FAQs

Male Infertility

What is semen analysis?

In semen analysis we evaluates certain characteristics of a male’s semen like Sperm count, Total sperm count, Motility, Morphology, Volume etc.

What are the long- term effects of the condition?

Male infertility can create major tension and the problem has caused many once healthy relationships to break up. It does not affect the couples’ life only, but it also affects the healthcare services and social environment. The feelings experienced by the infertile couples include depression, grief, guilt, shame and inadequacy with social isolation.

How is the condition diagnosed?

The diagnosis of infertility begins with a medical history and physical examination. The provider may order blood tests to look for hormone imbalances or disease. A semen sample may be needed. The volume of the semen is measured, as well as the number of sperm in the sample. How well the sperm move is also assessed.

What increases a man’s risk of infertility?

The number and quality of man’s sperm can be affected by his overall health and lifestyle. Some factors that may increase the risk of male infertility are :

  • alcohol
  • drugs
  • environmental toxins, including pesticides and lead
  • smoking cigarettes
  • health problems
  • medicines
  • radiation treatment and chemotherapy for cancer
  • age

Is male Impotency and infertility same?

No, Impotency is a sexual dysfunction characterized by the inability to develop or maintain an erection of the penis sufficient for satisfactory sexual performance. Impotency can lead to infertility.

What are the causes of male infertility?

Factors relating to male infertility include:

  • Pre-testicular causes

Pre-testicular factors refers to conditions that impede adequate support of the testes and include situations of poor hormonal support and poor general health like Hypogonadism due to various causes, Drugs alcohol, smoking, Medicines etc.

  • Testicular causes

Testicular factors refer to conditions where the testes produces semen of low quantity and /or poor quality despite adequate hormonal support and include : Age, Genetic defects on the Y chromosome etc.

  • Post – testicular causes

Post testicular factors decrease male fertility due to conditions that affect the male genital system after testicular sperm production and include defects of the genital tract as well as problems in ejaculation.

Is infertility a common problem?

It remains a major clinical and social problem, affecting perhaps one couple in six. It affects 13% to 15% of couples worldwide. Male infertility plays a key role in conception difficulties of up to 40% infertile couples.

How do you define Infertility?

Infertility is defined as inability of a couple to conceive naturally after one year of regular unprotected sexual intercourse.

How can one prevent a UTI?

  • Drink lots of water every day.
  • Don’t resist the urge to urinate, do so when you feel the need.
  • Urinate before and after you have sex.
  • Wipe from the front to the back after going to the bathroom.
  • For women, using a diaphragm or sepermicide for birth control can lead to UTIs by increasing bacteria growth.
  • Do not douche.
  • Take showers instead of tub baths.

When should one see the doctor?

You should see your doctor if you have any of these signs or symptoms:

  • burning feeling when you urinate
  • frequent or intense urges to urinate, even when you have little urine to pass
  • pain in your back or lower abdomen
  • cloudy, dark, bloody or unusual-smelling urine
  • fever or chills

How are urinary tract infections treated?

Doctor thinks you have a urinary tract infection, he or she will probably test a sample of your urine to find out if there are bacteria in it. If you have an infection, doctor will then prescribe an antibiotic. Usually, symptoms of the infection go away 1 to 2 days after you start taking the medicine.

How is UTI diagnosed?

A doctor can confirm if you have a urinary tract infection by testing a sample of your urine. Urine Tests we can do : Urinalysis, Urine Culture Ultrasound X-rays like:

  • Voiding cystourethrogram
  • IVP

Do women get urinary tract infections more often than men?

Yes, Women tend to get urinary tract infections more often than men because bacteria can reach the bladder more easily in women. The urethra is shorter in women than in men, so bacteria have a shorter distance to travel.

How can one tell that he or she have a UTI?

Urinary tract infection (UTI) is one of the most common health problems for which patients seek medical care. It is a bacterial infection anywhere in the urinary tract. The urinary tract makes and stores urine and removes it from the body. Parts of the urinary tract includes :

  • You urinate a lot but only a little bit each time.
  • It burns when you urinate.
  • You have to urinate suddenly.
  • There is blood in your urine.
  • Your urine is not clear.
  • Your urine smells bad.

Which people are the risk factors for Urinary Tract Infections (UTIs)?

  • People with kidney stones.
  • People with medical conditions that cause incomplete bladder emptying (for example, spinal cord injury)
  • Immunocompromised people : AIDS and diabetes
  • Women who are sexually active infection.
  • Women who use a diaphragm for birth control.
  • Men with an enlarged prostate.
  • Catheterized patients.

What is a Urinary Tract Infection (UTI)?

Urinary tract infection (UTI) is one of the most common health problems for which patients seek medical care. It is a bacterial infection anywhere in the urinary tract. The urinary tract makes and stores urine and removes it from the body. Parts of the urinary tract includes :

  • Kidneys
  • Ureters
  • Bladder
  • Urethra

What are factors that can effect the management renal calculi?

Management of a kidney stone depends on its size, location, and composition and the presence of anatomical malformation and complications. The presence of a complication (complicated stone) – infection or obstruction – may necessitate immediate intervention, whereas uncomplicated stones can be managed conservatively with adequate fluid intake and analgesia. If a stone does not pass spontaneously then definitive treatment is needed to remove it. The goals of treatment are to control symptoms, render the patient stone free and prevent recurrence.

What are factors that can effect the management renal calculi?

Kidney Yes, Nearly all urethral stones are supposed to be expelled spontaneously when their diameters are smaller than 4 mm. However, the spontaneous expulsion rate of distal ureter stones is about 25% if their sizes are between 4-6 mm and 5% if greater than 6mm. And calculi over 8mm are very rarely eliminated spontaneously. Therefore, active treatments are recommended for individuals with larger stones, especially their sizes are greater than 5 mm.

Can calculi pass spontaneously?

  • History and physical examination
  • Serum and blood testing Calcium, parathyroid hormone, vitamin D, electrolytes
  • Urine dipstick and microscopic examination
  • Urine culture
  • 24-Hours urine collection
  • Imagining ModalitiesPlain Radiography, IVP, USG, CT Scans.

How is Renal Calculi diagnosed?

  • Pain – classic colicky loin to groin pain or renal pain
  • Haematuria, gross or microscopic
  • Dysuria and strangury.

Systemic symptoms

    • Restless patient, often writhing in distress
    • Nausea, vomiting.
    • Fever and chills ( if associated infection)

Asymptomatic

  • Incidental stones

Which is the most common type of renal calculi?

Calcium oxalate (alone or in combination) is the most common type of urinary stone.

What are the risk factors for renal calculi?

  • Dietary risk factors associated with increased stone risk:
  • Low fluid intake, High intake of animal protein, High dietary sodium, Excessive intake of refined sugars, Foods rich in oxalate, High intake of grapefruit juice, apple juice and soft cola drinks.
  • Family history of kidney stones (increase risk by three times)
  • History of hypertension
  • Obesity
  • Various other medical conditions.

What is the prevalence of renal calculi?

Renal stone disease is common, with a worldwide prevalence of between 2 and 20%. Lifetime prevalence is nearly 10% in men and 5% in women. Approximately 50 percent of patients with previous urinary calculi have a recurrence within 10 years.

What are Renal Calculi?

Kidney Stones are also termed as Renal Calculi. (Nephrolithiasis) A kidney stone is a hard, crystalline material formed within the kidney or urinary tract.

What are the pelvic floor exercise and why are they important?

Pelvic floor exercises are done to strengthen the pelvic floor muscles, which support the uterus, bladder and bowel. These exercises helps to control the leaking of urine.

What is a Bladder diary?

This daily diary allows to accurately record the fluid intake (how much you drink) and the bladder activity each day. It helps the health care professional to decide whether you have an overactive bladder. Keep the diary nearby, and fill it out as completely as possible. If the health care professional prescribes treatment for overactive bladder, the diary can also be used to help measure your progress.

What are some general lifestyle measures which may help?

  • smoking cessation
  • caffeine reduction
  • reduced alcohol consumption
  • weight loss
  • limiting fluid intake

What is Behavioral Therapy?

Behavioral therapies are considered the mainstay of treatment for urinary incontinence because they are noninvasive and can be initiated at the primary care level.

Behavioral interventions include pelvic floor muscle training (PFMT), bladder training, Self-monitoring with bladder or voiding diaries and lifestyle modification.

