Q.What is Urology?
Answer
Urology is the study of diseases of the urinary tract and the genital organs of the male. It includes the medical and surgical care of patients of all ages and both sexes. Laparoscopy is the ability to use an instrument called a laparoscope, a sophisticated rod lens often connected to a camera system, to inspect the inner areas of the body cavities. Using recent innovations, surgeons are able to create working spaces where there are no natural ones.
Q.Why do stones form in urine? How to prevent them ?
Answer
Urine contains many salts. When the salt concentration in urine is saturated by increased intake or by decreased water content in urine they start sedimenting and subsequently become stones. To quote few such salts are, calcium, oxalate, uric acid, phosphate, etc. To prevent stone formation, take plenty of oral fluid and reduce dietary intake of food rich in above salts such as tomato, tea, juicy fruits, mutton, egg yellow, cabbage & milk products. Take more citrate (Potassium citrate) solution.
Q. Can stone in kidney removed without surgery ?
Answer
Yes upto 4-5 mm, by forceful hydration either orally or by intravenous fluids, stone can be passed off. Dissolving stone by medicine is not possible. Stones can be disintegrated without operation by shock waves & ultrasonic waves and the powdered stones pass out in urine.
Q. What are the latest techniques of treating kidney stone ?
Answer
Apart from open operation and removal, stones can also be treated in suitable cases by following methods:
- Percutaneous nephrolithotomy (PCNL). Removal through small puncture over the kidney.
- Basketng of stones in ureter (tube from kidney to urinary bladder), by endoscopy.
- The above can be aided by a device called ureteroscope.
- Cystoscopy and lithotripsy - endoscopic visualisation and crushing and evacuating bladder stones.
- Extracorporeal Shock Wave Lithotripsy (ESWL). Shattering stone by bombarding with ultrasound shock waves.
- Lithoclast - using airwaves.
- LASER has also been used for stone crushing.
Q. Can stone in kidney removed without surgery ?
Answer
Yes upto 4-5 mm, by forceful hydration either orally or by intravenous fluids, stone can be passed off. Dissolving stone by medicine is not possible. Stones can be disintegrated without operation by shock waves & ultrasonic waves and the powdered stones pass out in urine.
Q.Can kidney stone recur?
Answer
Yes, there is 10% chance in 5 years time
Q.How to avoid stone recurrence?
Answer
Adequate fluid intake and change in diet according to the previous stone analysis will reduce the chance of another stone.
Q.Should I have to avoid certain foodstuffs?
Answer
You do not need to avoid anything completely.Diet need to be modified according to your stone composition done by previous stone analysis.
Is Milk should be avoided completely for stone disease?
Answer
No need, you may the daily required amount.
Q. Why does prostate enlarge and what are the usual problems due to it ?
Answer
Prostate gland enlarges as age advances, from 45 to 65 years. This is due to influence of harmones and cell growth response. When the gland enlarges the flow of urine becomes thin, one has to strain more to pass urine. There will be increased frequency, urge and incomplete sensation of emptying. Occassionally blood may be passed in the urine.
Q. Can prostate enlargement be treated with medicines and what are present methods treatment ?
Answer
Yes, presently drugs are available to reduce the size of the prostate as well as to increase flow of urine when the enlargement is mild to moderate. In large glands Endoscopic methods of prostate resection is available by Electro cautery, LASER HOLEP & DIODE, Thermal and Ultrasound TURP. Open surgery is rarely done for very large glands (for glands weighing more than 100 gms).
Q.Is laser treatment indicated for all prostate surgery?
Answer
No, it is indicated only for very large prostate, people taking anti coagulant and high risk patients. It is very expensive and studies are ongoing. Still the gold standard is TURP.
Q.Is laser treatment indicated for all prostate surgery?
Answer
No, it is indicated only for very large prostate, people taking anti coagulant and high risk patients. It is very expensive and studies are ongoing. Still the gold standard is TURP.
Q.How long should I take medicine for BPH (Benign Prostatic hyperplasia)?
Answer
Prostate gland continues to increase in size until the age of 70, so it is advisable to continue taking the tablet until you are symptomatic.
Can I develop prostate cancer after TURP (Transurethral resection of prostate)?
Answer
Yes, TURP involves only removing of prostate tissue that is obstructing the urine passage. After TURP there is thin rim of prostate tissue from which prostate cancer can occur.
Q.Can BPH recur?
Answer
Yes. It depends on age of the patient and genetic risk.
Q.Will TURP (Transurethral Resection Prostate) affect sexual function?
Answer
Risk of erectile dysfunction is very minimal and it may be temporary but you will have retrograde ejaculation.
Q.What is retrograde ejaculation?
Answer
During orgasm seminal fluid will not come out instead it goes to bladder and you pass it out when you pass urine next time but you have normal sexual function and pleasure in other words it is called dry ejaculation.
