Filter :
The prostate is a gland in the body that produces the fluid which carries sperm during ejaculation. It surrounds the urethra and bladder.
An enlarged prostate represents a prostate gland that has grown bigger than its normal size which is about 18-22 grams.
It is a very common condition and almost every male undergoes through a prostate enlargement as they age. The condition is also called as benign prostatic hyperplasia.
This is not a cancerous condition and does not increase the risk of developing a prostate cancer.
The actual cause of a prostatic enlargement remains unknown. Age is considered to be a risk factor leading to the prostatic enlargement. The process of aging leads to changes in the cellular structure of testicles (which has a role in growth of the prostate gland) and in the levels of testosterone in the body.
Males who have undergone testicle removal at a very young age due to some condition like a testicular cancer do not develop benign prostatic hyperplasia.
Similarly, when testicles are removed following development of a benign prostate enlargement, (doctor for enlarged prostate) the prostate shrinks in size.
Diagnosis may be done with a rectal examination to feel the prostate gland.
The treatment modality is usually based on the intensity and severity of the symptoms and their effects on the daily life of the patient.
In some cases, watchful waiting is suggested and patient is advised not undergo any treatments if the symptoms are not too bothersome. In certain cases, self-care, medicines or surgery may be required.
Prostate surgery may be recommended for people who have incontinence, blood in urine, retention of urine, recurrent infections, kidney damage or other bothersome conditions not responding to medicines.
Depending on the severity of the symptoms and the size and shape of prostate gland different procedures can be recommended. Transurethral resection of prostate or TURP is the most commonly performed procedure for a benign prostatic hyperplasia.
In this procedure, a scope is inserted through the penis and the prostate gland is removed.
Men who are diagnosed with prostatic hyperplasia since a long time and the symptoms are worsening over time, are at the risk of developing urinary tract infections, severe damage to Kidneys and presence of blood in urine.
A benign prostatic hyperplasia may recur even after undergoing a surgical procedure. One must contact the doctor in case of less urine output than normal, fever or chills, pain in the back or sides of abdomen or presence of blood in urine. In modern day, medical treatment can help reverse prostate enlargement when started at the right time.
If you have any urinary symptoms like increase in frequency, sudden compelling urge to pass urine, getting up more than once to visit the washroom, poor stream, straining to pass urine, or feeling of incomplete emptying of the bladder then you should visit a urologist near you and get a uroflowmetry test and ultrasound to treat this common problem in time.
Varicocele is a common cause of pain in the scrotum in men and often a cause of infertility or the inability to bear children in men. It is with these complaints the patient comes to a urologist.
But many times, the varicocele problem is detected incidentally through an ultrasound. Hence, a small percentage of cases who come to the Urologist show no symptoms.
Varicocele means that the veins which are taking blood from the testes to the heart get abnormally dilated because they have some valves which get damaged.
Due to this, the blood starts to collect in these veins. When the blood starts to collect in these veins, these veins become dilated and the blood flow back from the testes to the heart is impaired.
Since the blood persists in these veins, the temperature of the testes increases. The testes have been placed outside the body so that their temperature can remain about two to four degrees lower than the core temperature of the body as this is the temperature that is required for the optimal production of the sperms.
Most commonly what is found in these patients is that in the sperm parameters on semen analysis such as the motility of the sperms is impaired, which means that even though the sperms may be good in number, they are not able to move to the extent that they should be able to move to be able to fertilize the egg.
The most common symptom usually would be an impaired semen parameter which means that there will be some problem in the motility or the number or the shape of the sperms.
Also, there could be a pain in the scrotum which is usually a constant dragging pain. This pain increases or aggravates on standing for prolonged periods of time.
Usually when the patient gets up in the morning, there is no pain. Only when he is standing for prolonged periods, he would experience a discomfort or pain in the scrotum.
The third common symptom that the patient often notices is a swelling in the scrotum. He will find a wormy sort of a swelling, which means that he will feel that veins or the vascular structures around the testes appears to be dilated and enlarged.
The diagnosis is usually done through a clinical examination. When the patient comes to the Varicocele Enlargement doctor who checks the scrotum, he will find that there are dilated veins felt on examination of the scrotum.