What are the treatment options for OAB?

  • Hygienic protection
  • Behavioral Therapy
  • Medications
  • Surgery

Can OAB affect the QoL?

OAB patients have a significantly poorer quality of life. Patients who suffer from OAB focus on and may be preoccupied with such concerns as locating the closest bathroom, estimating the amount of time until their next work break. Furthermore OAB affects daily activities, such as travel, physical activity, relationships, sexual functions and nocturnal bladder control which can affect sleep.

What are the symptoms of OAB?

  • Urgency
  • Frequency
  • Nocturia
  • Urge incontinence

What causes overactive bladder?

  • Large number of condition can cause OAB like
  • Neurological diseases
  • Urinary Tract Infection
  • Multiple Pregnancy
  • BPH/Prostate cancer/ Prostatitis
  • Diabetic Neuropathy

How common is the overactive bladder?

Overactive bladder is highly prevalent distressing medical condition. Despite the high prevalence of OAB and the availability of effective treatment options, OAB treatment remains suboptimal. The condition is under diagnosed, often because of patient’s reluctance to bring their urinary symptoms to the attention of their doctor. Many patients accept their symptoms as a “normal” part of aging or believe surgery is the only treatment available.

What is OAB?

OAB means overactive bladder in this the persons feels urgent desire to go to the toilet, goes to the toilet frequently and sometimes leaking of urine before reaching the toilet.

What are some of the treatments available for BPH?

Watchful waiting: Is recommended as an important option for men who have mild symptoms and do not find them particularly bothersome.

Medical therapy: Today’s most common method for controlling moderate symptoms of BPH. Several medications are available to control moderate symptoms of BPH.

Minimally invasive treatment: Several minimally invasive therapies are available that allows the doctor to access the prostate through urethra and reduce the size of the prostate or decrease obstruction of the urethra.

Surgical treatment: Surgical intervention is necessary in patients in whom benign prostates obstruction causes renal insufficiency, urinary retention, recurrent UTIs, bladder calculi, hydronephrosis, or large postvoid residual volume.

Surgical options for such patients include transurethralresection of the prostate, transurethral laser prostatectomy (which consists of resection, ablation, and vaporization), transurethral incision of the prostate, and open prostatectomy (usually when the prostate weight is >100 g).

How is BPH diagnosed?

In order to help assess the severity of such symptoms, the American Urological Association (AUA) BPH Symptom Score Index was developed. The AUA diagnostic system includes a series of questions that target the frequency of the urinary systems identified above, and as a result, helps identify the severity of the BPH – ranging from mild to severe.

There are a number of diagnostic test procedures that can be used to confirm BPH. The tests vary from patient to patient, but the following are the most common:

Physical examination

Digital rectal examination (DRE)

Laboratories Studies

Prostate Specific Antigen (PSA) Blood Test

Urinalysis

Urine Culture

Imaging techniques

Rectal Ultrasound

Intravenous Pyelogram (IVP)

Cystoscopy

Urodynamic Testing

Is BPH a rare condition?

No, it is a common condition, that can affect approximately 50 percent of men between the ages of 51 and 60 and up to 90 percent of men over the age of 80.

Is BPH a sign of cancer?

No. It is possible to have both BPH and prostate cancer, having BPH does not increase your risk of having prostate cancer. However, because early symptoms of both conditions are similar, it is important to see your doctor if you are experiencing any symptoms associated with a urinary condition.

Which are the most troublesome symptoms?

Many men find that having to get up and go to the toilet at night is the most troublesome aspect of this condition, as it makes them tired during the day. Having to urinate frequently during the day, sometimes with a sense of urgency, can also be trying for patients, and can make traveling or attending events, such as the theatre or cinema, rather difficult. Incomplete emptying of the bladder can be progressive and eventually result in complete retention of urine. If this occurs a catheter (tube into the bladder) will be necessary as the bladder rapidly becomes over distended and painful.

What are some of the symptoms associated with BPH?

Since the prostate surrounds the urethra just below the bladder, its enlargement can result in symptoms that irritate or obstruct the bladder. A common symptom is the need to frequently empty the bladder, especially at night. Other symptoms include difficulty in starting the urine flow or dribbling after urination ends. Also, size and strength of the urine stream may decrease.

What causes BPH?

Although the cause of BPH is poorly understood, the two major factors necessary for the onset of BPH in men are age and normal testicular function.

What is BPH?

Benign Prostatic Hyperplasia (BPH) is the non-cancerous enlargement of the prostate; usually begin in the fifth decade of life in men and which in many men may cause obstruction to urine flow.

What are the common disease conditions of Prostate?

Some common problems related to Prostate are

-Prostatitis

-Benign Prostatic Hyperplasia, or BPH

-Prostate cancer

Benign Prostatic Hyperplasia (BPH)

The prostate, is a part of the male reproductive system, is about the same size and shape as a walnut. It is located below the bladder and in front of the rectum and surrounds the urethra, the tube-like structure that carries urine from the bladder out through the penis. The main function of the prostate is to produce ejaculatory fluid.

Over Active Bladder

What is semen analysis?

In semen analysis we evaluates certain characteristics of a male’s semen like Sperm count, Total sperm count, Motility, Morphology, Volume etc.

What are the long- term effects of the condition?

Male infertility can create major tension and the problem has caused many once healthy relationships to break up. It does not affect the couples’ life only, but it also affects the healthcare services and social environment. The feelings experienced by the infertile couples include depression, grief, guilt, shame and inadequacy with social isolation.

How is the condition diagnosed?

The diagnosis of infertility begins with a medical history and physical examination. The provider may order blood tests to look for hormone imbalances or disease. A semen sample may be needed. The volume of the semen is measured, as well as the number of sperm in the sample. How well the sperm move is also assessed.

What increases a man’s risk of infertility?

The number and quality of man’s sperm can be affected by his overall health and lifestyle. Some factors that may increase the risk of male infertility are :

  • alcohol
  • drugs
  • environmental toxins, including pesticides and lead
  • smoking cigarettes
  • health problems
  • medicines
  • radiation treatment and chemotherapy for cancer
  • age

Is male Impotency and infertility same?

No, Impotency is a sexual dysfunction characterized by the inability to develop or maintain an erection of the penis sufficient for satisfactory sexual performance. Impotency can lead to infertility.

What are the causes of male infertility?

Factors relating to male infertility include:

  • Pre-testicular causes

Pre-testicular factors refers to conditions that impede adequate support of the testes and include situations of poor hormonal support and poor general health like Hypogonadism due to various causes, Drugs alcohol, smoking, Medicines etc.

  • Testicular causes

Testicular factors refer to conditions where the testes produces semen of low quantity and /or poor quality despite adequate hormonal support and include : Age, Genetic defects on the Y chromosome etc.

  • Post – testicular causes

Post testicular factors decrease male fertility due to conditions that affect the male genital system after testicular sperm production and include defects of the genital tract as well as problems in ejaculation.

Is infertility a common problem?

It remains a major clinical and social problem, affecting perhaps one couple in six. It affects 13% to 15% of couples worldwide. Male infertility plays a key role in conception difficulties of up to 40% infertile couples.

How do you define Infertility?

Infertility is defined as inability of a couple to conceive naturally after one year of regular unprotected sexual intercourse.

How can one prevent a UTI?

  • Drink lots of water every day.
  • Don’t resist the urge to urinate, do so when you feel the need.
  • Urinate before and after you have sex.
  • Wipe from the front to the back after going to the bathroom.
  • For women, using a diaphragm or sepermicide for birth control can lead to UTIs by increasing bacteria growth.
  • Do not douche.
  • Take showers instead of tub baths.

When should one see the doctor?

You should see your doctor if you have any of these signs or symptoms:

  • burning feeling when you urinate
  • frequent or intense urges to urinate, even when you have little urine to pass
  • pain in your back or lower abdomen
  • cloudy, dark, bloody or unusual-smelling urine
  • fever or chills

How are urinary tract infections treated?

Doctor thinks you have a urinary tract infection, he or she will probably test a sample of your urine to find out if there are bacteria in it. If you have an infection, doctor will then prescribe an antibiotic. Usually, symptoms of the infection go away 1 to 2 days after you start taking the medicine.

How is UTI diagnosed?

