Dr Shailendra Goel

Interstitial Cystitis

Urinating with urgency and pain are the main symptoms of interstitial cystitis, a disorder that affects mostly middle-aged women, a sector of the population that faces significant ignorance about this disease.

According to urologist in Noida, Interstitial cystitis (IC) is a chronic, rare and especially female disease (80% of cases are women), although men can be affected by a very similar pathology, prostatodynia. Although a good part of the population is aware of the problems that affect many men due to the prostate, the same is not true for women who suffer from this type of cystitis. With a peremptory and very frequent need to urinate, its problem is unknown even by the doctors themselves. And it is still having not been able to find out what are the causes that trigger it. At this time, one of the main hypotheses that is defended is that bad voiding habits, such as holding too much urine, may favour its appearance.

When cystitis is mentioned, it is almost always associated with bacterial bladder inflammation, in which the germ Escherichia coli is the most frequent cause. But other causes of bladder irritation that are not bacterial also coexist, but respond to factors such as irradiation, chemotherapy or obstruction. A separate mention deserves the chronic cystopathies, which are that cystitis without known cause. This group includes interstitial cystitis, which in the US affects more than 700,000 people, according to data from the Interstitial Cystitis Association., however, there is no epidemiological data on its incidence, explains urologist in Greater Noida.

Cystitis, colloquial name for which this disease is known, refers to a chronic inflammation of the bladder wall. On the other hand, the interstitial surname is related to the network of cells that form collagen fibres and, in turn, to the intercellular space called interstitium, which is the part that becomes inflamed and irritated. This is because certain chemical components of urine, such as potassium, can pass through the layer that lines the inside of the bladder (the urothelium) and irritate the interstitium. Consequently, affected people suffer pain every time the bladder filling occurs, explains urologist in Sector 93 Noida.

It must also be borne in mind that interstitial cystitis is included within the so-called “painful bladder syndrome”, referring to any pathology related to pain of the organ in question. All ICs are painful bladders, but not all painful bladders are IC. For this reason, before a painful bladder picture, interstitial cystitis is diagnosed when no organic cause is seen, such as a bladder tumour, stones (or stones) in the urinary tract or a urinary infection that justifies that pain. After discarding these organic causes and carrying out a series of tests, and provided that the patients meet certain clinical criteria, the professionals in urology reach the conclusion that they are facing a specific clinical picture: IC.

Discomfort

The symptoms that lead to seeing the urologist in Ghaziabad focus on the urgency to urinate and a frequency that results in going to the bathroom every 10 to 15 minutes, very strong bladder pain in the perineal area and much stinging in the form of burning continued.

The suffering is such that as soon as the first symptoms appear, the affected women decide to consult a specialist, although they often miss the professional to go to. Since the discomforts are in the area of the genitals, they go to the gynaecologist, or, because they can be confused with a urine infection, they also turn to the general practitioner. Then start a pilgrimage to find the specialist who can diagnose and treat this problem properly: the urologist, says best urologist in Noida.

The diagnosis is made to wait

At first, the symptoms of IC can be confused with those of a cystitis of bacterial origin, so it is usually treated with antibiotics. When it is observed that they do not respond to the treatment, other analytics are practiced verifying that the infection is not caused by bacteria. The same happens with men, since prostatidynia can be confused with an infectious prostatitis, says best urologist in Ghaziabad.

In order to arrive at the diagnosis, the most important thing, in either case, is for the urologist in Vaishali to interpret and create what the patient is explaining to him, since the symptomatology of the IC is very varied and subjective; each person feels the pain with different intensity.

Until it is concluded that it is an interstitial cystitis, those affected have had to undergo several tests:

Cystoscopy using an endoscope to examine the inside of the bladder.
Functional urodynamics, based on filling the bladder to reproduce the symptoms that the patient explains and study if it hurts and check the symptoms that it has.
The biopsy, in which a sample of tissue is taken to make a pathological analysis.

In addition, the same surgical act can be used to carry out a bladder hydrodisstination against chronic pelvic pain. This treatment consists of filling the bladder above its capacity and keeping it at that pressure between 5 and 10 minutes. A manoeuvre that allows patients to feel some improvement, although this is variable, depending on each person. Its duration is variable: between three and four months up to a year, after which it must be repeated. The result depends on the previous symptomatology, says best urologist in Greater Noida.

It is common for those affected to encounter long waiting lists for the first visit to the urologist. For this reason, since this specialist receives them at the first visit until the diagnosis is established, a one-year period may elapse in the best of cases. In others, due to the initial confusion of the symptoms with those of an infection, both they and they can live for some years with an incorrect diagnosis.

Treatment without cure

Currently, the IC has no cure and those affected cannot find another option but to learn to live with it for the rest of their lives, explains best urologist in Vaishali. However, there are several therapeutic routes that, prescribed and applied by an expert urologist in this pathology, allow controlling symptoms in 70% of patients, although they must be aware of the chronic nature of the disease and maintain realistic expectations.