This in medical science is called the ‘bag of worms’ feeling as if there are worms in a bag and you are kind of trying to feel them. To confirm the diagnosis a scrotal ultrasound is used. This is not a normal ultrasound, but a Doppler powered ultrasound.
Through a Doppler Ultrasound, the radiologist will be able to see the veins as engorged and there would be reversal of the flow of blood in these veins, which means that some blood will be going back from these veins into the testis.
So, based on the diameter of these veins, the radiologist will give a grade to the Varicocele which will also help the clinician to understand how severe the Varicocele is and how it should be best managed.
With regards to the clinical staging of the Varicocele, there are three grades of Varicocele.
So, these are the three grades of Varicocele on clinical examination and there are four grades of Varicocele on ultrasound, which are based on the diameter of these veins.
Usually grade one and two Varicocele can be managed or controlled with medicines. The medicines in the form of tablets can increase the strength of the veins by depositing calcium in the wall of the veins.
Hence, they stop the further deterioration or damage to the veins and try and control the situation.
However, if it is the grade three, Varicocele, where a surgery is required wherein the veins must be ligated so that the blood does not flow in them any further.
It is also important to understand that many times if there is pain or discomfort in the testis despite the grade not being very high and all other causes have been ruled out, urologist consider surgical treatment for these patients as well because surgical treatment is more effective in pain management.
Surgery is also indicated when the size of the testicle is shrinking.
Till few years back, a laparoscopic surgery was done and the root of the veins, from where the veins arise was ligated or tied which helped cure Varicocele.
But this laparoscopic surgery required the administration of general anaesthesia and was also an expensive surgery. Also, because of the other complications associated with this type of surgery such as hydrocele, recurrence and damage to the testis, the laparoscopic surgery became less in vogue.
The other treatment options used to be an inguinal approach to tying the veins in which a large cut was made just like for a hernia operation and the veins were exposed and individually tied.
And since this required a large scar of about three to four inches and because several complications were associated with this process, it became less common.
The recovery period after any sort of procedure is about a week because there may be some swelling around the area and the tied veins still have accumulated clotted blood in them.
The veins slowly shrink in size and the swelling recedes and disappears completely in about 4-6 weeks. However, the patient can resume his normal work in a couple of days after the procedure.
Hence, Varicocele management is simple in today’s time. If it’s a high-grade Varicocele, the suggested treatment is a sub-inguinal microscopic surgical repair. And if it is a low-grade Varicocele, the patient can be treated through medication.
For more details on Varicocele surgery and management, you can contact our experts from the Urology center at the CK Birla Hospital. Book an appointment on +91 124 4882200 to evaluate and provide customized treatment options based on your condition.
The percentage of men with breast cancer is extremely rare, compared to the prevalence among women. For men, the lifetime risk of being diagnosed with breast cancer is about 1 in 1,000, representing 0.4-1.2% of all male cancers.
In 2018, about 2,550 men are expected to be diagnosed with the disease, compared with 2 million news cases for women in 2018.
However, while the numbers are low, the risk remains real and should not be ignored. The “breasts” of an adult man are like the breasts of a girl before puberty. In men, the tissue doesn’t grow, but because it is still breast tissue, men can get breast cancer.
In Western countries, the age of onset in men is approximately 60-65 years, about 8 to 10 years later than in women, and that risk increases with age.
Screening procedures for women are well established, with recommendations for regular mammograms, fundraising and awareness events to finance research and publicize the importance of early diagnosis.
None of these events is aimed at men and this lack of readily available information means that most men are unaware that it could happen to them.
Men are also less likely to be suspicious of something abnormal in that area. Also, the small amount of breast tissue in men makes it harder to feel and so more difficult to spot a problem early.
Like those in women and most male breast cancers are detected when a man complains soreness and lump in nipples.
But men usually procrastinate going to the doctor until they have more severe symptoms, like bleeding from the nipple.
At that point, cancer may have already spread to another part of the body. Men also find it embarrassing to talk to a doctor about their breasts.
In 20-25% of men who develop breast cancer, there may be a genetic abnormality, a mutation of the gene Brca2. In other cases, certain risk factors may be identified.
If a close relative (male or female) has had breast cancer, the risk is higher and this risk increases if several close relatives are affected; if one of the affected parents was under 40; or if cancer has spread to both breasts.
Children whose fathers have breast cancer are also more likely to have the disease.
