BPH (Enlarged Prostate)
Benign Prostatic Hyperplasia (BPH), also known as an enlarged prostate, is a common condition in men, especially as they get older. The prostate is a small gland that produces fluid that nourishes and transports sperm. When it enlarges, it can press against the urethra (the tube that carries urine from the bladder out of the body) causing a variety of urinary symptoms.
Common symptoms include frequent or urgent need to urinate, increased frequency of urination at night (nocturia), difficulty starting urination, weak urine stream or a stream that stops and starts, inability to completely empty the bladder, and urinary tract infections. These symptoms occur because the enlarged prostate is pressing on the urethra, causing an obstruction or blockage to the flow of urine.
Several treatment options are available depending on the severity of symptoms and how much they interfere with lifestyle. Medications such as alpha blockers and 5- alpha reductase inhibitors can help by relaxing the bladder neck muscles or shrinking the prostate. For more severe symptoms, minimally invasive procedures like transurethral resection of the prostate (TURP) or prostate implants can be used. If other treatments aren’t successful, surgery might be recommended.
Renal stones, or kidney stones, are hard deposits made of minerals and salts that form inside your kidneys. They can affect any part of your urinary tract from your kidneys to your bladder. They’re one of the most painful medical conditions, but fortunately they don’t cause permanent damage if they’re recognized in a timely fashion.
Symptoms don’t usually occur until the stone begins to move down the ureters (tubes that connect kidneys and bladder) and cause blockage. They can include severe pain in the side and back, below the ribs, pain that radiates to the lower abdomen and groin, pain during urination, pink, red or brown urine, cloudy or foul-smelling urine, persistent need to urinate, and fever and chills if an infection is present.
Treatment for kidney stones varies depending on the size and type of the stone, whether it is causing pain, and whether it is blocking your urinary tract. Pain can be managed with over-the-counter or prescription medications. Small stones usually pass out in the urine and only require pain management and drinking plenty of water. However, larger stones may need to be broken up with sound waves (extracorporeal shock wave lithotripsy), removed using a scope inserted through the urethra (ureteroscopy), or surgically removed.
A ureteric calculus is a kidney stone that has moved down into the ureter. Just like renal stones, these are solid pieces of material that form in the kidney when substances like calcium, oxalate, cystine, or uric acid concentrate in the urine.
The symptoms of a ureteric calculus are usually more severe than a renal stone because it can block the passage of urine from the kidney to the bladder. This can cause severe pain in the back or side that may spread towards the groin, blood in the urine, frequent urge to urinate, pain while urinating, and cloudy or bad-smelling urine. There may also be nausea and vomiting.
Treatment depends on the size of the stone, its location, and whether it’s causing a blockage. Small stones may pass on their own, with plenty of fluids and medication to manage pain. But larger stones might require medical intervention. This can include extracorporeal shock wave lithotripsy, which uses sound waves to break up the stone, or ureteroscopy, where a thin tube is used to catch and remove the stone or break it up with laser energy.
Urinary Bladder Stone
A bladder stone is a hard mass of minerals that forms in the bladder when the minerals in concentrated urine crystallize. This can occur if the bladder isn’t completely emptied each time you urinate.
Symptoms of bladder stones can include lower abdominal pain, pain in the penis for men, frequent need to urinate, interrupted urine flow, blood in the urine, cloudy or abnormally dark urine, and pain during urination. In men, there may also be pain or discomfort in the penis or testicles.
Treatment for bladder stones usually involves either removing them or breaking them down. Small bladder stones may pass on their own, aided by drinking lots of water and using over-the-counter painkillers. For larger stones, a procedure called a cystolitholapaxy is often used or if required open surgery may also be done. In this procedure, a small tube with a camera at the end (cystoscope) is inserted through the urethra to the bladder, the stone is broken up with a laser or ultrasound, and the fragments are then removed. If the stone is too large to be broken up, it may need to be removed with surgery.
A urethral stricture involves narrowing of the urethra due to injury, inflammation, or infection. This can block the flow of urine from the bladder and can cause serious complications.
Symptoms of a urethral stricture can include decreased urine stream, incomplete bladder emptying, straining to urinate, frequent urination or urinary retention, pain during urination, urinary tract infections, and swelling of the penis.
The treatment of urethral stricture depends on its severity and the patient’s overall health. Non-surgical treatments include urethral dilation, where the urethra is gradually widened, and urethrotomy, where a small knife is used to cut the stricture. Surgical treatments can involve reconstruction of the urethra using a graft, or placement of a stent to keep the urethra open.
Hypospadias is a birth defect in boys where the opening of the urethra (the tube through which urine exits the body) is not located at the tip of the penis. Instead, it’s located on the underside of the penis, often causing difficulty with urinating while standing and issues with sexual function later in life.
Symptoms of hypospadias can include an opening of the urethra that is not at the tip of the penis, downward curve of the penis (chordee), hooded appearance of the penis because only the top half of the penis is covered by foreskin, and abnormal spraying during urination.
Surgery is typically the chosen treatment for hypospadias, and it is usually performed before the child is 18 months old. The goals of surgery are to make the penis look normal, allow urination while standing, and ensure normal sexual function. This is typically done in one procedure, but more complex cases might require additional surgeries.