A doctor can confirm if you have a urinary tract infection by testing a sample of your urine. Urine Tests we can do : Urinalysis, Urine Culture Ultrasound X-rays like:

  • Voiding cystourethrogram
  • IVP

Do women get urinary tract infections more often than men?

Yes, Women tend to get urinary tract infections more often than men because bacteria can reach the bladder more easily in women. The urethra is shorter in women than in men, so bacteria have a shorter distance to travel.

How can one tell that he or she have a UTI?

Urinary tract infection (UTI) is one of the most common health problems for which patients seek medical care. It is a bacterial infection anywhere in the urinary tract. The urinary tract makes and stores urine and removes it from the body. Parts of the urinary tract includes :

  • You urinate a lot but only a little bit each time.
  • It burns when you urinate.
  • You have to urinate suddenly.
  • There is blood in your urine.
  • Your urine is not clear.
  • Your urine smells bad.

Which people are the risk factors for Urinary Tract Infections (UTIs)?

  • People with kidney stones.
  • People with medical conditions that cause incomplete bladder emptying (for example, spinal cord injury)
  • Immunocompromised people : AIDS and diabetes
  • Women who are sexually active infection.
  • Women who use a diaphragm for birth control.
  • Men with an enlarged prostate.
  • Catheterized patients.

What is a Urinary Tract Infection (UTI)?

Urinary tract infection (UTI) is one of the most common health problems for which patients seek medical care. It is a bacterial infection anywhere in the urinary tract. The urinary tract makes and stores urine and removes it from the body. Parts of the urinary tract includes :

  • Kidneys
  • Ureters
  • Bladder
  • Urethra

What are factors that can effect the management renal calculi?

Management of a kidney stone depends on its size, location, and composition and the presence of anatomical malformation and complications. The presence of a complication (complicated stone) – infection or obstruction – may necessitate immediate intervention, whereas uncomplicated stones can be managed conservatively with adequate fluid intake and analgesia. If a stone does not pass spontaneously then definitive treatment is needed to remove it. The goals of treatment are to control symptoms, render the patient stone free and prevent recurrence.

What are factors that can effect the management renal calculi?

Kidney Yes, Nearly all urethral stones are supposed to be expelled spontaneously when their diameters are smaller than 4 mm. However, the spontaneous expulsion rate of distal ureter stones is about 25% if their sizes are between 4-6 mm and 5% if greater than 6mm. And calculi over 8mm are very rarely eliminated spontaneously. Therefore, active treatments are recommended for individuals with larger stones, especially their sizes are greater than 5 mm.

Can calculi pass spontaneously?

  • History and physical examination
  • Serum and blood testing Calcium, parathyroid hormone, vitamin D, electrolytes
  • Urine dipstick and microscopic examination
  • Urine culture
  • 24-Hours urine collection
  • Imagining ModalitiesPlain Radiography, IVP, USG, CT Scans.

How is Renal Calculi diagnosed?

  • Pain – classic colicky loin to groin pain or renal pain
  • Haematuria, gross or microscopic
  • Dysuria and strangury.

Systemic symptoms

    • Restless patient, often writhing in distress
    • Nausea, vomiting.
    • Fever and chills ( if associated infection)

Asymptomatic

  • Incidental stones

Which is the most common type of renal calculi?

Calcium oxalate (alone or in combination) is the most common type of urinary stone.

What are the risk factors for renal calculi?

  • Dietary risk factors associated with increased stone risk:
  • Low fluid intake, High intake of animal protein, High dietary sodium, Excessive intake of refined sugars, Foods rich in oxalate, High intake of grapefruit juice, apple juice and soft cola drinks.
  • Family history of kidney stones (increase risk by three times)
  • History of hypertension
  • Obesity
  • Various other medical conditions.

What is the prevalence of renal calculi?

Renal stone disease is common, with a worldwide prevalence of between 2 and 20%. Lifetime prevalence is nearly 10% in men and 5% in women. Approximately 50 percent of patients with previous urinary calculi have a recurrence within 10 years.

What are Renal Calculi?

Kidney Stones are also termed as Renal Calculi. (Nephrolithiasis) A kidney stone is a hard, crystalline material formed within the kidney or urinary tract.

What are the pelvic floor exercise and why are they important?

Pelvic floor exercises are done to strengthen the pelvic floor muscles, which support the uterus, bladder and bowel. These exercises helps to control the leaking of urine.

What is a Bladder diary?

This daily diary allows to accurately record the fluid intake (how much you drink) and the bladder activity each day. It helps the health care professional to decide whether you have an overactive bladder. Keep the diary nearby, and fill it out as completely as possible. If the health care professional prescribes treatment for overactive bladder, the diary can also be used to help measure your progress.

What are some general lifestyle measures which may help?

  • smoking cessation
  • caffeine reduction
  • reduced alcohol consumption
  • weight loss
  • limiting fluid intake

What is Behavioral Therapy?

Behavioral therapies are considered the mainstay of treatment for urinary incontinence because they are noninvasive and can be initiated at the primary care level.

Behavioral interventions include pelvic floor muscle training (PFMT), bladder training, Self-monitoring with bladder or voiding diaries and lifestyle modification.

What are the treatment options for OAB?

  • Hygienic protection
  • Behavioral Therapy
  • Medications
  • Surgery

Can OAB affect the QoL?

OAB patients have a significantly poorer quality of life. Patients who suffer from OAB focus on and may be preoccupied with such concerns as locating the closest bathroom, estimating the amount of time until their next work break. Furthermore OAB affects daily activities, such as travel, physical activity, relationships, sexual functions and nocturnal bladder control which can affect sleep.

What are the symptoms of OAB?

  • Urgency
  • Frequency
  • Nocturia
  • Urge incontinence

What causes overactive bladder?

  • Large number of condition can cause OAB like
  • Neurological diseases
  • Urinary Tract Infection
  • Multiple Pregnancy
  • BPH/Prostate cancer/ Prostatitis
  • Diabetic Neuropathy

How common is the overactive bladder?

Overactive bladder is highly prevalent distressing medical condition. Despite the high prevalence of OAB and the availability of effective treatment options, OAB treatment remains suboptimal. The condition is under diagnosed, often because of patient’s reluctance to bring their urinary symptoms to the attention of their doctor. Many patients accept their symptoms as a “normal” part of aging or believe surgery is the only treatment available.

What is OAB?

OAB means overactive bladder in this the persons feels urgent desire to go to the toilet, goes to the toilet frequently and sometimes leaking of urine before reaching the toilet.

What are some of the treatments available for BPH?

Watchful waiting: Is recommended as an important option for men who have mild symptoms and do not find them particularly bothersome.

Medical therapy: Today’s most common method for controlling moderate symptoms of BPH. Several medications are available to control moderate symptoms of BPH.

Minimally invasive treatment: Several minimally invasive therapies are available that allows the doctor to access the prostate through urethra and reduce the size of the prostate or decrease obstruction of the urethra.

Surgical treatment: Surgical intervention is necessary in patients in whom benign prostates obstruction causes renal insufficiency, urinary retention, recurrent UTIs, bladder calculi, hydronephrosis, or large postvoid residual volume.

Surgical options for such patients include transurethralresection of the prostate, transurethral laser prostatectomy (which consists of resection, ablation, and vaporization), transurethral incision of the prostate, and open prostatectomy (usually when the prostate weight is >100 g).

How is BPH diagnosed?

In order to help assess the severity of such symptoms, the American Urological Association (AUA) BPH Symptom Score Index was developed. The AUA diagnostic system includes a series of questions that target the frequency of the urinary systems identified above, and as a result, helps identify the severity of the BPH – ranging from mild to severe.

There are a number of diagnostic test procedures that can be used to confirm BPH. The tests vary from patient to patient, but the following are the most common:

Physical examination

Digital rectal examination (DRE)

Laboratories Studies

Prostate Specific Antigen (PSA) Blood Test

Urinalysis

Urine Culture

Imaging techniques

Rectal Ultrasound

Intravenous Pyelogram (IVP)

Cystoscopy

Urodynamic Testing

Is BPH a rare condition?

No, it is a common condition, that can affect approximately 50 percent of men between the ages of 51 and 60 and up to 90 percent of men over the age of 80.

Is BPH a sign of cancer?

No. It is possible to have both BPH and prostate cancer, having BPH does not increase your risk of having prostate cancer. However, because early symptoms of both conditions are similar, it is important to see your doctor if you are experiencing any symptoms associated with a urinary condition.

