Muljibhai Patel Urological Hospital
An ISO 9001:2008 Certified Institute
0091 268 2520323-30
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Frequently Asked Questions

Department of Urology

The department of urology strives to cure surgically kidney ailments such as kidney stones, kidney failures, prostate and cancer of the prostate, and sexual dysfunction. The various kinds of operative procedures used for treating these diseases are supported by the latest available technology.                                                                          Robotic Surgery

FAQ is not the link to ask questions. Please user other links on our website such as 'Ask your Health Queries' or 'Inquiry Form' for asking your questions. In this case, you may email your question to mishra [at] mpuh [dot] org

Please email your question to hegde [at] mpuh [dot] org. When you ask questions using FAQ, we do not receive your contact details and hence we are unable to reply directly.

Please email your question to mishra [at] mpuh [dot] org. When you ask questions using FAQ, we do not receive your contact details and hence we are unable to reply directly.

Pl email your question to hegde [at] mpuh [dot] org

Please email your question to mishra [at] mpuh [dot] org

Hi, we are unable to respond to you as we do not have your contact details. Please use the section 'Ask your health queries' on our website www.mpuh.org. Or, you may email to our Urologist, mishra [at] mpuh [dot] org who will answer your question.

Please note, FAQ is not meant for asking questions. This section provides answers to frequently asked questions, which are updated at regular intervals only. For asking questions, please use 'Inquiry Form' or 'Ask your Questions' on our website. When you place questions on FAQ we do not get your email ID. So, we are unable to respond. You may please email to our Urologist mishra [at] mpuh [dot] org who will answer to your question.

pl email our nephrologist, hegde [at] mpuh [dot] org

please email to our urologist, mishra [at] mpuh [dot] org
there are three different fee structures based on General Ward, Semi-Special and Special room categories.

Please email your question to mishra [at] mpuh [dot] org.
The FAQ section is not meant for questions of general nature, but meant for answers to Frequently Asked Questions (FAQ). Besides, we do not get your email ID from this section to answer you directly.

Please note, the FAQ is not for asking questions. Instead, please use other features provided on our website, e.g. 'Ask your Health Queries' or 'Inquiry Form'. You may also send email directly to our Urologist mishra [at] mpuh [dot] org who will answer your questions.

Please note, the FAQ is not for asking questions. Instead, please use other features provided on our website, e.g. 'Ask your Health Queries' or 'Inquiry Form'. You may also send email directly to our Urologist mishra [at] mpuh [dot] org who will answer your questions.

please email to mishra [at] mpuh [dot] org, or seek an appointment at opd [at] mpuh [dot] org, telephone 0268-2520323 - 30

please email to mishra [at] mpuh [dot] org
or seek an appointment at opd [at] mpuh [dot] org
or phone 0268-2520323 - 30

Please note, if you write your questions under FAQ, it will not get answers. Because, it does not give your contact details. Besides, FAQ is for answers to FREQUENTLY ASKED QUESTIONS. You may please email to hegde [at] mpuh [dot] org, and you will receive answer. Thanks. joseph [at] mpuh [dot] org

Hello, you may ask this question using other features on our website. FAQ is meant for Frequently Asked Questions, and your email ID is not given, and hence we are unable to answer. You may also like to email to mishra [at] mpuh [dot] org who will answer your question. Thanks / joseph [at] mpuh [dot] org

Question not found. Please ask questions using the MPUH website links LIVE CHAT or ASK YOUR HEALTH QUERIES or INQUIRY FORM for treatment estimates. FAQ is not meant for general questions. Thanks.

Department of Nephrology

The department of nephrology has 6 consultants and 9 fellows. Our department is recognized for training in Nephrology subspecialty by the National Board of Examinations, New Delhi. We take three fellows every year. They are trained for a period of 3 years. Unit1Unit 2Outpatient Days  Monday, Wednesday, FridayTuesday,Thursday,SaturdayConsultants1.Dr.Mohan M Rajapurkar,MDDirector,Postgraduate Studies & Research2.Dr Umapati N Hegde, MD, DNB  Vice-chairman, Department of Nephrology3.Dr Manish Dabhi, MD,DNB Consultant Nephrologist                                                                                                   1.Dr Sishir Gang,MD,DM,DNBChairman, Department of Nephrology2.D Kalpesh Gohel,MD,DNBConsultant Nephrologist3.Dr Anil Ganju, MDConsultant Nephrologist                                             Fellows1.Dr.Jayesh Modi2.Dr.Abhay Joshi3.Dr Ajay Naxane4.Dr Pankaj Mishra1.Dr.Tushar Malavade2.Dr.Manish Tripathi 3. Dr Shahabaj Ahmed4. Dr Anil PatelDialysis FellowDr Maulik Shah The Division of Nephrology at MPUH provides comprehensive services for nephrology outpatient and inpatient care, dialysis, and kidney transplant services. Diseases:MPUH Nephrology Department treats virtually any nephrology disease, including but not limited to: 

