Symptoms constitute problems with the normal urinary process including discomfort, pain and irritability. When the stone obstructs the urine flow, the ureter dilates and stretches causing muscle spasms giving rise to immense gripping pain (renal colic); felt in flank, lower abdomen, groin or leg of affected side. Some stones are called ‘silent’ as they cause no pain. Other kidney stone symptoms include blood in urine (hematuria), increased frequency of urination, fever/chills, nausea/vomiting, pain/burning during urination etc.

• Those who stay in the hot environmental conditions, such as tropical areas.
• Positive family history of stone disease in first blood relation (25%).
• Decreased fluid intake, which reduces urine output, and forms supersaturated urine.

Common causes of stone formation are:

• Supersaturation of urine by decreased intake of water and/or hot environmental conditions leading to loss of body fluid by perspiration, and in breathing.
• Urine infection where crystals deposit on and around the infection causing organism, and the stone grows over the period in the supersaturated urine.
• Diet rich in oxalates, uric acid.
• Functional or structural obstruction of the urinary system can precipitate the stone formation, like Pelvi-Ureteric Junction (PUJ) obstruction, Ectopic kidney etc.

Yes but not all stones. Small stones of 3-6 mm can be passed out with the increased intake of water.

If you find a stone, take it to your doctor for analysis. The type of stone you have, will determine the diet and prevention programme. You may need additional tests to ensure that new stones do not form in future.

There is no damage to other organs as the shock waves are effective on the focused point at the junction of solid and liquid, which is stone and urine respectively.

No there is no known link between the two. They are formed in different areas of the body under different systems.

Stones during pregnancy demand conservative treatment. Surgery, if required may be done – ureteric stenting/PCNL, but only during the first half of the pregnancy term. ESWL is absolutely contraindicated.

Prostate gland is a walnut sized male reproductive gland located in front of rectum, at the base of urinary bladder, surrounding the urethra. In a normal adult, the prostate gland weighs around 20 grams. The size of the prostate gland increases slowly with age. This is known as benign prostatic hyperplasia (BPH) or lower urinary tract symptoms (LUTS). This condition is very common in elderly males over 50 years of age. Enlarged prostate affects urination, ejaculation and sometimes defecation.

Symptoms of BPH may include frequency of urination, urgency to urinate, straining, hesitancy while urination (weak stream), urging even after urination, burning/pain during urination (dysuria), dribbling after voiding urine, some amount of blood in urine (hematuria), frequency of urination especially at night (nocturia), and/or uncontrolled outflow of urine. The early symptoms of benign prostatic hyperplasia and prostate cancer are nearly the same.

Medications play a role in case of moderate to severe symptoms. Two classes of medicines are given, alpha-adrenergic blockers and 5-alpha-reductase inhibitors, either alone or in combination, which help in shrinking the prostate and helping it to relax. Medications result in symptom relief and slow progress of the disease. However, the effect ceases when the medication is stopped. The patient has to continue the medicines throughout life even if urination becomes normal.

No. BPH is non-cancerous enlargement and it does not even increase the risk for prostate cancer.

Holmium Laser Enucleation of Prostate (HoLEP) is used in the management of enlarged prostate. In this, Holmium laser is used to remove the obstructive tissue and also to seal the blood vessels.

In this procedure, a resectoscope is inserted into the urethra through penis. Then a 550 micron fibre attached to the 100 watt Holmium laser machine is passed through it, which enucleates the excessive prostatic tissue. The enucleated gland is then pushed into the bladder, which is then shred into smaller pieces and sucked out using a device called Morcellator. The procedure takes around 15-90 minutes, depending upon the size of the prostate gland. HoLEP is almost bloodless as the laser beam seals the blood vessels also. At the end of the surgery, a catheter is inserted to keep the bladder empty. The catheter is usually kept for 24–48 hours. After the catheter removal, patient is discharged.

Size is not the limiting factor for HoLEP, the largest gland enucleated at RG till date is 424 grams. HoLEP can effectively treat the largest of glands with minimal morbidity. It completely removes the prostate lobes with immediate resolution of the obstruction.

HoLEP technique can be used safely in BPH patients suffering from hypertension, diabetes, cardiac problems, using cardiac pacemakers, or those in whom open surgery cannot be performed due to high risk of complications. This is a safe procedure.

Screening for prostate cancer is a simple procedure. One may begin with a visit to the urologist. Urologist will be able to help you learn more about the screening process.

Urologists, radiation oncologists and medical oncologists all play a vital role in the treatment of prostate cancer.

The treatment depends on the cause. Get yourself checked for medical problems and medicines that might cause ED. Medications may help with erectile dysfunction, some of which may be injected into your penis. Other medicines are taken by mouth. Not everyone can use these medicines. Your doctor will help you decide if you can try them.

Urinary incontinence is the inability to hold urine leading to involuntary loss of urine. The urine loss can range from slight leakage of urine to severe frequent wetting. This condition severely affects quality of life by interfering with work, travel, social recreation and sexual activities.

No, women experience incontinence twice more often than men. Pregnancy, child-birth, menopause, and short female urinary tract account for this difference. However, both women and men can become incontinent from stroke, multiple sclerosis, and old age.

Risk factors include:

• Pregnancy
• Childbirth
• Obesity
• Menopause
• Cigarette smoking
• Prostate enlargement
• Uterus removal
• Radiation to pelvis
• Diabetes
• Parkinson’s disease
• Back injury
• Cerebral vascular accident

Most types of urinary incontinence can be effectively treated. In some patients, incontinence is often improved by weight loss. Smokers who have a chronic cough have fewer problems when they stop smoking (coughing). Some common drugs can also aggravate the situation.

In these patients, pelvic floor exercises (e.g. Kegel exercises) can be effective. These exercises strengthen both peri-urethral and pelvic floor muscles. However, these must be performed frequently throughout the day and continued for long-term effect. Certain drugs are also available for the management of stress incontinence. Oestrogen replacement therapy can also be very helpful, particularly in postmenopausal women. There are several surgical procedures, which may also prove helpful.

When we eat fatty food the gall bladder squeezes the bile through the common bile duct into the intestine. When cholesterol or fat concentration increases in the bile juice, the juice precipitates as stone.

• Gaseous distension or bloating (gas formation).
• Flatulent dyspepsia (acidity).
• Acute upper abdominal pain along with vomiting and fever. This occurs when a gall stone gets impacted at the neck of the GB.
• Jaundice – Occurs when a gall stone drops down from the GB into the common bile duct resulting in obstruction to the flow of bile.
• Pancreatitis – Occurs when the slipped gall stone in the common bile duct irritates the duct of the pancreas gland leading to inflammation of the gland. This is an emergency situation and patient requires admission into the ICU most times.

Being even moderately overweight increases the risk for developing gallstones. Obesity is a major risk factor for gallstones, especially in women.

As the body metabolizes fat during prolonged fasting and rapid weight loss, such as “crash diets”, it can cause gallstones.

Silent gallstones are usually left alone and sometimes they disappear on their own. Symptomatic gallstones are usually treated. The most common treatment is surgery to remove the gallbladder. This operation is called a cholecystectomy. This is done through laparoscopy. In other cases, drugs are used to dissolve the gallstones. Your doctor can help determine which option is best for you.