Which are the most troublesome symptoms?

Many men find that having to get up and go to the toilet at night is the most troublesome aspect of this condition, as it makes them tired during the day. Having to urinate frequently during the day, sometimes with a sense of urgency, can also be trying for patients, and can make traveling or attending events, such as the theatre or cinema, rather difficult. Incomplete emptying of the bladder can be progressive and eventually result in complete retention of urine. If this occurs a catheter (tube into the bladder) will be necessary as the bladder rapidly becomes over distended and painful.

What are some of the symptoms associated with BPH?

Since the prostate surrounds the urethra just below the bladder, its enlargement can result in symptoms that irritate or obstruct the bladder. A common symptom is the need to frequently empty the bladder, especially at night. Other symptoms include difficulty in starting the urine flow or dribbling after urination ends. Also, size and strength of the urine stream may decrease.

What causes BPH?

Although the cause of BPH is poorly understood, the two major factors necessary for the onset of BPH in men are age and normal testicular function.

What is BPH?

Benign Prostatic Hyperplasia (BPH) is the non-cancerous enlargement of the prostate; usually begin in the fifth decade of life in men and which in many men may cause obstruction to urine flow.

What are the common disease conditions of Prostate?

Some common problems related to Prostate are

-Prostatitis

-Benign Prostatic Hyperplasia, or BPH

-Prostate cancer

Benign Prostatic Hyperplasia (BPH)

The prostate, is a part of the male reproductive system, is about the same size and shape as a walnut. It is located below the bladder and in front of the rectum and surrounds the urethra, the tube-like structure that carries urine from the bladder out through the penis. The main function of the prostate is to produce ejaculatory fluid.

Benign Prostatic Hyperplasia

What is semen analysis?

In semen analysis we evaluates certain characteristics of a male’s semen like Sperm count, Total sperm count, Motility, Morphology, Volume etc.

What are the long- term effects of the condition?

Male infertility can create major tension and the problem has caused many once healthy relationships to break up. It does not affect the couples’ life only, but it also affects the healthcare services and social environment. The feelings experienced by the infertile couples include depression, grief, guilt, shame and inadequacy with social isolation.

How is the condition diagnosed?

The diagnosis of infertility begins with a medical history and physical examination. The provider may order blood tests to look for hormone imbalances or disease. A semen sample may be needed. The volume of the semen is measured, as well as the number of sperm in the sample. How well the sperm move is also assessed.

What increases a man’s risk of infertility?

The number and quality of man’s sperm can be affected by his overall health and lifestyle. Some factors that may increase the risk of male infertility are :

  • alcohol
  • drugs
  • environmental toxins, including pesticides and lead
  • smoking cigarettes
  • health problems
  • medicines
  • radiation treatment and chemotherapy for cancer
  • age

Is male Impotency and infertility same?

No, Impotency is a sexual dysfunction characterized by the inability to develop or maintain an erection of the penis sufficient for satisfactory sexual performance. Impotency can lead to infertility.

What are the causes of male infertility?

Factors relating to male infertility include:

  • Pre-testicular causes

Pre-testicular factors refers to conditions that impede adequate support of the testes and include situations of poor hormonal support and poor general health like Hypogonadism due to various causes, Drugs alcohol, smoking, Medicines etc.

  • Testicular causes

Testicular factors refer to conditions where the testes produces semen of low quantity and /or poor quality despite adequate hormonal support and include : Age, Genetic defects on the Y chromosome etc.

  • Post – testicular causes

Post testicular factors decrease male fertility due to conditions that affect the male genital system after testicular sperm production and include defects of the genital tract as well as problems in ejaculation.

Is infertility a common problem?

It remains a major clinical and social problem, affecting perhaps one couple in six. It affects 13% to 15% of couples worldwide. Male infertility plays a key role in conception difficulties of up to 40% infertile couples.

How do you define Infertility?

Infertility is defined as inability of a couple to conceive naturally after one year of regular unprotected sexual intercourse.

How can one prevent a UTI?

  • Drink lots of water every day.
  • Don’t resist the urge to urinate, do so when you feel the need.
  • Urinate before and after you have sex.
  • Wipe from the front to the back after going to the bathroom.
  • For women, using a diaphragm or sepermicide for birth control can lead to UTIs by increasing bacteria growth.
  • Do not douche.
  • Take showers instead of tub baths.

When should one see the doctor?

You should see your doctor if you have any of these signs or symptoms:

  • burning feeling when you urinate
  • frequent or intense urges to urinate, even when you have little urine to pass
  • pain in your back or lower abdomen
  • cloudy, dark, bloody or unusual-smelling urine
  • fever or chills

How are urinary tract infections treated?

Doctor thinks you have a urinary tract infection, he or she will probably test a sample of your urine to find out if there are bacteria in it. If you have an infection, doctor will then prescribe an antibiotic. Usually, symptoms of the infection go away 1 to 2 days after you start taking the medicine.

How is UTI diagnosed?

A doctor can confirm if you have a urinary tract infection by testing a sample of your urine. Urine Tests we can do : Urinalysis, Urine Culture Ultrasound X-rays like:

  • Voiding cystourethrogram
  • IVP

Do women get urinary tract infections more often than men?

Yes, Women tend to get urinary tract infections more often than men because bacteria can reach the bladder more easily in women. The urethra is shorter in women than in men, so bacteria have a shorter distance to travel.

How can one tell that he or she have a UTI?

Urinary tract infection (UTI) is one of the most common health problems for which patients seek medical care. It is a bacterial infection anywhere in the urinary tract. The urinary tract makes and stores urine and removes it from the body. Parts of the urinary tract includes :

  • You urinate a lot but only a little bit each time.
  • It burns when you urinate.
  • You have to urinate suddenly.
  • There is blood in your urine.
  • Your urine is not clear.
  • Your urine smells bad.

Which people are the risk factors for Urinary Tract Infections (UTIs)?

  • People with kidney stones.
  • People with medical conditions that cause incomplete bladder emptying (for example, spinal cord injury)
  • Immunocompromised people : AIDS and diabetes
  • Women who are sexually active infection.
  • Women who use a diaphragm for birth control.
  • Men with an enlarged prostate.
  • Catheterized patients.

What is a Urinary Tract Infection (UTI)?

Urinary tract infection (UTI) is one of the most common health problems for which patients seek medical care. It is a bacterial infection anywhere in the urinary tract. The urinary tract makes and stores urine and removes it from the body. Parts of the urinary tract includes :

  • Kidneys
  • Ureters
  • Bladder
  • Urethra

What are factors that can effect the management renal calculi?

Management of a kidney stone depends on its size, location, and composition and the presence of anatomical malformation and complications. The presence of a complication (complicated stone) – infection or obstruction – may necessitate immediate intervention, whereas uncomplicated stones can be managed conservatively with adequate fluid intake and analgesia. If a stone does not pass spontaneously then definitive treatment is needed to remove it. The goals of treatment are to control symptoms, render the patient stone free and prevent recurrence.

What are factors that can effect the management renal calculi?

Kidney Yes, Nearly all urethral stones are supposed to be expelled spontaneously when their diameters are smaller than 4 mm. However, the spontaneous expulsion rate of distal ureter stones is about 25% if their sizes are between 4-6 mm and 5% if greater than 6mm. And calculi over 8mm are very rarely eliminated spontaneously. Therefore, active treatments are recommended for individuals with larger stones, especially their sizes are greater than 5 mm.

Can calculi pass spontaneously?

  • History and physical examination
  • Serum and blood testing Calcium, parathyroid hormone, vitamin D, electrolytes
  • Urine dipstick and microscopic examination
  • Urine culture
  • 24-Hours urine collection
  • Imagining ModalitiesPlain Radiography, IVP, USG, CT Scans.

How is Renal Calculi diagnosed?

  • Pain – classic colicky loin to groin pain or renal pain
  • Haematuria, gross or microscopic
  • Dysuria and strangury.

Systemic symptoms

    • Restless patient, often writhing in distress
    • Nausea, vomiting.
    • Fever and chills ( if associated infection)

Asymptomatic

  • Incidental stones

Which is the most common type of renal calculi?

Calcium oxalate (alone or in combination) is the most common type of urinary stone.

What are the risk factors for renal calculi?