Research has shown that participation in the LST program can cut drug use in half.<>1] These reductions (in both the prevalence and incidence)<>2] of drug use have primarily been with respect to tobacco, alcohol, and marijuana use. For example, long-term follow-up data indicate that reductions in drug use produced with seventh graders can last up to the end of high school. viagra all. viagra online without prescription State prison 0.6 1.1 0.8 4.2 from 1992 to 2003 in the number of 12- to 17- How is erectile dysfunction diagnosed? viagra online This interactive group discussion educates participants about California natural viagra causing the blood to turn dark red. Pycnogenol has been found to greatly help those with, at least, advanced venous 5. Do you believe that tamper free prescription pads help to prevent diversion? cheap viagra

FAQ is not the link to ask questions. Please user other links on our website such as 'Ask your Health Queries' or 'Inquiry Form' for asking your questions. In this case, you may email your question to mishra [at] mpuh [dot] org

FAQ is not the link to ask questions. Please user other links on our website such as 'Ask your Health Queries' or 'Inquiry Form' for asking your questions. In this case, you may email your question to hegde [at] mpuh [dot] org

FAQ is not the link to ask questions. Please user other links on our website such as 'Ask your Health Queries' or 'Inquiry Form' for asking your questions. In this case, you may email your question to hegde [at] mpuh [dot] org

FAQ is not the link to ask questions. Please user other links on our website such as 'Ask your Health Queries' or 'Inquiry Form' for asking your questions. In this case, you may email your question to hegde [at] mpuh [dot] org

please email your question to hegde [at] mpuh [dot] org or call 0268-2520323 - 29 (7 lines)

Please email your question to our Nephrologist Hegde [at] mpuh [dot] org

FAQ is not meant for asking questions, and when you place questions on FAQ, we do not get your email ID. Therefore, we are unable to respond to you. Please email your question to hegde [at] mpuh [dot] org or use 'Ask your health queries' section on www.mpuh.org

We are unable to answer your question in the absence of your email ID. Please email your question to mishra [at] mpuh [dot] org. You may also use 'Ask your Health queries on our website to ask questions. FAQ is not intended to ask general questions.

Please note, the FAQ is not for asking questions. Instead, please use other features provided on our website, e.g. 'Ask your Health Queries' or 'Inquiry Form'. You may also send email directly to our Nephrologist hegde [at] mpuh [dot] org who will answer your questions.

Please note, the FAQ is not for asking questions. Instead, please use other features provided on our website, e.g. 'Ask your Health Queries' or 'Inquiry Form'. You may also send email directly to our Nephrologist hegde [at] mpuh [dot] org who will answer your questions.

Please note, the FAQ is not for asking questions. Instead, please use other features provided on our website, e.g. 'Ask your Health Queries' or 'Inquiry Form'. You may also send email directly to our Urologist mishra [at] mpuh [dot] org who will answer your questions.

You may please email the question to our Nephrologist, hegde [at] mpuh [dot] org. We are unable to answer you as we do not have your email ID.

Please note that FAQ is not for asking questions, rather it is meant for answers to 'frequently asked questions'. Specific questions may be asked using other features on our website, e.g. 'Ask your Health Queries', 'Inquiry Form', or Live Chat.

You may please email the question to our Nephrologist, hegde [at] mpuh [dot] org. We are unable to answer you as we do not have your email ID.

Please note that FAQ is not for asking questions, rather it is meant for answers to 'frequently asked questions'. Specific questions may be asked using other features on our website, e.g. 'Ask your Health Queries', 'Inquiry Form', or Live Chat.

Sorry for the delayed response. FAQ is not meant for questions. You may please write to mishra [at] mpuh [dot] org for advise, or seek an appointment by emailing opd [at] mpuh [dot] org, or telephone 0268-2520323 - 30 (8 lines).

When you ask questions at FAQ, we do not get your contact details. There are other sections on our website to ask questions.
Please email to hegde [at] mpuh [dot] org, or seek an appointment at opd [at] mpuh [dot] org, or phone 0268-2520323 - 30

Sorry for the late reply. Please note, FAQ is not a forum for questions. It is for Answers to Frequently Asked Questions.

