- by Manipal Hospitals
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- Oct 11 2017
Caring for the urinary and sexual health
The burden of urological problems has increased tremendously over the last four decades. Increasing life expectancy in both men and women in India has exposed the elderly population to the diseases of the genito-urinary tract that was previously seen only in the West. The increase is also driven by greater public awareness of urinary problems and sexual health because of its impact on quality of life. Urologists are in the forefront of technological innovation such as endoscopic surgery, minimally invasive laparoscopy and indeed robotic surgery.
Common Urological Problems
Kidney Stones: The incidence of kidney stones is increasing in India and is possibly related to better diagnosis but is also due to increasing incidence of obesity. Kidney stones are also caused by dietary factors (especially decreased fluid intake) and genetic factors. CT KUB is the gold standard investigation for kidney stones. Although stones smaller than 4 mm pass spontaneously, delay in de-obstructing the kidney can lead to destruction of the kidney. Surgical intervention includesendoscopic treatment (LASER, ultrasonic lithotripsy), Percutaneous Nephrolithotomy (PCNL) and Extra-corporeal Shock Wave Lithotripsy (ESWL).
Kidney Infections: Acute pyelonephritis is not an uncommon presentation in patients who have had urinary tract infection. This condition is usually bilateral, with patients presenting with back pain and fever. Diagnosis is made by urine examination and upper tract imaging such as CT scan or Ultrasound scan. In diabetics, this condition needs to be aggressively treated as it can progress to Acute Emphysematous Pyelonephritis.
Haematuria: Haematuria is the presence of blood in the urine. It can be visible or non-visible haematuria (Dipstick or Microscopy). Any form of haematuria (RED FLAG SYMTPOM) needs to be thoroughlyinvestigated by the Urologist. The causes of haematuria are myriad but cancer affecting the genito-urinary system (kidney, ureter, bladder, prostate and urethra) needs to be ruled out. CT urogram and a cystoscopic assessment are mandatory in almost all cases.
Dysuria: Dysuria is a common urological problem affecting both men and women. In men, the most distressing symptom is the burning sensation at the tip of the penis. In women, the dysuria is throughout the urethra. Sexually transmitted diseases need to be ruled out. However, in many patients, despite investigating extensively, no cause can be found out. Investigations include STI screen (urethral discharge or urethral swab), urine for Culture and Microscopy, ultrasound of the kidneys and bladder, and recurrent cases need cystoscopic evaluation.
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