  • Dietary risk factors associated with increased stone risk:
  • Low fluid intake, High intake of animal protein, High dietary sodium, Excessive intake of refined sugars, Foods rich in oxalate, High intake of grapefruit juice, apple juice and soft cola drinks.
  • Family history of kidney stones (increase risk by three times)
  • History of hypertension
  • Obesity
  • Various other medical conditions.

What is the prevalence of renal calculi?

Renal stone disease is common, with a worldwide prevalence of between 2 and 20%. Lifetime prevalence is nearly 10% in men and 5% in women. Approximately 50 percent of patients with previous urinary calculi have a recurrence within 10 years.

What are Renal Calculi?

Kidney Stones are also termed as Renal Calculi. (Nephrolithiasis) A kidney stone is a hard, crystalline material formed within the kidney or urinary tract.

What are the pelvic floor exercise and why are they important?

Pelvic floor exercises are done to strengthen the pelvic floor muscles, which support the uterus, bladder and bowel. These exercises helps to control the leaking of urine.

What is a Bladder diary?

This daily diary allows to accurately record the fluid intake (how much you drink) and the bladder activity each day. It helps the health care professional to decide whether you have an overactive bladder. Keep the diary nearby, and fill it out as completely as possible. If the health care professional prescribes treatment for overactive bladder, the diary can also be used to help measure your progress.

What are some general lifestyle measures which may help?

  • smoking cessation
  • caffeine reduction
  • reduced alcohol consumption
  • weight loss
  • limiting fluid intake

What is Behavioral Therapy?

Behavioral therapies are considered the mainstay of treatment for urinary incontinence because they are noninvasive and can be initiated at the primary care level.

Behavioral interventions include pelvic floor muscle training (PFMT), bladder training, Self-monitoring with bladder or voiding diaries and lifestyle modification.

What are the treatment options for OAB?

  • Hygienic protection
  • Behavioral Therapy
  • Medications
  • Surgery

Can OAB affect the QoL?

OAB patients have a significantly poorer quality of life. Patients who suffer from OAB focus on and may be preoccupied with such concerns as locating the closest bathroom, estimating the amount of time until their next work break. Furthermore OAB affects daily activities, such as travel, physical activity, relationships, sexual functions and nocturnal bladder control which can affect sleep.

What are the symptoms of OAB?

  • Urgency
  • Frequency
  • Nocturia
  • Urge incontinence

What causes overactive bladder?

  • Large number of condition can cause OAB like
  • Neurological diseases
  • Urinary Tract Infection
  • Multiple Pregnancy
  • BPH/Prostate cancer/ Prostatitis
  • Diabetic Neuropathy

How common is the overactive bladder?

Overactive bladder is highly prevalent distressing medical condition. Despite the high prevalence of OAB and the availability of effective treatment options, OAB treatment remains suboptimal. The condition is under diagnosed, often because of patient’s reluctance to bring their urinary symptoms to the attention of their doctor. Many patients accept their symptoms as a “normal” part of aging or believe surgery is the only treatment available.

What is OAB?

OAB means overactive bladder in this the persons feels urgent desire to go to the toilet, goes to the toilet frequently and sometimes leaking of urine before reaching the toilet.

What are some of the treatments available for BPH?

Watchful waiting: Is recommended as an important option for men who have mild symptoms and do not find them particularly bothersome.

Medical therapy: Today’s most common method for controlling moderate symptoms of BPH. Several medications are available to control moderate symptoms of BPH.

Minimally invasive treatment: Several minimally invasive therapies are available that allows the doctor to access the prostate through urethra and reduce the size of the prostate or decrease obstruction of the urethra.

Surgical treatment: Surgical intervention is necessary in patients in whom benign prostates obstruction causes renal insufficiency, urinary retention, recurrent UTIs, bladder calculi, hydronephrosis, or large postvoid residual volume.

Surgical options for such patients include transurethralresection of the prostate, transurethral laser prostatectomy (which consists of resection, ablation, and vaporization), transurethral incision of the prostate, and open prostatectomy (usually when the prostate weight is >100 g).

How is BPH diagnosed?

In order to help assess the severity of such symptoms, the American Urological Association (AUA) BPH Symptom Score Index was developed. The AUA diagnostic system includes a series of questions that target the frequency of the urinary systems identified above, and as a result, helps identify the severity of the BPH – ranging from mild to severe.

There are a number of diagnostic test procedures that can be used to confirm BPH. The tests vary from patient to patient, but the following are the most common:

Physical examination

Digital rectal examination (DRE)

Laboratories Studies

Prostate Specific Antigen (PSA) Blood Test

Urinalysis

Urine Culture

Imaging techniques

Rectal Ultrasound

Intravenous Pyelogram (IVP)

Cystoscopy

Urodynamic Testing

Is BPH a rare condition?

No, it is a common condition, that can affect approximately 50 percent of men between the ages of 51 and 60 and up to 90 percent of men over the age of 80.

Is BPH a sign of cancer?

No. It is possible to have both BPH and prostate cancer, having BPH does not increase your risk of having prostate cancer. However, because early symptoms of both conditions are similar, it is important to see your doctor if you are experiencing any symptoms associated with a urinary condition.

Which are the most troublesome symptoms?

Many men find that having to get up and go to the toilet at night is the most troublesome aspect of this condition, as it makes them tired during the day. Having to urinate frequently during the day, sometimes with a sense of urgency, can also be trying for patients, and can make traveling or attending events, such as the theatre or cinema, rather difficult. Incomplete emptying of the bladder can be progressive and eventually result in complete retention of urine. If this occurs a catheter (tube into the bladder) will be necessary as the bladder rapidly becomes over distended and painful.

What are some of the symptoms associated with BPH?

Since the prostate surrounds the urethra just below the bladder, its enlargement can result in symptoms that irritate or obstruct the bladder. A common symptom is the need to frequently empty the bladder, especially at night. Other symptoms include difficulty in starting the urine flow or dribbling after urination ends. Also, size and strength of the urine stream may decrease.

What causes BPH?

Although the cause of BPH is poorly understood, the two major factors necessary for the onset of BPH in men are age and normal testicular function.

What is BPH?

Benign Prostatic Hyperplasia (BPH) is the non-cancerous enlargement of the prostate; usually begin in the fifth decade of life in men and which in many men may cause obstruction to urine flow.

What are the common disease conditions of Prostate?

Some common problems related to Prostate are

-Prostatitis

-Benign Prostatic Hyperplasia, or BPH

-Prostate cancer

Benign Prostatic Hyperplasia (BPH)

The prostate, is a part of the male reproductive system, is about the same size and shape as a walnut. It is located below the bladder and in front of the rectum and surrounds the urethra, the tube-like structure that carries urine from the bladder out through the penis. The main function of the prostate is to produce ejaculatory fluid.

Renal Calculi

What is semen analysis?

In semen analysis we evaluates certain characteristics of a male’s semen like Sperm count, Total sperm count, Motility, Morphology, Volume etc.

What are the long- term effects of the condition?

Male infertility can create major tension and the problem has caused many once healthy relationships to break up. It does not affect the couples’ life only, but it also affects the healthcare services and social environment. The feelings experienced by the infertile couples include depression, grief, guilt, shame and inadequacy with social isolation.

How is the condition diagnosed?

The diagnosis of infertility begins with a medical history and physical examination. The provider may order blood tests to look for hormone imbalances or disease. A semen sample may be needed. The volume of the semen is measured, as well as the number of sperm in the sample. How well the sperm move is also assessed.

What increases a man’s risk of infertility?

The number and quality of man’s sperm can be affected by his overall health and lifestyle. Some factors that may increase the risk of male infertility are :

  • alcohol
  • drugs
  • environmental toxins, including pesticides and lead
  • smoking cigarettes
  • health problems
  • medicines
  • radiation treatment and chemotherapy for cancer
  • age

Is male Impotency and infertility same?

No, Impotency is a sexual dysfunction characterized by the inability to develop or maintain an erection of the penis sufficient for satisfactory sexual performance. Impotency can lead to infertility.

What are the causes of male infertility?

Factors relating to male infertility include:

  • Pre-testicular causes

Pre-testicular factors refers to conditions that impede adequate support of the testes and include situations of poor hormonal support and poor general health like Hypogonadism due to various causes, Drugs alcohol, smoking, Medicines etc.

  • Testicular causes

Testicular factors refer to conditions where the testes produces semen of low quantity and /or poor quality despite adequate hormonal support and include : Age, Genetic defects on the Y chromosome etc.