You may please email your question to hegde [at] mpuh [dot] org. You will receive answer. If you are to ask questions online from our website, please use 'Ask your health queries' or 'Inquiry Form'. You can also use the feature 'Live Chat'. If the doctor is not online, your question will come to us as an email which will also be replied. Thanks. joseph [at] mpuh [dot] org

Since you have not given your contact details (email), we are unable to respond to your questions. Please use any other mode (other than FAQ) to ask questions, e.g. Ask a Question, Inquiry, Chat, etc. Alternatively, you may write to hegde [at] mpuh [dot] org (He is a Consultant Nephrologist and Vice-Chairman, Dept of Nephrology at MPUH Nadiad.

You may please write to info [at] mpuh [dot] org. FAQ is for answers to FREQUENTLY ASKED QUESTIONS only.

Department of Anaesthesia

We have a well-equipped anaesthesia department with a trained staff. This department especially is well-equipped for high risk surgeries. It also has state-of-the-art equipment and monitoring devices. This includes ventilators, cardiac monitors, pulse oximeters, and non-invasive monitoring of blood pressure, arterial gases and ventilatory gases.

Often times cash is hard to find and payday is still a week or two apart. A cash advance can sort out that it will assist you to have enough money you should get by. See the subsequent information and facts to learn about payday loans.

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Department of Pathology

We have a full-fledged pathology department which includes and automated biochemistry laboratory, radio immuno assay, histopathology including flurescent staining for renal biopsies, microbiology, and tissue typing facilities. We have qualified pathologists and biochemist supported by a number of trained laboratory technicians. Patient’s can avail of this facility on an out-patient basis, if properly prescribed. OverviewOurs is a team of experienced pathologist, biochemist and a highly skilled and dedicated technical staff who are committed to provide the highest quality results needed to deliver the most effective patient care. Our department functions 24hrs a day and ensures that accurate results are conveyed quickly to the treating clinician.We provide quality service through fully automated analyzers, highest quality imported reagents with regular calibrations and controls. The department is linked with the LAN system which ensures easy accessibility to all results.The department has the following sections:

  • Biochemistry
  • Hematology
  • Histopathology and Cytology
  • Microbiology
  • Clinical pathology
  • Immunology
  • Research

BiochemistryThis section is fully automated. All routine and specialized tests required for the detection and treatment of renal and urological diseases are performed here.Beckman Coulter CX5 Pro random access chemistry analyzer performs the routine as well as specialized biochemistry tests. This has a supportive backup system of Transasia-XL300 (Erba) as well. Roche Omni Electrolyte and blood gas analyzer, Nova 4+ (Nova-Biomed) electrolyte analyzer and the Electrophoresis system from Sebia completes the list of the equipment in this section. Apart from the routine clinical chemistry analysis, we also perform theradioimmunoassay (RIA) and Enzyme-linked immunosorbent assay (ELISA)tests for a number of specialized investigations. The automated ELISAsystem and Gamma counter are thus the important part of this section. Drug monitoring, tumour markers, hormone assay, protein markers,viral screening and anaemia profile are regularly performed.HematologyAll routine hematology tests and coagulation studies are performed. The Beckman Coulter HMX analyzer delivers consistently reliable results with a fully automated differential and semi-automated reticulocyte counts. Histopathology and cytologyThe histopathology section processesaround 500 renal biopsies annually, including renal allograft biopsies. We provide both light microscopy and immunofluorescence studies and deliver same-day biopsy results. No case is signed out without direct contact with the clinician to ensure a correct diagnosis focusing on the critical clinical questions.Urological pathology reports generated here are based on AJCC/UICC TNM (2009) system. We also provide intraoperative frozen section biopsy services. Urine cytology to detect malignancies of the urinary tract is also performed here.We are also referral centre for renal and urological pathology and reportbiopsies for many hospitals within and outside Gujarat.This section is equipped with Leica 1950 cryostat, Leica microtome, Shandon Histocentre 3 Embeddig Centre, Shandon Citadel Tissue processor and Cytocentrifuge.Clinical pathologyUrine routine examination, semen analysis, stool analysis and body fluid analysis are done on a daily basis with a turn around time of about 2 hoursMicrobiology Provides services for the diagnosis of infectious diseases. In addition to the routine diagnostic methods like microscopy and culture, we have automated BacT/Alert 3D (Biomerieux) system which aids in the rapid detection of microorganisms in blood and body fluids. The miniAPI(Biomerieux) identification system accurately identifies and provides antimicrobial susceptibility. The rapid turn around time on many occasions may be life saving for the patient.We are also equipped with Gen-Probe's AMPLIFIED MTD Test which detects Mycobacterium tuberculosis rRNA directly and rapidly. Lymphocyte cross match by Complement Dependent Cytotoxicity (CDC).This test which is performed during donor screening as well as immediately prior to renal transplant detects the potentially harmful antibodies directed specifically against the donor’s HLA antigens.  Research section The clinical laboratory routinely takes part in all hospital sponsored and laboratory based research and clinical trial activities. This section is specially equipped with Beckman UV-Vis and Amkett UV-Vis spectrophotometer for special analysis. A highly experienced and talented group of workers who are constantly involved in novel assay development and innovative clinical research work form a part of this section.  

