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RG Marathon Championship 2022


What Causes Kidney Stones?

The basic cause of kidney stone occurrence is unknown, but wrong food habits and inadequate fluid intake are to be blamed. Other conditions such as urinary tract infection, gout, arthritis, hypercalciuria (increased calcium levels in urine), enlarged prostate, thyroid disorder, etc are also known to cause urinary stones.

What Are The Symptoms Of Kidney Stones?

Symptoms constitute problems with the normal urinary process including discomfort, pain and irritability. When the stone obstructs the urine flow, the ureter dilates and stretches causing muscle spasms giving rise to immense gripping pain (renal colic); felt in flank, lower abdomen, groin or leg of affected side. Some stones are called ‘silent’ as they cause no pain. Other kidney stone symptoms include blood in urine (hematuria), increased frequency of urination, fever/chills, nausea/vomiting, pain/burning during urination etc.

Who Have Greater Tendency Towards Kidney Stones?

  • Those who stay in the hot environmental conditions, such as tropical areas.
  • Positive family history of stone disease in first blood relation (25%).
  • Decreased fluid intake, which reduces urine output, and forms supersaturated urine.

Why Do Stones Form?

Common causes of stone formation are:

  • Supersaturation of urine by decreased intake of water and/or hot environmental conditions leading to loss of body fluid by perspiration, and in breathing.
  • Urine infection where crystals deposit on and around the infection causing organism, and the stone grows over the period in the supersaturated urine.
  • Diet rich in oxalates, uric acid.
  • Functional or structural obstruction of the urinary system can precipitate the stone formation, like Pelvi-Ureteric Junction (PUJ) obstruction, Ectopic kidney etc.

Does Water Help In Flushing Out The Stones?

Yes but not all stones. Small stones of 3-6 mm can be passed out with the increased intake of water.

What Should I Do If I Have Passed A Stone In Urine?

If you find a stone, take it to your doctor for analysis. The type of stone you have, will determine the diet and prevention programme. You may need additional tests to ensure that new stones do not form in future.

Is There Any Damage To The Kidney Or Other Organs During Lithotripsy (ESWL)?

There is no damage to other organs as the shock waves are effective on the focused point at the junction of solid and liquid, which is stone and urine respectively.

Are Kidney Stones And Gallstones Related?

No there is no known link between the two. They are formed in different areas of the body under different systems.

What Should Be Done In Pregnant Females With Kidney Stone?

Stones during pregnancy demand conservative treatment. Surgery, if required may be done – ureteric stenting/PCNL, but only during the first half of the pregnancy term. ESWL is absolutely contraindicated.

What Is Benign Prostatic Hyperplasia?

Prostate gland is a walnut sized male reproductive gland located in front of rectum, at the base of urinary bladder, surrounding the urethra. In a normal adult, the prostate gland weighs around 20 grams. The size of the prostate gland increases slowly with age. This is known as benign prostatic hyperplasia (BPH) or lower urinary tract symptoms (LUTS). This condition is very common in elderly males over 50 years of age. Enlarged prostate affects urination, ejaculation and sometimes defecation.

What Are The Symptoms Of BPH?

Symptoms of BPH may include frequency of urination, urgency to urinate, straining, hesitancy while urination (weak stream), urging even after urination, burning/pain during urination (dysuria), dribbling after voiding urine, some amount of blood in urine (hematuria), frequency of urination especially at night (nocturia), and/or uncontrolled outflow of urine. The early symptoms of benign prostatic hyperplasia and prostate cancer are nearly the same.

Are There Any Medicines That I Can Take?

Medications play a role in case of moderate to severe symptoms. Two classes of medicines are given, alpha-adrenergic blockers and 5-alpha-reductase inhibitors, either alone or in combination, which help in shrinking the prostate and helping it to relax. Medications result in symptom relief and slow progress of the disease. However, the effect ceases when the medication is stopped. The patient has to continue the medicines throughout life even if urination becomes normal.

Does Bph Imply Prostate Cancer?

No. BPH is non-cancerous enlargement and it does not even increase the risk for prostate cancer.

What Is HoLEP?

Holmium Laser Enucleation of Prostate (HoLEP) is used in the management of enlarged prostate. In this, Holmium laser is used to remove the obstructive tissue and also to seal the blood vessels.

In this procedure, a resectoscope is inserted into the urethra through penis. Then a 550 micron fibre attached to the 100 watt Holmium laser machine is passed through it, which enucleates the excessive prostatic tissue. The enucleated gland is then pushed into the bladder, which is then shred into smaller pieces and sucked out using a device called Morcellator. The procedure takes around 15-90 minutes, depending upon the size of the prostate gland. HoLEP is almost bloodless as the laser beam seals the blood vessels also. At the end of the surgery, a catheter is inserted to keep the bladder empty. The catheter is usually kept for 24–48 hours. After the catheter removal, patient is discharged.