In addition, the risk is higher if the level of estrogen (female sex hormone) is significant, if the level of androgens (male hormone) is low as is the case for rare genetic diseases such as Klinefelter syndrome (a genetic disorder that affects men and is characterized by abnormalities in the genital tract).
Other risk factors are related to obesity, which increases the risk of breast cancer in women and could also increase the risk in men.
Fat cells turn androgens into estrogen, so men who have more fat cells have higher estrogen levels. A man who has had mumps in adulthood and has had inflammation of a testicle may also be at higher risk for this type of cancer.
The symptoms, diagnosis and management of breast cancer in men are largely identical to that in women.
In principle, men cannot undergo surgery that just removes the lump, because there is little tissue in the breast and the cancer is usually near the nipple.
Treatment options depend on the progress of cancer once it has been diagnosed. In general, treatment involves a mastectomy, an operation that involves removing the entire breast. Lymph nodes located nearby (e.g. under the arm) are also removed in case cancer has spread, followed by radiotherapy, chemotherapy or hormonal therapy.
Although the medical procedures are like those for women, the aftercare for men is very different. There is no discussion of breast reconstruction or any consideration of the emotional fallout post-cancer.
Yet the psychosocial impact on men is considerable. Support during and after treatment is crucial and much remains to be done in this area.
Here are some tips to help lower your odds of getting breast cancer:
Keep checking for any abnormalities/unusual changes in your breast from time to time. Consult our expert Breast cancer Doctors at The Breast Centre to help detect breast cancer in its early stage.
Diabetes has multiple long-term complications that develop gradually over a period of time. The longer a person is diabetic and lesser the control he has on his blood sugar, higher is the risk of complications.
High blood pressure or hypertension is a condition that almost every other individual we see around is affected with. It is also called a silent killer as it does not manifest symptoms but can lead to serious and life-threatening conditions like stroke and heart diseases.
Blood pressure has two components: systolic blood pressure and diastolic blood pressure. The systolic blood pressure represents the top number which is the pressure in the blood vessels when the heartbeats, the diastolic blood pressure or bottom number represents pressure in the blood vessels when the heart is resting or in between the beats. Optimal blood pressure is less than 120/80. Blood pressure lower than 90/60 mm HG is considered as low blood pressure, a pressure of 130/80 or higher is considered to be high blood pressure.
The positive aspect of blood pressure is that certain modifications in lifestyle can help in maintaining normal blood pressure and hence reduces the chances of developing conditions associated with the disease.
Women of all ages face the threat of coronary artery disease (CAD) commonly referred to as a “heart attack”. Recent data shows the overall prevalence of CAD is 6.2% in males and 10.8% in females. It commonly occurs at a later age in women, mostly in the 60’s while men have it at an earlier age. The female hormone, estrogen is “cardioprotective” and as its level in the body declines at menopause, the risk of CAD becomes higher. Overall, CAD is a leading cause of death in both men and women.
CAD is caused by plaque buildup in the walls of the arteries that supply blood to the heart (called coronary arteries). Plaque is made up of deposits of cholesterol and other substances in the artery. Plaque buildup cause narrowing inside the arteries over time, which could partially or totally block the blood flow and eventually lead to angina or heart attack respectively.
The most common symptom of heart attack is severe central chest pain. One challenge always remains, that symptom in women differs from those in men. They usually have subtle or vague discomfort or pressure over the chest. Sometimes women may not experience chest discomfort but may have pain or discomfort in one or both arms, the back, neck, jaw or stomach, shortness of breath, nausea and vomiting, lightheadedness or fatigue. Recognizing the signs early and seeking treatment promptly is of utmost importance.
Women generally suffer from obesity, high blood pressure; high cholesterol levels and has higher chances of suffering from CAD. The risk increases manifold with diabetes, smoking, mental stress, physical inactivity and menopause. Women <65yrs having family history of heart disease needs to pay more attention to these risk factors.
The golden rule to prevent heart disease is quit smoking, exercise regularly, eat healthy diet and maintains healthy body weight. Eat plenty of fruits and vegetables, lean meats, wholegrains. Eat less of salt, sugar, saturated fats, cholesterol and trans-fats, processed food. Regular brisk walk for 30-45 min per day for 5 days a week is good enough to stay fit. Regular check-ups are key in picking up heart problems at early stage. All healthy adults> 20 yrs should get their blood pressure checked once every two years, blood cholesterol levels checked once every 4-6 years, blood sugar levels checked once every 3 years.