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Department of Radiology

We have full fledged radiology department with X-ray, ultrasound and colour doppler facilites. Our 3 x-ray machines perform conventional x-rays as well as certain specialised radiological procedures such as intravenous pyelography (IVP), micturating cystourethrography (MCUG) and ascending urethrography (AUG).

MPUH RADIOLOGY DEPT is proud to have inhouse facilities of two X-ray units (500 MA units), Three colour Doppler Machines & Four other Ultrasound Scanners, one MDCP scanner from GE with 16 slace detectors.

We have an active interventional uro-radiology section which performs a variety of urological and vascular procedures with fluroscopy and ultrasound guidance. These include percutaneous nephrostomy (PCN), renal angiography alongwith angioplasty and stenting, transrectal prostatic biopsy, renal cyst aspiration amongst others.A patient  undergoing Sonography Patients can avail this facility on an out-patient basis without being registered patients of the hospital, if appropriately prescribed by a physician.

Hello, you may please email your question to rajan [at] mpuh [dot] org, because FAQ is a place for answers to commonly asked (selected) Questions only. Since you have not given your email we are unable to request the doctor to reply to you directly.

General FAQ

Research has shown that participation in the LST program can cut drug use in half.<>1] These reductions (in both the prevalence and incidence)<>2] of drug use have primarily been with respect to tobacco, alcohol, and marijuana use. For example, long-term follow-up data indicate that reductions in drug use produced with seventh graders can last up to the end of high school. viagra all. viagra online without prescription State prison 0.6 1.1 0.8 4.2 from 1992 to 2003 in the number of 12- to 17- How is erectile dysfunction diagnosed? viagra online This interactive group discussion educates participants about California natural viagra causing the blood to turn dark red. Pycnogenol has been found to greatly help those with, at least, advanced venous 5. Do you believe that tamper free prescription pads help to prevent diversion? cheap viagra

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Use a strong policy for making payment on the bank loan back. For the majority of best payday loans online firms, you're required to repay the borrowed funds in weeks or maybe you are charged far more interest in the loan. Figure out the quantity it will be possible to pay back without having harming your financial situation.

Payday cash loans may help you be worthwhile immediate bills, but you may even use them like a cash managing approach. Extra cash can be used starting a spending budget that can help you steer clear of taking out a lot more loans. For that reason, although you will have to pay back the cash advance plus attention, the financing could in fact assist you to in the end. Be certain to adhere to common sense.

Don't fill out personal loan applications before knowing what amount you'll be billed for what you're credit. You operate the potential risk of becoming accountable for the loan after they procedure the paperwork, and you may be caught up paying back one thing with extremely high prices.

You really should mark your loan because of day with a calender. This should help you continue to keep that transaction time under consideration. It's very easy to just forget about payday cash loans you are obligated to pay, and writing it down will certainly be a note. Be certain you might have your payday advance because of date engraved on your storage.
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Payday loans will not be helpful when employed frequently, even so, they can be a sensible way to manage emergency situations, on occasion. In order to avoid problems, it is important that you will be intelligent in terms of how you employ payday loans. Retain the details useful whenever you're hoping to get that speedy income!

FAQ is not the link to ask questions. Please user other links on our website such as 'Ask your Health Queries' or 'Inquiry Form' for asking your questions. In this case, you may email your question to hegde [at] mpuh [dot] org

please email your question to hegde [at] mpuh [dot] org or call 0268-2520323 - 29 (7 lines)

Please email your question to our Nephrologist Hegde [at] mpuh [dot] org

Please email your question to hegde [at] mpuh [dot] org. When you ask questions using FAQ, we do not receive your contact details and hence we are unable to reply directly.