What Is The Maximum Size Of Prostate Treatable Through HoLEP?

Size is not the limiting factor for HoLEP, the largest gland enucleated at RG till date is 424 grams. HoLEP can effectively treat the largest of glands with minimal morbidity. It completely removes the prostate lobes with immediate resolution of the obstruction.

Is HoLEP Safe In Cardiac Patients?

HoLEP technique can be used safely in BPH patients suffering from hypertension, diabetes, cardiac problems, using cardiac pacemakers, or those in whom open surgery cannot be performed due to high risk of complications. This is a safe procedure.

What Type Of Doctor Should I Visit For Prostate Cancer Screening?

Screening for prostate cancer is a simple procedure. One may begin with a visit to the urologist. Urologist will be able to help you learn more about the screening process.

How Do I Know Which Specialists To See To Treat Prostate Cancer?

Urologists, radiation oncologists and medical oncologists all play a vital role in the treatment of prostate cancer.

How Is Erectile Dysfunction Treated?

The treatment depends on the cause. Get yourself checked for medical problems and medicines that might cause ED. Medications may help with erectile dysfunction, some of which may be injected into your penis. Other medicines are taken by mouth. Not everyone can use these medicines. Your doctor will help you decide if you can try them.

What Is Urinary Incontinence?

Urinary incontinence is the inability to hold urine leading to involuntary loss of urine. The urine loss can range from slight leakage of urine to severe frequent wetting. This condition severely affects quality of life by interfering with work, travel, social recreation and sexual activities.

Is The Incidence Of Urinary Incontinence Similar In Men And Women?

No, women experience incontinence twice more often than men. Pregnancy, child-birth, menopause, and short female urinary tract account for this difference. However, both women and men can become incontinent from stroke, multiple sclerosis, and old age.

What Are The Risk Factors For Urinary Incontinence?

Risk factors include:

  • Pregnancy
  • Childbirth
  • Obesity
  • Menopause
  • Cigarette smoking
  • Prostate enlargement
  • Uterus removal
  • Radiation to pelvis
  • Diabetes
  • Parkinson’s disease
  • Back injury
  • Cerebral vascular accident

Is There Any Treatment Of Urinary Incontinence?

Most types of urinary incontinence can be effectively treated. In some patients, incontinence is often improved by weight loss. Smokers who have a chronic cough have fewer problems when they stop smoking (coughing). Some common drugs can also aggravate the situation.

What Are The Treatment Options For Stress Incontinence?

In these patients, pelvic floor exercises (e.g. Kegel exercises) can be effective. These exercises strengthen both peri-urethral and pelvic floor muscles. However, these must be performed frequently throughout the day and continued for long-term effect. Certain drugs are also available for the management of stress incontinence. Oestrogen replacement therapy can also be very helpful, particularly in postmenopausal women. There are several surgical procedures, which may also prove helpful.

What Are Gallstones?

When we eat fatty food the gall bladder squeezes the bile through the common bile duct into the intestine. When cholesterol or fat concentration increases in the bile juice, the juice precipitates as stone.

What Are The Symptoms Of Gallstones?

  • Gaseous distension or bloating (gas formation).
  • Flatulent dyspepsia (acidity).
  • Acute upper abdominal pain along with vomiting and fever. This occurs when a gall stone gets impacted at the neck of the GB.
  • Jaundice – Occurs when a gall stone drops down from the GB into the common bile duct resulting in obstruction to the flow of bile.
  • Pancreatitis – Occurs when the slipped gall stone in the common bile duct irritates the duct of the pancreas gland leading to inflammation of the gland. This is an emergency situation and patient requires admission into the ICU most times.

Is Obesity A Risk Factor For Gallstones?

Being even moderately overweight increases the risk for developing gallstones. Obesity is a major risk factor for gallstones, especially in women.

Is Weight–loss Dieting A Risk Factor For Gallstones?

As the body metabolizes fat during prolonged fasting and rapid weight loss, such as “crash diets”, it can cause gallstones.

What Is The Treatment For Gallstones?

Silent gallstones are usually left alone and sometimes they disappear on their own. Symptomatic gallstones are usually treated. The most common treatment is surgery to remove the gallbladder. This operation is called a cholecystectomy. This is done through laparoscopy. In other cases, drugs are used to dissolve the gallstones. Your doctor can help determine which option is best for you.