To conclude CAD is no more a male disease, it equally affects female, in a more subtle form, with atypical manifestation, which tends to get ignored. Hence, recognizing symptoms early and seeking health support is of paramount importance. Regular exercise and eating healthy diet helps in maintaining healthy body weight eventually leading to decrease in heart problems.
Consult expert cardiologist in Gurgaon at the CK Birla Hospital to seek medical support and advice. Book an appointment today!
Vagina infections are common and almost every female in the world has been affected by some form of vaginal infection in her lifetime. The infection can be caused by various microorganisms like bacteria, virus, fungus, or parasite which might grow in the vagina or in the surrounding region. These infections can be treated very easily and quickly. It is important to initiate treatment as soon as an infection is detected to prevent other complications.
Some common symptoms of vaginal infection are white vaginal discharge which may be white, green, or yellow in colour with a peculiar odour, soreness and itching in and around the vaginal region, dyspareunia (pain during intercourse), dysuria (pain during urination), intermenstrual bleeding, formation of ulcers or warts around the vulval region are some of the common manifestations. Some form of vaginal discharge which is colourless, odourless coma and does not irritate all lead to itching around the vaginal region normal. The amount and colour of vaginal discharge may vary according to the time of menstrual cycle and age.
Products like soaps, body washes, vaginal douches can lead to changes in the pH level of vagina which might cause vaginal discharge.
Diagnosis can be formed by examination conducted externally, looking for signs of inflammation and discharge around the vagina. A per vaginal or per speculum examination may be required in certain cases to view the interior. Vaginal swab can help in getting a clearer picture of the infection. A urine sample can often suggest probability of a spreading infection from the urinary tract to the vagina.
Bacterial vaginosis, this is caused by an uncontrolled growth of a particular type of bacteria. It often remains asymptomatic and continues to be undiagnosed in many females. Some common symptoms are whitish vaginal discharge which is usually foul smelling, with itching and irritation. It is not a sexually transmitted infection, but a recent change in partner can increase the risk. Other important factors that can lead to this infection or increase the risk are using sprays, vaginal douching, inserting IUDs, using perfumes, and smoking. The infection is treated with the help of antibiotics. Some cases might require local application of gel or cream. It can lead to some complications if left untreated for a long period of time and interfere with pregnancy leading to frequent miscarriages, preterm labour or pelvic inflammatory disease.
Another common bacterial infection is Chlamydia. It is a sexually transmitted infection caused by chlamydia trachomatis. Most of the patients having Chlamydia infection remain asymptomatic. Those presenting with symptoms can have some form of vaginal discharge, bleeding, bleeding and pain during intercourse and urination. Chlamydia is treated with antibiotics. In this case, diagnosis and treatment of the partner is also important. A patient may be advised to take a re- examination within 3 to 6 months of completing the course of treatment to check if the patient has been free from infection completely or there are chances of a re- infection. It can lead to complications like pelvic inflammatory disease and might lead to preterm birth.
Genital herpes is caused by herpes simplex virus. It is a sexually transmitted infection, not everybody affected with this condition has symptoms, but if present, it usually leads to painful blister formation around the genitals. The patient might develop fever, headache and a general feeling of sickness. Once infected, the virus remains in the body, there is no cure for the condition. The symptoms are not evident all the time and subside for a certain period of time just to recur later on. Any factor that leads to triggering of the virus can flare up the inspection; stress, smoking, illness, and alcohol may become cause o flaring up of the infection. Antivirus can be taken, but the infection will not get eradicated completely from the body. Medicines can be given to control the symptoms and reduce the number of flair ups and complications.
Genital warts are also sexually transmitted diseases caused by human papilloma virus. It presents as small growth in the vulval, cervical, vaginal and anal region. The warts can be itchy and may have painful bleeding. They may subside on their own within a few months. Creams, ointment, cryotherapy, or electrocautery can be done to treat the warts. The infection, however, remains in the body.