Pl email your question to hegde [at] mpuh [dot] org

Please email your question to mishra [at] mpuh [dot] org

FAQ is not meant for asking questions, and when you place questions on FAQ, we do not get your email ID. Therefore, we are unable to respond to you. Please email your question to hegde [at] mpuh [dot] org or use 'Ask your health queries' section on www.mpuh.org

Hi, we are unable to respond to you as we do not have your contact details. Please use the section 'Ask your health queries' on our website www.mpuh.org. Or, you may email to our Urologist, mishra [at] mpuh [dot] org who will answer your question.

pl email our nephrologist, hegde [at] mpuh [dot] org

please email to our urologist, mishra [at] mpuh [dot] org
there are three different fee structures based on General Ward, Semi-Special and Special room categories.

Please email your question to mishra [at] mpuh [dot] org.
The FAQ section is not meant for questions of general nature, but meant for answers to Frequently Asked Questions (FAQ). Besides, we do not get your email ID from this section to answer you directly.

Please note, the FAQ is not for asking questions. Instead, please use other features provided on our website, e.g. 'Ask your Health Queries' or 'Inquiry Form'. You may also send email directly to our Urologist mishra [at] mpuh [dot] org who will answer your questions.

You may please email the question to our Nephrologist, hegde [at] mpuh [dot] org. We are unable to answer you as we do not have your email ID.

Please note that FAQ is not for asking questions, rather it is meant for answers to 'frequently asked questions'. Specific questions may be asked using other features on our website, e.g. 'Ask your Health Queries', 'Inquiry Form', or Live Chat.

You may please email the question to our Nephrologist, hegde [at] mpuh [dot] org. We are unable to answer you as we do not have your email ID.

Please note that FAQ is not for asking questions, rather it is meant for answers to 'frequently asked questions'. Specific questions may be asked using other features on our website, e.g. 'Ask your Health Queries', 'Inquiry Form', or Live Chat.

please email to mishra [at] mpuh [dot] org, or seek an appointment at opd [at] mpuh [dot] org, telephone 0268-2520323 - 30

Please note, if you write your questions under FAQ, it will not get answers. Because, it does not give your contact details. Besides, FAQ is for answers to FREQUENTLY ASKED QUESTIONS. You may please email to hegde [at] mpuh [dot] org, and you will receive answer. Thanks. joseph [at] mpuh [dot] org

You may please write to info [at] mpuh [dot] org. FAQ is for answers to FREQUENTLY ASKED QUESTIONS only.

Water helps flush out stones by increasing urine production. Water also reduces your risk of new stones by diluting the chemicals in your urine. Also avoid liquids that dehydrate you, such as caffeine and alcohol.

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

Some of the stones are formed due to infection. In the Kidney calyx they pass spontaneously or lodge else where in the urinary tract - stay and grow.

Some stones move to the Kidney pelvis and increase in size blocking the flow of urine, thus compromising Kidney function giving rise to pain, swelling and sometimes infection.

Stones which grow in the Kidney and occupy all its area form a staghorn calculus. They are of different types depending upon presence or absence of infection.

A stone if small (less than 7 mm) comes down further into the ureter, blocks the flow of urine, producing symptoms like pain, blood in urine, burning during urination.

Stones form due to many reasons:

  • Fluid loss : Commonly known as dehydration, makes concentrated urine which in turn precipitates salts which result in stone formation.
  • Certain Foods : Contain high amounts of the chemicals which in particular situations crystallize and grow into stones.
  • Kidney Infection : Foster stones due to the process of precipitation of certain chemicals.
  • Abnormal Urinary Tract Anatomy : Results into obstruction and stagnation of urine resulting into stone formation e.g. horseshoe kidney, ectopic kidney, obstruction.

Identifying Kidney Stones:

Kidney stones are identified by their size, shape and composition.

If certain chemicals concentrate within the kidney they can form a stone ranging in size from microscopic to about as large as a golf-ball. Stones may stay in the kidney or move into the urinary tract.

People who tend to form stones have certain risic factors in common.

  • Those who have lived or are still living in the stone belt of the country e.g. Punjab - Rajasthan - North Gujarat Kutch-Saurashtra
  • Those with a family history of stones.
  • Those whose fluid intake is minimal.

Each human being has two Kidneys - one on either side of the spine in the lower back, shaped like a bean, each is the size of an adult fist and is pinkish - brown in colour. Kidneys are complex, versatile filtering as well as manufacturing units:

  • They remove fatal toxic substances from the blood stream and maintain normal chemical composition by forming urine.
  • They regulate the blood pressure of the human system.
  • They process Vitamin D.
  • They produce chemicals that go to form the red blood cells.

The presentation of symptoms depends upon the location, size and shape of the stone.

  • Sudden severe pain - starting at the flanks and moving towards groins.
  • Nausea and Vomiting.
  • Blood in urine.
  • Urinary frequency.
  • Burning sensation on passing urine.
  • Infection in urine.

