vaginal estrogens in postmenopausal women
Symptoms of urinary incontinence
SUI – Leakage of urine due to increase in abdominal pressure (e.g.) during coughing, sneezing ,Laughing, exercising or lifting weight.
Sudden intense urge to urinate followed by an involuntary loss of urine
Frequent or constant dribbling of urine due to a bladder that does not empty completely
More than one type of urinary incontinence.
Temporary incontinence can be caused by intake of alcohol, caffeine, carbonated drinks, sweetness, citrus fruits, heart and blood pressure medications etc.
Other causes are UTI, constipation, pregnancy, childbirth,menopause, hysterectomy, enlarged prostate, prostate cancer, obstruction, neurological disorders , multiple sclerosis, parkinson’s disease, stroke, spinal injury etc.
2. Bladder diary
3. PVR measurement
Depends on the type of incontinence:
a) Behavioural techniques 1) Bladder training 2) Double voiding 3) Scheduled toilet trips 4) Fluid and diet management
b) Pelvic floor exercises
c) Electrical stimulation
d) Medications eg. Anticholinergics
e) Medical devices 1) Urethral insert 2) Pessary 3) Scheduled toilet trips 4) Fluid and diet management
2) Ovarian causes in women
3) Salphingitis in women
1) Pain killers
2) Plenty of fluids
INDICATIONS FOR SURGERY 1) Persistent loin pain
2) Vomiting due to stone obstruction
3) Failure of stone progression
TREATMENT Laser Lithotripsy
1) Lower abdominal pain
2) Burning while passing urine
3) Interupted urine flow 4) Blood in urine / cloudy urine
CAUSES OF BLADDER STONES:
1) Prostate gland enlargement can obstruct the flow of urine, preventing complete emptying of the bladder
2) Neurogenic bladder – preventing bladder emptying
3) Medical devices – bladder catheters causes formation of mineral crystals which later become stones
1) Chronic bladder dysfunction
2) Urinary tract infection
3) Carcinoma bladder in long standing erosion due to bladder stone
1) X ray – some type of stones may not be visible on conventional X rays
3) CT – most sensitive test to identify small stones
1) Lithotripters / Laser lithotripsy
2) Surgical removal by making an incision in the bladder
Renal stones are formed in the kidneys. They most often occur in the age group of 20 – 40 yrs.
TYPES OF RENAL CALCULI
1) Calcium stones – oxalate, phosphate eg. Those who take diet rich in oxalates
2) Uric acid stones eg. Those with gout
3) Struvite – due to infection most commonly UTI. Eg. Potato chips, nuts, spinach
4) Cystine stones
1) Family history
2) Urinary tract abnormalities
3) Diet – high levels of protein, salt and sugar
1) Severe colicky pain
2) Vomiting2) Immobilization
3) Fever with rigors
2) Abdominal pain
3) Palpable mass is seen in ≤ 10 % of cases
Ultrasound / CT with contrast
MRI to evaluate tumor extension into IVC
Needle biopsy if mass < 3 cms.
1) Radical nephrectomy is the treatment of choice and depends on the stage of disease.
2) Immunotherapy – reserved for patients with a good prognosis.
3) Chemotherapy – for treating metastatic diseases
Signs & Symptoms:
1) Excessive growth of facial & body hair
2) Enlargement of penis in boys or clitoris in girls
3) Puberty earlier than usual 4) Enlargement of breast in male 5) Weight gain 6) Purple stretch marks on the abdomen. 7) Menstrual irregularities 8) Depression 9) High BP 10) High sugar
2) CT scan
3) MRI 4) Image guided FNAC of the mass
Bladder cancer is the abnormal growth of bladder cells and is a common cancer.
RISK FACTORS: 1) Using tobacco, especially smoking cigarettes
2) Having a family history of bladder cancer
3) Post chemoradiation
4) drinking water that has been treated with chlorine
5) Using urinary catheters for a long time.
6) Older age is a risk factor for most cancers. The chance of getting cancer increases as you get older
7) More common in men than women
1) Avoid smoking
2) Limit exposure to chemicals
3) Intake of plenty of fluids
4) Intake of plenty of fruits and vegetables
SIGNS AND SYMPTOMS:
1) Passing blood in urine
3) Pain and burning during urination
4) Poor urine stream
5) Difficulty in passing urine
6) Loss of weight
1) Superfical bladder tumour: Transurethral resection of bladder tumor or "TURBT."
2) INVASIVE BLADDER TUMOR
a) Ileal conduit
b) Orthotopic neobladder
c) Continent catheterizable pouch - A Form Of Neobladder
d) Radical cystectomy (open, laparoscopic, or robot assisted) combined with one of the three urinary diversion methods is the gold standard
3) METASTATIC TUMOR: Chemotherapy
It is a malignant growth found on the skin or in the tissues of the penis. 95% of penile cancers are squamous cell carcinomas.
1) INFECTIONS :
a) HIV infection – eight fold increase
b) HPV infection – contributes to 40 % of penile cancers
c) Genital warts
2) Hygiene and injury:
a) Poor hygiene
b) Smegma – a whitish substance that can accumulate beneath the foreskin and increase the risk of penile cancer.
c) Balanitis and penile injury – inflammation of the foreskin and the glans penis, increases risk. Allergic reactions to soaps, infection or diabetes can predispose.
3) Other causes – age more than 55 yrs; Lichen sclerosus; tobacco smoking, ultraviolet light increases risk of penile cancer.
1) HPV vaccine
2) Use of condoms – acting protective against HPV.
3) Good genital HYGIENE
4) Cessation of smoking
5) Circumcision during infancy or childhood.
6) Preventing phimosis and paraphimosis.
1) SURGERY: Amputation of the Penis – partial or total.
2) RADIATION THERAPY
Earlier the cancer is diagnosed, the better the prognosis.