Friday 18 December 2020

Stress Urinary Incontinence (SUI)

 What is Stress Urinary Incontinence?

Sudden uncontrollable leak of urine with sudden increase in intra-abdominal pressure like coughing and sneezing.

A patient who complains of an involuntary or sudden passing of urine is said to be suffering from Urinary Incontinence. The sudden passing of urine could be due to any effort generated by sudden forceful bodily actions like coughing, sneezing, exercising and laughing, and is termed as Stress Urinary Incontinence. This disorder is the most common urinary incontinence in women.

What are the main causes of Stress Urinary Incontinence?

The main cause is weakness in pelvic floor muscles that support the pelvic organs. The factors primarily causing this condition could be due to various reasons or habits formed over a period of time, such as:

  •     Increasing Age
  •     Obesity
  •     Prostate surgery
  •     Smoking, as it causes cough
  •     Prolapse
  •     Hormonal deficiencies
  •     Constipation
  •     Pregnancy

How is Stress Urinary Incontinence treated?

The treatment that you need to undergo would depend on the causes of your problem. Your doctor will plan your treatment depending on the level or stage of your disease. You may be required to undergo a combination of lifestyle alterations and medication.

  1. Behavioural Therapy

    By bringing small changes in your lifestyle, you may be able to reduce the stress incontinence episodes. Your doctor may advise you the following:

  • Weight loss, if you are over weight
  • Proper and sufficient Fluid Intake
  • Physiotherapy - Pelvic Floor Exercises
  • Cut back on smoking
  • Reduce caffeine intake
    2.  Medication

    Though there still aren’t many options when it comes to medicines, many doctors recommend dulaxitin, however it must be kept in mind that no medicine should be taken without your doctor’s prescription/consultation.

    3. Surgery

 A severe case of stress incontinence that interferes with your everyday activities may be treated through surgery. A qualified surgeon would be able to explain to you the available options.

If you or someone you know is suffering from Stress Urinary Incontinence, immediate medical help must be sought so that timely diagnoses can be made and the best solution can be worked upon.


Reviewed By: Dr Mahendra Jain
Mail Us: urologistbangalore@gmail.com 

Friday 26 June 2020

Retrograde ureteroscopic Intrarenal Surgery ( RIRS ) for kidney stone removal

Kidney stones are hard deposits of waste products of the human body like uric acid or minerals like calcium. Usually, they are very small and naturally flush out of the body, but some grow bigger as the minerals accumulate, and if they block the urinary tract, they can be very painful. They may then need to be surgically removed. 

 RIRS

Surgery would be advised when the stone is too large to flush out by itself; it is blocking the urine flow out of the kidney or is extremely painful and is causing urinary infections.

Retrograde ureteroscopic Intrarenal Surgery (RIRS) is one of the methods used these days. With advances in technology, RIRS has become a safe and efficient option. RIRS can be used as primary treatment for patients with stones smaller than 2 cm. It is also used for those with obesity; muscular and skeletal deformities and bleeding disorders.

This procedure, done under general anaesthesia, involves inserting a flexible endoscope called a ureteroscope through the urinary opening into the bladder, through the ureter into the kidney. This is ‘Retrograde’ as it moves up the urinary system and ‘Intrarenal’ as it enters the kidney. 

The stones are then viewed through the scope and either grabbed with an extremely tiny forcep, also inserted the same way, and then gently pulled out; or, vapourised using a laser probe.
RIRS should be performed by an endourologist, a urologist specialising in the diagnosis and treatment of diseases of the kidneys, ureter and bladder.

 RIRS

RIRS can be considered much superior to others, with its less complicated methods; causes fewer medical complications; has a good stone-free rate and the patient can leave the hospital in a day and restart normal life within two or three days.



Reviewed By: Dr Mahendra Jain
Mail Us: urologistbangalore@gmail.com 

Wednesday 19 February 2020

Radical Perineal prostatectomy: What You Should Know?

Radical perineal prostatectomy is a surgical procedure performed to completely remove the prostate gland through a small incision in the perineum, the area between the anus and the scrotum. This procedure is typically carried out on men with prostate cancer that has not spread and involved other organs of the body. 


Radical perineal prostatectomy is rarely used than other surgery such as the open radical retropubic prostatectomy or the robot-assisted laparoscopic radical retropubic prostatectomy. Just like the retropubic approach, a radical perineal prostatectomy achieves the same rate of cure when the cancer is small and confined to the prostate. However, less blood is lost and provides quick recovery. One downside to the perineal approach is an increased risk of fecal incontinence.

Advantages of radical perineal prostatectomy
RPP provides patients with several benefits, including:
  •     Shorter operating time 
  •     Short hospital stay 
  •     Low blood loss
  •     Equally low rate of surgical complications
  •     Short recovery period
  •     Lower rates of urinary incontinence
  •     Preservation of erectile function

Who is not suitable for radical perineal prostatectomy?
Radical perineal prostatectomy is not suitable for men with conditions that limit correct positioning during the procedure. These conditions are:
  •     Ankylosis,
  •     Unstable artificial hip replacement, 
  •     Severe arthritis of the joints in the pelvis

Having very large prostates is also a technical challenge. However, the size can be reduced to aid surgical removal by hormone therapy before surgery.  

Lympg node sampling can not be done in radical perineal prostatectomy, which can be considered as a drawback of this procedure.


A discussion with expert professionals can help you to choose the right method. Factors, such as a man’s life expectancy and other comorbidities, are also taken into account while considering the procedure


Reviewed By: Dr Mahendra Jain
Mail Us: urologistbangalore@gmail.com