Stones occur with sudden agonizing pain which comes in waves, starting from the lower back and spreading towards the groins.

  • Some kidney stones are silent they produce no pain.

  • 80% of kidney stones are passed naturally without damage to the kidneys or the urinary tract system, while 20% can prove harmful.
  • Timely diagnosis and prompt action reduces the suffering and preserves kidney function.
  • The stone once removed is prevented from recurring.

In more than half of all impotence cases the cause is physical - the result of diabetes, a hormone problem, blocked arteries or other causes. In other cases, the cause could be psychological - the result of stress or depression. And in many cases, physical causes can produce psychological side effects.

Diagnosing the cause is the first step before reconunending a treatment. Your urologist will require a thorough history, physical examination and laboratory tests to determine whether the impotence has a physical or psychological cause.

The good news is that there are treatments available. And there is usually more than one option to choose from, ranging from sex counselling or marriage counselling to medical and surgical treatments. Your urologist can determine which treatment alternative is appropriate for you. Most impotence problems can be treated successfully.

Impotence is the inability to maintain an erection that is firm enough or that lasts long enough to have successful sexual intercourse. It is a frustrating condition that may have either physical or psychological causes. But there are many types of sexual dysfunctions which may be confused with impotence.

For instance premature ejaculation is not a sign of impotence. Nor is a low sex drive, or the fact that you may need manual or oral stimulation to get an erection. Impotence cannot be caused by too much sex or masturbation earlier in life. And there is no connection between impotence and infertility. Most importantly, impotence is not "normal" at any age. Impotence is common and experienced by many individuals.

Depending on your diagnosis your recommended treatment may be medical or surgical.

Medical : Medical treatments range from simply changing your prescribed drugs to hormone replacement therapy, antldepressant therapy, and devices or self-injection therapy to produce erections.

Surgical : Surgical treatments Include vascular surgery or Implants. Your urologist will discuss options that may be appropriate in treating your impotence, as well as the risks and benefits of each option.

PSYCHOLOGICAL CAUSES:

Masturbation Guilt can lead to sexual problems. It is a widespread false belief that masturbation is harmful. The actual fact is that alirnost all men masturbate. Masturbation provides a safe release for sexual energy when sexual intercourse is not possible. If however, a man becomes tense and anxious because of a false belief that masturbation will harm him, then this tension and anxiety will lead to psychological and sexual problems.

Depression can cause a lack of energy and a reduced sex drive, which may result In an occasional inability to get an erection. This itself may produce more depression resulting into impotence. The first step is to treat the depression.

Stress, whether caused by your job, marital, financial, or other problems, adds to the impotence. Performance anxiety or fear of failure, happens to most men occasionally, but if it persists it can lead to Impotence.

Misinformation about sexuality and about how men should not be able to "perform" at a certain age can lead to anxiety and stress, which can lead to impotenc.

 

PHYSICAL CAUSES:

Diabetes can cause damage to the nerves or blood vessels that control the low of blood to the penis. In some cases, keeping your diet and blood sugar under control may decrease the risk of impotence. But permanent damage to these nerves and vessels may result in chronic impotence.

Cardiovascular problems, such as hardening of the arteries, can slow the blood flowing into the penis, making it difficult for you to get or keep an erection. In other cases, the veins that keep blood in the penis during an erection are damaged, and you cannot keep the erection long enough for sexual intercourse.Impotence can also occur if the nerves that control this flow of blood to the penis are damaged.

Pelvic surgery or trauma, including cancer surgery in the prostate, bladder, colon or rectal area, can cause impotence. In cancer surgery, the surgeon's most important goal is to remove all of the cancer. Nerves and blood vessels that control erections may be near the cancerous tissue; sometimes these are damaged in an effort to remove the cancer.

Neurological disorders such as spinal cord injuries can cause impotence. The spinal cord is the relay center for nerve impulses, brain messages and blood flow. When the spinal cord is damaged in certain locations, messages can't get through to the nerves of the penis, causing impotence.

Medications, including some prescriptions for high blood pressure, depression and a number of other conditions, may cause impotence by interfering with the nerve impulses or blood flow to the penis. Sometimes a change in the medication or the dosage will decrease the risk of iirnpotence. However, medications should never be changed without the doctor's permission.

Alcoholism disrupts hormone levels and can lead to permanent nerve damage, causing impotence. This type of impotence may be reversible depending on the severity of the nerve damage.

Hormone problems are rarely the cause of impotence, but certain diseases can disrupt the balance of hormones which control erections. Kidney failure and liver disease are among these conditions.