  • Post – testicular causes

Post testicular factors decrease male fertility due to conditions that affect the male genital system after testicular sperm production and include defects of the genital tract as well as problems in ejaculation.

Is infertility a common problem?

It remains a major clinical and social problem, affecting perhaps one couple in six. It affects 13% to 15% of couples worldwide. Male infertility plays a key role in conception difficulties of up to 40% infertile couples.

How do you define Infertility?

Infertility is defined as inability of a couple to conceive naturally after one year of regular unprotected sexual intercourse.

How can one prevent a UTI?

  • Drink lots of water every day.
  • Don’t resist the urge to urinate, do so when you feel the need.
  • Urinate before and after you have sex.
  • Wipe from the front to the back after going to the bathroom.
  • For women, using a diaphragm or sepermicide for birth control can lead to UTIs by increasing bacteria growth.
  • Do not douche.
  • Take showers instead of tub baths.

When should one see the doctor?

You should see your doctor if you have any of these signs or symptoms:

  • burning feeling when you urinate
  • frequent or intense urges to urinate, even when you have little urine to pass
  • pain in your back or lower abdomen
  • cloudy, dark, bloody or unusual-smelling urine
  • fever or chills

How are urinary tract infections treated?

Doctor thinks you have a urinary tract infection, he or she will probably test a sample of your urine to find out if there are bacteria in it. If you have an infection, doctor will then prescribe an antibiotic. Usually, symptoms of the infection go away 1 to 2 days after you start taking the medicine.

How is UTI diagnosed?

A doctor can confirm if you have a urinary tract infection by testing a sample of your urine. Urine Tests we can do : Urinalysis, Urine Culture Ultrasound X-rays like:

  • Voiding cystourethrogram
  • IVP

Do women get urinary tract infections more often than men?

Yes, Women tend to get urinary tract infections more often than men because bacteria can reach the bladder more easily in women. The urethra is shorter in women than in men, so bacteria have a shorter distance to travel.

How can one tell that he or she have a UTI?

Urinary tract infection (UTI) is one of the most common health problems for which patients seek medical care. It is a bacterial infection anywhere in the urinary tract. The urinary tract makes and stores urine and removes it from the body. Parts of the urinary tract includes :

  • You urinate a lot but only a little bit each time.
  • It burns when you urinate.
  • You have to urinate suddenly.
  • There is blood in your urine.
  • Your urine is not clear.
  • Your urine smells bad.

Which people are the risk factors for Urinary Tract Infections (UTIs)?

  • People with kidney stones.
  • People with medical conditions that cause incomplete bladder emptying (for example, spinal cord injury)
  • Immunocompromised people : AIDS and diabetes
  • Women who are sexually active infection.
  • Women who use a diaphragm for birth control.
  • Men with an enlarged prostate.
  • Catheterized patients.

What is a Urinary Tract Infection (UTI)?

Urinary tract infection (UTI) is one of the most common health problems for which patients seek medical care. It is a bacterial infection anywhere in the urinary tract. The urinary tract makes and stores urine and removes it from the body. Parts of the urinary tract includes :

  • Kidneys
  • Ureters
  • Bladder
  • Urethra

What are factors that can effect the management renal calculi?

Management of a kidney stone depends on its size, location, and composition and the presence of anatomical malformation and complications. The presence of a complication (complicated stone) – infection or obstruction – may necessitate immediate intervention, whereas uncomplicated stones can be managed conservatively with adequate fluid intake and analgesia. If a stone does not pass spontaneously then definitive treatment is needed to remove it. The goals of treatment are to control symptoms, render the patient stone free and prevent recurrence.

What are factors that can effect the management renal calculi?

Kidney Yes, Nearly all urethral stones are supposed to be expelled spontaneously when their diameters are smaller than 4 mm. However, the spontaneous expulsion rate of distal ureter stones is about 25% if their sizes are between 4-6 mm and 5% if greater than 6mm. And calculi over 8mm are very rarely eliminated spontaneously. Therefore, active treatments are recommended for individuals with larger stones, especially their sizes are greater than 5 mm.

Can calculi pass spontaneously?

  • History and physical examination
  • Serum and blood testing Calcium, parathyroid hormone, vitamin D, electrolytes
  • Urine dipstick and microscopic examination
  • Urine culture
  • 24-Hours urine collection
  • Imagining ModalitiesPlain Radiography, IVP, USG, CT Scans.

How is Renal Calculi diagnosed?

  • Pain – classic colicky loin to groin pain or renal pain
  • Haematuria, gross or microscopic
  • Dysuria and strangury.

Systemic symptoms

    • Restless patient, often writhing in distress
    • Nausea, vomiting.
    • Fever and chills ( if associated infection)

Asymptomatic

  • Incidental stones

Which is the most common type of renal calculi?

Calcium oxalate (alone or in combination) is the most common type of urinary stone.

What are the risk factors for renal calculi?

  • Dietary risk factors associated with increased stone risk:
  • Low fluid intake, High intake of animal protein, High dietary sodium, Excessive intake of refined sugars, Foods rich in oxalate, High intake of grapefruit juice, apple juice and soft cola drinks.
  • Family history of kidney stones (increase risk by three times)
  • History of hypertension
  • Obesity
  • Various other medical conditions.

What is the prevalence of renal calculi?

Renal stone disease is common, with a worldwide prevalence of between 2 and 20%. Lifetime prevalence is nearly 10% in men and 5% in women. Approximately 50 percent of patients with previous urinary calculi have a recurrence within 10 years.

What are Renal Calculi?

Kidney Stones are also termed as Renal Calculi. (Nephrolithiasis) A kidney stone is a hard, crystalline material formed within the kidney or urinary tract.

What are the pelvic floor exercise and why are they important?

Pelvic floor exercises are done to strengthen the pelvic floor muscles, which support the uterus, bladder and bowel. These exercises helps to control the leaking of urine.

What is a Bladder diary?

This daily diary allows to accurately record the fluid intake (how much you drink) and the bladder activity each day. It helps the health care professional to decide whether you have an overactive bladder. Keep the diary nearby, and fill it out as completely as possible. If the health care professional prescribes treatment for overactive bladder, the diary can also be used to help measure your progress.

What are some general lifestyle measures which may help?

  • smoking cessation
  • caffeine reduction
  • reduced alcohol consumption
  • weight loss
  • limiting fluid intake

What is Behavioral Therapy?

Behavioral therapies are considered the mainstay of treatment for urinary incontinence because they are noninvasive and can be initiated at the primary care level.

Behavioral interventions include pelvic floor muscle training (PFMT), bladder training, Self-monitoring with bladder or voiding diaries and lifestyle modification.

What are the treatment options for OAB?

  • Hygienic protection
  • Behavioral Therapy
  • Medications
  • Surgery

Can OAB affect the QoL?

OAB patients have a significantly poorer quality of life. Patients who suffer from OAB focus on and may be preoccupied with such concerns as locating the closest bathroom, estimating the amount of time until their next work break. Furthermore OAB affects daily activities, such as travel, physical activity, relationships, sexual functions and nocturnal bladder control which can affect sleep.

What are the symptoms of OAB?

  • Urgency
  • Frequency
  • Nocturia
  • Urge incontinence

What causes overactive bladder?

  • Large number of condition can cause OAB like
  • Neurological diseases
  • Urinary Tract Infection
  • Multiple Pregnancy
  • BPH/Prostate cancer/ Prostatitis
  • Diabetic Neuropathy

How common is the overactive bladder?

Overactive bladder is highly prevalent distressing medical condition. Despite the high prevalence of OAB and the availability of effective treatment options, OAB treatment remains suboptimal. The condition is under diagnosed, often because of patient’s reluctance to bring their urinary symptoms to the attention of their doctor. Many patients accept their symptoms as a “normal” part of aging or believe surgery is the only treatment available.

What is OAB?

OAB means overactive bladder in this the persons feels urgent desire to go to the toilet, goes to the toilet frequently and sometimes leaking of urine before reaching the toilet.

What are some of the treatments available for BPH?

Watchful waiting: Is recommended as an important option for men who have mild symptoms and do not find them particularly bothersome.

Medical therapy: Today’s most common method for controlling moderate symptoms of BPH. Several medications are available to control moderate symptoms of BPH.