Gonorrhea is caused by the bacteria Neisseria gonorrhoeae. This is a sexually transmitted infection. Almost 50% of the women affected with Gonorrhea do not develop any symptoms. In case one presents with symptoms, they usually appear within the first 10 days of being infected. Amount of vaginal discharge in Gonorrhea is usually higher than normal, pain and discomfort around the lower abdomen, pain during urination and intermenstrual spotting can be common in this condition. Treatment usually consists of antibiotics. Re-examination may be advised after a week of finishing the treatment to ensure that the infection has cured completely. As the condition spreads through sexual contact it is important to inform the current or recent sexual partner about it who may be required to be tested and treated accordingly.
Vaginal thrush, also called as, Candidiasis is caused by candida albicans. Most of the women wo have this condition are asymptomatic. Some common symptoms are itching, irritation, and soreness around the vulva region. Thick cottage cheese like vaginal discharge is a common presentation of vaginal thrush. Pain during intercourse and urination are common. Common triggers for trash are usage of certain types of antibiotics, pregnancy, and diabetes. Certain types of soaps, shower gels, feminine sprays and washers, and wearing extremely tight undergarments can increase the chances of developing a thrush. This is not a sexually transmitted infection, but intercourse can act as a trigger for the condition. Fungal tablets, creams or pessaries may be advised for treatment of this infection.
Trichomoniasis is developed by a parasite called Trichomonas vaginalis. It is a sexually transmitted infection. Symptoms can be yellow coloured frothy discharge, with a foul smell. Itching and soreness are common in this condition. Antibiotics are usually the preferred line of treatment. Partners need to be treated even if they remain asymptomatic to prevent chances of re- infection.
Prevention strategies include using condoms to prevent spread of infection from one person to another, avoiding strong soaps, feminine hygiene products, washing of vagina too aggressively can lead to disruption of the normal flora of the vagina and hence make it more prone to infections.
Back pain during Pregnancy is very common, especially in the second half of pregnancy. Some common causes of back pain during pregnancy are as follows:
Back pain resulting from pregnancy usually subsides after delivery. Certain steps can be taken to relieve back pain to some extent:
Treatment might consist of some pain killers or muscle relaxants. One should seek medical treatment in case of severe pain, cramps, difficulty in urination or feeling of needle like pain in the extremities.
Consult Dr. Astha Dayal, expert obstetrician in Gurgaon at the CK Birla Hospital to learn more about this condition and possible treatment. Book an appointment today!
A second time pregnant woman was diagnosed with isolated umbilical vein varix at 31 weeks of gestation. Isolated Umbilical vein varix is a rare anomaly diagnosed on ultrasonography which has been reported to be associated with fetal anomalies and intrauterine fetal death but inconsistently. Since the cause of this variation is unknown, the consulting Obstetrician and Gynaecologist recommended the patient to get a thorough evaluation done for associated fetal anomalies. She also recommended a close follow up with regular doppler as intrauterine demise is known to be caused in cases of umbilical vein varix.
The couple had a non-consanguineous marriage and had conceived the baby spontaneously. She had a history of caesarean delivery 7 years ago for placental abruption with gestational hypertension. In this pregnancy, she had a normal detailed anomaly scan, screen negative for quadruple marker and had normal fetal echocardiography. She was on regular aspirin from second trimester onwards as she had a history of high BP and placental abruption in the previous pregnancy.
At 31 weeks of gestation, the ultrasound scan showed a well-defined cystic lesion in the upper abdomen which was seen to communicate with the umbilical vein suggestive of intraabdominal umbilical vein varix. Doppler colour flow imaging of both uterine arteries, umbilical artery, middle cerebral artery and ductus venosus were within normal limits. Amniotic fluid index was also within normal limits.
The patient was counselled in length about the uncertainty of this finding and the associated risk of still birth and fetal anomalies. Regular follow up scans were done to monitor the size of the umbilical vein and rule out complications like turbulence, thrombosis and rupture. Weekly follow up dopplers thereafter showed no change in the size or appearance of umbilical vein. A satisfactory interval fetal growth was also appreciated.
At 37 weeks 3 days gestation, an elective caesarean section was performed in view of poor Bishop’s score (also known as Pelvic Score, the most commonly used method to rate the readiness of the cervix for induction of labour). The woman delivered a healthy appropriately grown male baby of 2.8kg and the baby also showed no clinical signs of abnormalities.