If it is detern-dned that you are impotent, and that your impotence Is caused by a physical problem, your doctor can offer several options for treatment. These may include hormone therapy, injections, vaccum devices, penile implants or vascular surgery.

Certain tests help us in diagnosing cancer.

  1. Digital rectal examination : The doctor will put a finger in the rectum and palpate the prostate gland. Normally it feels firm but if some area is hard, it is suspicious of cancer. 80-90% times this simple examination Itself will detect presence of cancer.
  2. PSA : This is a special blood test. If the PSA level is raised beyond a certain limit, it is suspicious of cancer.
  3. Trans-rectal Sonography : This is a special ultrasound test. It is done by passing a robe in the rectum. With this complete internal structure of prostate can be studied. In helps not only in detecting cancer but also in staging the cancer. If cancer is present, whether it is situated only in 1 part, or in whole gland, whether the capsule Is broken or not, whether it has spread to nearby seminal vesicles, etc. All these details can be known. In addition biopsy from a suspicious area can be taken under this ultrasound guidance.
  4. Bone scan : To detect any deposition of cancer in the bone.
  5. X-ray Chest : To detect any deposition of cancer in the lungs.
  6. Ultimate confirmation of cancer is done by taking a biopsy (removing a piece of prostate and studying it under microscope).
  7. This is done by passing a needle through the rectum - either with or without ultrasound control. Ultrasound guided biopsy has the advantage - It is accurate and all suspicious areas can be biopsied.

The symptoms produced are same as those of enlarged prostate. In addition they may feel heaviness in the perineum, pain radiating to both legs), bleeding from urethra & blood in urine. In advanced disease, pain in back or bones, cough, blood in cough, breathlessness, swelling of penis and/or scrotum and thickening and swelling of lower abdominal skin may occur.

As we have seen, patients having Is because of enlargement of prostate due to benign adenoma.(non dangerous tumour) but 20% of times, this enlargement is due to cancer in the prostate. Hence patients having urinary trouble must undergo all investigations to check whether they are harbouring cancer.

Cancer of the prostate is a slow growing tumour. It starts as a small focus along with benign adenoma and over a period can become gross In size and can occupy the whole gland. This cancer can also be of different severity, which can be determined by seeing the grade on histology. (higher grade severe type, lower grade less aggressive). As the cancer grows it spreads to surrounding structures, it's covering (capsule) gets broken, it spreads to the seminal vesicle, bladder, ureter or to lymph nodes.

In advanced stage it goes into blood and metastases occur. It is commonly seen in bone (vertebrae, pelvic bone, hip joint bone, ribs etc.), lungs or brain. The growth & spread of this cancer is under control of testosterone - a hormone produced by the testes.

The answer is prostatic hypertrophy (BPH). All men above 40 years have microscopic evidence of hypertrophy but around 20% of them suffer due to this problem, 50% of whom require surgery. A new kind of tissue, known as adenoma arises from the normal prostatic tissue, which Is benign in nature. Cancer when present usually starts near the outside of the prostate. Around 3% of male population suffers from it. Cancerous tumour feels hard on examination.

  1. You may take a long time to pass urine and the stream Is slow.
  2. You may hesitate for some time before you start passing urine.
  3. You may have to urinate more often - more noticeable at night time.
  4. You may pass urine unintentionally at times.
  5. You may have a sense of incomplete voiding and feel like passing urine repeatedly or you may simply not pass urine at all.

As people are living longer these days because of improved health facilities, prostate problems are becoming more and more common. Fortunately most prostate disorders are not a threat to life. However, they often cause a lot of discomfort, inconvenience and embarassment at times.

As prostate enlarges it spreads inwards as well as outwards and it compresses the urethra and produces obstruction to the urinary passage and creates difficulty In passing urine. This is how the prostate problem begins in old age.

The common problem of prostate In young age i.e. during active sexual life, is Infection. Infection may travel from the urinary passage (urethra) and go to the prostate or it may be secondary to other diseases like stones, congenital anomalies of urinary tract, etc. Many times infection takes place because of unhygienic habits like not retracting and cleaning the foreskin of penis, or due to phlmosis i.e. where there is inability to retract the foreskin. Urine infection can be specific such as tuberculosis, venereal diseases etc., or nonspecific which is caused by organisms like E.Coll, Klebsellla, etc. The diagnosis is made by clinical examination and urinalysls. Organisms can be identified by urine culture.