Minimally invasive treatment: Several minimally invasive therapies are available that allows the doctor to access the prostate through urethra and reduce the size of the prostate or decrease obstruction of the urethra.

Surgical treatment: Surgical intervention is necessary in patients in whom benign prostates obstruction causes renal insufficiency, urinary retention, recurrent UTIs, bladder calculi, hydronephrosis, or large postvoid residual volume.

Surgical options for such patients include transurethralresection of the prostate, transurethral laser prostatectomy (which consists of resection, ablation, and vaporization), transurethral incision of the prostate, and open prostatectomy (usually when the prostate weight is >100 g).

How is BPH diagnosed?

In order to help assess the severity of such symptoms, the American Urological Association (AUA) BPH Symptom Score Index was developed. The AUA diagnostic system includes a series of questions that target the frequency of the urinary systems identified above, and as a result, helps identify the severity of the BPH – ranging from mild to severe.

There are a number of diagnostic test procedures that can be used to confirm BPH. The tests vary from patient to patient, but the following are the most common:

Physical examination

Digital rectal examination (DRE)

Laboratories Studies

Prostate Specific Antigen (PSA) Blood Test

Urinalysis

Urine Culture

Imaging techniques

Rectal Ultrasound

Intravenous Pyelogram (IVP)

Cystoscopy

Urodynamic Testing

Is BPH a rare condition?

No, it is a common condition, that can affect approximately 50 percent of men between the ages of 51 and 60 and up to 90 percent of men over the age of 80.

Is BPH a sign of cancer?

No. It is possible to have both BPH and prostate cancer, having BPH does not increase your risk of having prostate cancer. However, because early symptoms of both conditions are similar, it is important to see your doctor if you are experiencing any symptoms associated with a urinary condition.

Which are the most troublesome symptoms?

Many men find that having to get up and go to the toilet at night is the most troublesome aspect of this condition, as it makes them tired during the day. Having to urinate frequently during the day, sometimes with a sense of urgency, can also be trying for patients, and can make traveling or attending events, such as the theatre or cinema, rather difficult. Incomplete emptying of the bladder can be progressive and eventually result in complete retention of urine. If this occurs a catheter (tube into the bladder) will be necessary as the bladder rapidly becomes over distended and painful.

What are some of the symptoms associated with BPH?

Since the prostate surrounds the urethra just below the bladder, its enlargement can result in symptoms that irritate or obstruct the bladder. A common symptom is the need to frequently empty the bladder, especially at night. Other symptoms include difficulty in starting the urine flow or dribbling after urination ends. Also, size and strength of the urine stream may decrease.

What causes BPH?

Although the cause of BPH is poorly understood, the two major factors necessary for the onset of BPH in men are age and normal testicular function.

What is BPH?

Benign Prostatic Hyperplasia (BPH) is the non-cancerous enlargement of the prostate; usually begin in the fifth decade of life in men and which in many men may cause obstruction to urine flow.

What are the common disease conditions of Prostate?

Some common problems related to Prostate are

-Prostatitis

-Benign Prostatic Hyperplasia, or BPH

-Prostate cancer

Benign Prostatic Hyperplasia (BPH)

The prostate, is a part of the male reproductive system, is about the same size and shape as a walnut. It is located below the bladder and in front of the rectum and surrounds the urethra, the tube-like structure that carries urine from the bladder out through the penis. The main function of the prostate is to produce ejaculatory fluid.

Urinary Tract Infection

What is semen analysis?

In semen analysis we evaluates certain characteristics of a male’s semen like Sperm count, Total sperm count, Motility, Morphology, Volume etc.

What are the long- term effects of the condition?

Male infertility can create major tension and the problem has caused many once healthy relationships to break up. It does not affect the couples’ life only, but it also affects the healthcare services and social environment. The feelings experienced by the infertile couples include depression, grief, guilt, shame and inadequacy with social isolation.

How is the condition diagnosed?

The diagnosis of infertility begins with a medical history and physical examination. The provider may order blood tests to look for hormone imbalances or disease. A semen sample may be needed. The volume of the semen is measured, as well as the number of sperm in the sample. How well the sperm move is also assessed.

What increases a man’s risk of infertility?

The number and quality of man’s sperm can be affected by his overall health and lifestyle. Some factors that may increase the risk of male infertility are :

  • alcohol
  • drugs
  • environmental toxins, including pesticides and lead
  • smoking cigarettes
  • health problems
  • medicines
  • radiation treatment and chemotherapy for cancer
  • age

Is male Impotency and infertility same?

No, Impotency is a sexual dysfunction characterized by the inability to develop or maintain an erection of the penis sufficient for satisfactory sexual performance. Impotency can lead to infertility.

What are the causes of male infertility?

Factors relating to male infertility include:

  • Pre-testicular causes

Pre-testicular factors refers to conditions that impede adequate support of the testes and include situations of poor hormonal support and poor general health like Hypogonadism due to various causes, Drugs alcohol, smoking, Medicines etc.

  • Testicular causes

Testicular factors refer to conditions where the testes produces semen of low quantity and /or poor quality despite adequate hormonal support and include : Age, Genetic defects on the Y chromosome etc.

  • Post – testicular causes

Post testicular factors decrease male fertility due to conditions that affect the male genital system after testicular sperm production and include defects of the genital tract as well as problems in ejaculation.

Is infertility a common problem?

It remains a major clinical and social problem, affecting perhaps one couple in six. It affects 13% to 15% of couples worldwide. Male infertility plays a key role in conception difficulties of up to 40% infertile couples.

How do you define Infertility?

Infertility is defined as inability of a couple to conceive naturally after one year of regular unprotected sexual intercourse.

How can one prevent a UTI?

  • Drink lots of water every day.
  • Don’t resist the urge to urinate, do so when you feel the need.
  • Urinate before and after you have sex.
  • Wipe from the front to the back after going to the bathroom.
  • For women, using a diaphragm or sepermicide for birth control can lead to UTIs by increasing bacteria growth.
  • Do not douche.
  • Take showers instead of tub baths.

When should one see the doctor?

You should see your doctor if you have any of these signs or symptoms:

  • burning feeling when you urinate
  • frequent or intense urges to urinate, even when you have little urine to pass
  • pain in your back or lower abdomen
  • cloudy, dark, bloody or unusual-smelling urine
  • fever or chills

How are urinary tract infections treated?

Doctor thinks you have a urinary tract infection, he or she will probably test a sample of your urine to find out if there are bacteria in it. If you have an infection, doctor will then prescribe an antibiotic. Usually, symptoms of the infection go away 1 to 2 days after you start taking the medicine.

How is UTI diagnosed?

A doctor can confirm if you have a urinary tract infection by testing a sample of your urine. Urine Tests we can do : Urinalysis, Urine Culture Ultrasound X-rays like:

  • Voiding cystourethrogram
  • IVP

Do women get urinary tract infections more often than men?

Yes, Women tend to get urinary tract infections more often than men because bacteria can reach the bladder more easily in women. The urethra is shorter in women than in men, so bacteria have a shorter distance to travel.

How can one tell that he or she have a UTI?

Urinary tract infection (UTI) is one of the most common health problems for which patients seek medical care. It is a bacterial infection anywhere in the urinary tract. The urinary tract makes and stores urine and removes it from the body. Parts of the urinary tract includes :

  • You urinate a lot but only a little bit each time.
  • It burns when you urinate.
  • You have to urinate suddenly.
  • There is blood in your urine.
  • Your urine is not clear.
  • Your urine smells bad.

Which people are the risk factors for Urinary Tract Infections (UTIs)?

  • People with kidney stones.
  • People with medical conditions that cause incomplete bladder emptying (for example, spinal cord injury)
  • Immunocompromised people : AIDS and diabetes
  • Women who are sexually active infection.
  • Women who use a diaphragm for birth control.
  • Men with an enlarged prostate.
  • Catheterized patients.

What is a Urinary Tract Infection (UTI)?

Urinary tract infection (UTI) is one of the most common health problems for which patients seek medical care. It is a bacterial infection anywhere in the urinary tract. The urinary tract makes and stores urine and removes it from the body. Parts of the urinary tract includes :

  • Kidneys
  • Ureters
  • Bladder
  • Urethra

What are factors that can effect the management renal calculi?