Q. What is a Hernia?
Answer
A hernia occurs when the intestine pushes it's way out through an opening in the wall of the abdomen. It usually appears as a swelling in the groin. This swelling becomes more prominent whenever the child strains or cries.
Q. Why does it occur in children?
Answer
A hernia occurs when the intestine pushes it's way out through an opening in the wall of the abdomen. It usually appears as a swelling in the groin. This swelling becomes more prominent whenever the child strains or cries.
Q. Does hernia occur in girls too?
Answer
Yes, hernias can also occur in girls, though this is less common than in boys. Though there is no testes to come down in girls, the connection exists and follows the same timetable to closure.
Q. How do I know if my child has a hernia?
Answer
A hernia usually appears as a swelling in the groin. This swelling gets more prominent and larger whenever the child cries or strains. It is usually painless. Occasionally, the intestine gets stuck and cannot return to the abdomen. When this happens, the child gets pain and vomiting. The hernia now appears tense and is painful. This is an emergency and you should consult a doctor immediately.
Q. Do all children with a hernia need surgery?
Answer
Yes, all children with a hernia need an operation. This is because there is always a risk of the hernia getting stuck and this can endanger the child's life.
Q. What does the surgery entail?
Answer
Surgery to repair a hernia in a child is a minor operation. The surgeon will make a small cut in the groin and tie off and divide the connection between the abdomen and the scrotum. This is all that is required. The child will be able to return home the same day or the next day. There is very little pain and this is easily controlled with syrups.
Q. Are hernias in adults different than those in children?
Answer
Yes, this is true. In adults , the natural connection that is seen in children has closed off. They develop weakness in certain areas of the abdominal wall and have hernias through them. Therefore , the surgery too is more complex than that in children.
Q. My son has had a hernia repaired. Will he develop another hernia on the opposite side?
Answer
There is a slight increase in the chances of a hernia developing on the opposite side. This chance is greater if .
- the baby was premature at birth,
- the first hernia was on the left side and
- in girls – especially if the first hernia was on the left side. Recurrence after surgery on the same side too is known, though this is rare if an experienced surgeon has done the operation.
Q. What is a hydrocele?
Answer
A hydrocele is a collection of fluid around the testis.
Q. Why does it occur?
Answer
It occurs by the same mechanism as the hernia. Only here, the opening is very small and does not permit the intestine to come thorough. All our abdomens contain some fluid. This acts like a lubricant, allowing smooth movement of the intestines. This fluid can trickle down through this small connection and this causes a hydrocele.
Q. Do all hydroceles too need operation?
Answer
No, when hydroceles occur in children below the age of one year, there is a 70% chance that they will disappear on their own. The connection tends to close off on its own by 2 years of age and the hydrocele disappears. Only if the hydrocele persists beyond 2 years of age will surgery be required. As there is no intestine involved, there is no chance of the intestine getting stuck. It is safe to wait until the age of 2 years for spontaneous resolution of the hydrocele.
Q.What is Laparoscopy?
Answer
Laparoscopy is the ability to use an instrument called a laparoscope, a sophisticated rod lens often connected to a camera system, to inspect the inner areas of the body cavities. Using recent innovations, surgeons are able to create working spaces where there are no natural ones.
Q.What is the advantage of laparoscopic surgery?
Answer
- Less painful
- Early discharge from hospital within 24 to 48 hours (open surgery 5 to 6 days)
- Small scars
- Return to normal activity in 1 week (open surgery 4 to 6 weeks)
Q.Can be done for kidney cancers?
Answer
Yes. It is useful for small cancers less than 7 cm and non-function kidney.
Q.Will the cost be more than the open surgery?
Answer
It will be more but you will save on hospital stay and return to work early.
Q.What is stricture urethra?
Answer
It is obstruction due to narrowing in the urine pipe.
Q.Will it recur?
Answer
Yes, but can be avoided by regular self catheterization and by Buccal graft urethroplasty in selective cases.
Q.Is self catheterization need to be sterile?
Answer
No, but it has to be clean.
Q.Can it predispose to infection?
Answer
Yes, but risk is less if done properly.
Q.What is the indication for Varicocoele surgery?
Answer
Testicular pain, infertility and abnormal semen parameter.
Q.Can it recur?
Answer
Yes it can recur.
Q.How does the surgery help?
Answer
Surgery only help to improve semen parameter but that does not translate to paternal rate.
Q.How useful is the surgery?
Answer
According to literature it does improve semen parameter but not 100 percent.
Q.Does vasectomy increase risk of prostate cancer?
Answer
No, vasectomy does not increase the risk of prostate cancer.
Q.Will vasectomy affect sexual function?
Answer
No, vasectomy do not affect sexual function, you can have normal sexual activity and pleasure after vasectomy.
Q.Will circumcision affect sexual function?
Answer
No. Surgery involves only removal of foreskin.
Q.Will circumcision help premature ejaculation?
Answer
No.
Q.Will circumcision increase sexual pleasure?
Answer
No,it may be indicated in persistent painful sexual intercourse for males.