The prostate problem at 60 years is usually due to prostatic enlargement which compresses the urethra and produces symptoms of obstruction. Urine now has a difficult time travelling through a narrow passage and the bladder has to work harder to push the urine out. This added effort causes thickening and stretching of the bladder wall. Due to overwork, the bladder becomes less efficient and some urine may be retained therein. If allowed to go untreated, this condition can lead to infection and kidney failure.

All men have a prostate gland. It is a sex gland located just below the urinary bladder.

The prostate surrounds the urethra, a tube that carries urine from the bladder to outside.It produces milky fluid which Is a major component of semen.

It undergoes various changes from birth to old age which are most often normal but sometimes pathological. At puberty, the prostate is about the size of an almond; around the age of 50, it starts Increasing in size and gradually may reach the size of an orange. This is probably secondary to hormonal changes that occur with ageing. The enlargement is benign (harmless) in 88% of cases.

Kidneys are obtained from 4 sources:

  1. CADAVER DONORS : A cadaver kidney is removed from an individual who has been declared as brain-dead from non-kidney related causes, such as an accident or a stroke. Since a cadaver kidney is from a person not related to the patient, the kidney has less possibility of close antigen matching and thus less chances of success. Also, the recipient has to wait till a suitable kidney is obtained. In our country, cadaver organs are not yet a practically feasible alternative, though legislation for making removal of organs from cadavers has been passed in Parliament.
  2. LIVING RELATED DONORS : Very close relatives-parents, siblings (brothers & sisters), children, grandparents may donate a kidney to a near relative. This is because a normal individual has two kidneys and can live safely in good health with one kidney. Kidney donation does not alter the physical capacity or life-style or longevity of life of such a donor.
  3. EMOTIONALLY RELATED RECIPIENT DONOR MOTHER KIDNEY DONOR : In the situation where cadaver donor transplant is not available & living related donors are found unfit, emotionally related kidney donors like spouse (husband/wife) cousins, uncles, aunts, in-laws may donate a kidney and they are called emotionally related kidney donors.
  4. UNRELATED KIDNEY DONORS : When cadaver donors, living related donors, emotionally related donors are not available or are found unfit, then unrelated donor kidney transplantation can be considered. Patients should understand that the chances of rejection are higher & costly medicines like Cyclosporin-A, ATG, etc. have to be taken for better function of the transplanted kidney.

A kidney donor should have a compatible blood group, age above 18 years and preferably below 60-65 years and should not have any major disease. In the absence of all the above potential kidney donors, the only option for such patients is lifelong dialysis which is very expensive and which may not be available to the patient where he is staying.

  1. There is no dependence on the machine thrice a week for the rest of one's life.
  2. There are hardly any restrictions in the diet and fluid intake after a successful transplant.
  3. The physical sense of well-being is so much better that one can go back to work in a style similar to that before the illness.
  4. Usually the anaemia (and feeling of tiredness) seen in patients with renal failure is reversed after a successful transplant, since the kidney is functioning to maintain normal red cell production. For patients on dialysis, correction of anaemia requires life-long use of erythropoietin injections which are extremely expensive.
  5. A woman may be able to conceive a child after having a successful transplant. (Women on dialysis usually do not ovulate and therefore are unable to become pregnant.)
  6. Men who may be having sexual problems such as inability to maintain an erection may find this problem eliminated once they receive a successful transplant.

The removal of the kidneys (Nephrectomy) which are diseased is usually not necessary prior to the time of transplant. The original kidneys may have to be removed if they are producing damaging effects in the body, such as in case of

  1. High blood pressure (due to original kidneys), that cannot be controlled by the use of medications.
  2. Infected kidneys with recurring urinary tract infection.
  3. Large polycystic kidneys.

When a person has 'RENAL FAILURE', the kidneys do not properly filter harmful waste products; as a result,excess wastes and chemicals start to accumulate in the blood. When this happens, a dangerous accumulation of waste products can occur, causing a condition known as uremia. Patients with irreversible renal failure have two options of treatment :

  • Dialysis: Where the waste products from the blood are removed artificially.
  • Kidney transplantation: Any patient whose own kidneys have failed permanently is a potential candidate for a kidney transplant.

There are several factors in each individual case which determine whether a kidney transplant or lifelong dialysis is the better form of treatment for that patient. These factors include age, availability of family donors and the presence of antibodies in the patients (this increases the risk of kidney failure after transplantation). The health factors which increase the risk of the transplant operation are mainly heart disease, cancer or infection.

A kidney transplant is a surgical procedure in which a kidney is removed from one person (donor) and placed into the body of a person suffering from renal failure recipient, in whom the transplanted kidney can perform all the functions which the patient's own kidneys are not able to perform.