Management of a kidney stone depends on its size, location, and composition and the presence of anatomical malformation and complications. The presence of a complication (complicated stone) – infection or obstruction – may necessitate immediate intervention, whereas uncomplicated stones can be managed conservatively with adequate fluid intake and analgesia. If a stone does not pass spontaneously then definitive treatment is needed to remove it. The goals of treatment are to control symptoms, render the patient stone free and prevent recurrence.

What are factors that can effect the management renal calculi?

Kidney Yes, Nearly all urethral stones are supposed to be expelled spontaneously when their diameters are smaller than 4 mm. However, the spontaneous expulsion rate of distal ureter stones is about 25% if their sizes are between 4-6 mm and 5% if greater than 6mm. And calculi over 8mm are very rarely eliminated spontaneously. Therefore, active treatments are recommended for individuals with larger stones, especially their sizes are greater than 5 mm.

Can calculi pass spontaneously?

  • History and physical examination
  • Serum and blood testing Calcium, parathyroid hormone, vitamin D, electrolytes
  • Urine dipstick and microscopic examination
  • Urine culture
  • 24-Hours urine collection
  • Imagining ModalitiesPlain Radiography, IVP, USG, CT Scans.

How is Renal Calculi diagnosed?

  • Pain – classic colicky loin to groin pain or renal pain
  • Haematuria, gross or microscopic
  • Dysuria and strangury.

Systemic symptoms

    • Restless patient, often writhing in distress
    • Nausea, vomiting.
    • Fever and chills ( if associated infection)

Asymptomatic

  • Incidental stones

Which is the most common type of renal calculi?

Calcium oxalate (alone or in combination) is the most common type of urinary stone.

What are the risk factors for renal calculi?

  • Dietary risk factors associated with increased stone risk:
  • Low fluid intake, High intake of animal protein, High dietary sodium, Excessive intake of refined sugars, Foods rich in oxalate, High intake of grapefruit juice, apple juice and soft cola drinks.
  • Family history of kidney stones (increase risk by three times)
  • History of hypertension
  • Obesity
  • Various other medical conditions.

What is the prevalence of renal calculi?

Renal stone disease is common, with a worldwide prevalence of between 2 and 20%. Lifetime prevalence is nearly 10% in men and 5% in women. Approximately 50 percent of patients with previous urinary calculi have a recurrence within 10 years.

What are Renal Calculi?

Kidney Stones are also termed as Renal Calculi. (Nephrolithiasis) A kidney stone is a hard, crystalline material formed within the kidney or urinary tract.

What are the pelvic floor exercise and why are they important?

Pelvic floor exercises are done to strengthen the pelvic floor muscles, which support the uterus, bladder and bowel. These exercises helps to control the leaking of urine.

What is a Bladder diary?

This daily diary allows to accurately record the fluid intake (how much you drink) and the bladder activity each day. It helps the health care professional to decide whether you have an overactive bladder. Keep the diary nearby, and fill it out as completely as possible. If the health care professional prescribes treatment for overactive bladder, the diary can also be used to help measure your progress.

What are some general lifestyle measures which may help?

  • smoking cessation
  • caffeine reduction
  • reduced alcohol consumption
  • weight loss
  • limiting fluid intake

What is Behavioral Therapy?

Behavioral therapies are considered the mainstay of treatment for urinary incontinence because they are noninvasive and can be initiated at the primary care level.

Behavioral interventions include pelvic floor muscle training (PFMT), bladder training, Self-monitoring with bladder or voiding diaries and lifestyle modification.

What are the treatment options for OAB?

  • Hygienic protection
  • Behavioral Therapy
  • Medications
  • Surgery

Can OAB affect the QoL?

OAB patients have a significantly poorer quality of life. Patients who suffer from OAB focus on and may be preoccupied with such concerns as locating the closest bathroom, estimating the amount of time until their next work break. Furthermore OAB affects daily activities, such as travel, physical activity, relationships, sexual functions and nocturnal bladder control which can affect sleep.

What are the symptoms of OAB?

  • Urgency
  • Frequency
  • Nocturia
  • Urge incontinence

What causes overactive bladder?

  • Large number of condition can cause OAB like
  • Neurological diseases
  • Urinary Tract Infection
  • Multiple Pregnancy
  • BPH/Prostate cancer/ Prostatitis
  • Diabetic Neuropathy

How common is the overactive bladder?

Overactive bladder is highly prevalent distressing medical condition. Despite the high prevalence of OAB and the availability of effective treatment options, OAB treatment remains suboptimal. The condition is under diagnosed, often because of patient’s reluctance to bring their urinary symptoms to the attention of their doctor. Many patients accept their symptoms as a “normal” part of aging or believe surgery is the only treatment available.

What is OAB?

OAB means overactive bladder in this the persons feels urgent desire to go to the toilet, goes to the toilet frequently and sometimes leaking of urine before reaching the toilet.

What are some of the treatments available for BPH?

Watchful waiting: Is recommended as an important option for men who have mild symptoms and do not find them particularly bothersome.

Medical therapy: Today’s most common method for controlling moderate symptoms of BPH. Several medications are available to control moderate symptoms of BPH.

Minimally invasive treatment: Several minimally invasive therapies are available that allows the doctor to access the prostate through urethra and reduce the size of the prostate or decrease obstruction of the urethra.

Surgical treatment: Surgical intervention is necessary in patients in whom benign prostates obstruction causes renal insufficiency, urinary retention, recurrent UTIs, bladder calculi, hydronephrosis, or large postvoid residual volume.

Surgical options for such patients include transurethralresection of the prostate, transurethral laser prostatectomy (which consists of resection, ablation, and vaporization), transurethral incision of the prostate, and open prostatectomy (usually when the prostate weight is >100 g).

How is BPH diagnosed?

In order to help assess the severity of such symptoms, the American Urological Association (AUA) BPH Symptom Score Index was developed. The AUA diagnostic system includes a series of questions that target the frequency of the urinary systems identified above, and as a result, helps identify the severity of the BPH – ranging from mild to severe.

There are a number of diagnostic test procedures that can be used to confirm BPH. The tests vary from patient to patient, but the following are the most common:

Physical examination

Digital rectal examination (DRE)

Laboratories Studies

Prostate Specific Antigen (PSA) Blood Test

Urinalysis

Urine Culture

Imaging techniques

Rectal Ultrasound

Intravenous Pyelogram (IVP)

Cystoscopy

Urodynamic Testing

Is BPH a rare condition?

No, it is a common condition, that can affect approximately 50 percent of men between the ages of 51 and 60 and up to 90 percent of men over the age of 80.

Is BPH a sign of cancer?

No. It is possible to have both BPH and prostate cancer, having BPH does not increase your risk of having prostate cancer. However, because early symptoms of both conditions are similar, it is important to see your doctor if you are experiencing any symptoms associated with a urinary condition.

Which are the most troublesome symptoms?

Many men find that having to get up and go to the toilet at night is the most troublesome aspect of this condition, as it makes them tired during the day. Having to urinate frequently during the day, sometimes with a sense of urgency, can also be trying for patients, and can make traveling or attending events, such as the theatre or cinema, rather difficult. Incomplete emptying of the bladder can be progressive and eventually result in complete retention of urine. If this occurs a catheter (tube into the bladder) will be necessary as the bladder rapidly becomes over distended and painful.

What are some of the symptoms associated with BPH?

Since the prostate surrounds the urethra just below the bladder, its enlargement can result in symptoms that irritate or obstruct the bladder. A common symptom is the need to frequently empty the bladder, especially at night. Other symptoms include difficulty in starting the urine flow or dribbling after urination ends. Also, size and strength of the urine stream may decrease.

What causes BPH?

Although the cause of BPH is poorly understood, the two major factors necessary for the onset of BPH in men are age and normal testicular function.

What is BPH?

Benign Prostatic Hyperplasia (BPH) is the non-cancerous enlargement of the prostate; usually begin in the fifth decade of life in men and which in many men may cause obstruction to urine flow.

What are the common disease conditions of Prostate?

Some common problems related to Prostate are

-Prostatitis

-Benign Prostatic Hyperplasia, or BPH

-Prostate cancer

Benign Prostatic Hyperplasia (BPH)

The prostate, is a part of the male reproductive system, is about the same size and shape as a walnut. It is located below the bladder and in front of the rectum and surrounds the urethra, the tube-like structure that carries urine from the bladder out through the penis. The main function of the prostate is to produce ejaculatory fluid.