Drugs: Treatment begins in a staggered fashion, with anti-inflammatories to reduce inflammation and anticholinergics to relax the bladder. Sometimes, anxiolytic or antidepressant drugs are also administered, but not because of anxiety or depression, but because the pain can generate a great sensation of anxiety. In this case, the goal is to get the patient to relax and break the circle of pain. When patients do not improve with these treatments, analgesics can be administered as a means of protection against harmful agents and in order to reduce the intensity of symptoms.
Neuromodulation This treatment, hitherto applied to the spine, consists in the placement of an electrode in the sacral root 3 that collects the afferents (the afferent nerves transport sensory signals from the organs to the brain) of the bladder. This electrode is a kind of pacemaker that, with electrical stimuli, orders the sensations of patients with respect to the bladder. Initially, it is placed for a variable time of 15 days and a month, time in which you can lead a normal life. The patient who follows it must also fill in a voiding schedule prior to the placement of the electrode and another afterwards. In this way, it is checked whether it has improved or not. In the affirmative case, the device will be permanently implanted.
Other treatments: Some affected also resort to treatments such as physiotherapy since it is proven that certain massages on the muscles of the area work in some women and even go to the support of a therapist due to the impact that the IC can have on the well-being mental of those affected.

A vital turn

According to urologist in Sector 108 Noida, the daily life of a person diagnosed with Interstitial Cystitis takes a 180 degree turn in many cases, since it affects daily, work and couple life in several aspects:

In day to day. Frequent urination, accompanied by pain, prevents many of those affected from going shopping, traveling, going for a walk or to the movies. Once the disease manifests itself, women who suffer from it are aware of the shortage of public toilets in cities. To access one of them they must enter a bar or restaurant and pay a drink, which is unfeasible for the pocket every quarter hour. In addition, frequent drinking is counterproductive for them because it accelerates the urge to urinate urgently. Trying to endure produces pain and wearing a diaper to hold the urine, a great stinging.
At work. The working life of some of those affected ends when the disease begins. The displacements to the workplace, meet a set schedule and perform as one more becomes a very difficult task because the urgent urge to urinate and pain prevent meet all requirements. Depending on the level of the disease, some affected have achieved a certain degree of work disability, even absolute.
Sex life and couple. This area also suffers considerably. Inflammation of the bladder, accompanied by pain and stinging, radiates to the genital area of the woman and prevents her, on numerous occasions, from having sexual intercourse without pain. The inflamed bladder feels like a rock that bothers enormously. A fact that can generate conflicts of couple and even reach separation.

Blood in the Urine (Haematuria)

Although not always due to a serious illness, if a person has blood in the urine should see the doctor as soon as possible to find out the origin and can put the most appropriate treatment.

However, do not be afraid because the causes can be very diverse and most of them are mild and have an easy solution.

WHAT IS HAEMATURIA (BLOOD IN THE URINE)?

Haematuria is the medical term used for the presence of blood in the urine, which can be in greater or lesser amounts.

In itself, haematuria is not a disease, but a symptom of another adjacent pathology or an alteration in the urinary tract. For this reason, depending on the cause, it may be accompanied or not by other symptoms, says Urologist in Noida.

In any case, presenting a urine stained with blood requires a consultation with the Urologist in Greater Noida.

WHAT ARE THE SYMPTOMS?

Although it can be thought that the main warning signal is to see red blood in the urine, this is not always the case and this can create confusion in the affected person, says Urologist in Sector 93 Noida.

The urine that contains blood can appear in different colours, from a rosier tone to a pure and intense red. But it can also have a dark coloration, pulling brown, reminiscent of cola drinks.

According to Urologist in Ghaziabad, sometimes the blood is in such small amounts that the colour of the urine is normal. In these cases, it is usually discovered when doing a urinalysis or a urine culture for any other reason. It is what is called microhaematuria, but its study is also necessary.

If they also appear clots, you have inability to urinate or is accompanied by fever, chills, nausea, vomiting or significant pain, you must go to the emergency immediately, says the Best Urologist in Noida.

WHAT CAN CAUSE IT?

The presence of blood in the urine can be due to an infinity of pathologies, both benign and malignant. The most frequent are usually these:

Bladder infection
Calculations (stones) in the kidney .
Diseases of the prostate .
Coagulation problems .
Abdominal or lumbar trauma .
Bladder or kidney tumours .

Other motives

Make a major physical activity. After running a marathon, for example, blood may appear in the urine, even up to 48 hours after the race. This is due to the excessive impact that is exerted on the red blood cells, which end up breaking. Although in principle it is not a serious disorder, it must always be studied to rule out that the cause is another.
Take some medications. Like allopurinol (for uric acid), antibiotics (penicillin’s …), anti-inflammatories (ibuprofen, diclofenac), etc.
Consume certain foods. Although it is not blood, the urine can also be dyed red due to the intake of some foods such as beets or blackberries.

WHICH IS THE TREATMENT?

Since haematuria is not a disease but a symptom, treatment will focus on the cause that has caused the presence of blood in the urine, says the Best Urologist in Ghaziabad.

To make the diagnosis, a urine sample will be analysed to rule out a false haematuria(coloration of the urine by food, drugs …). This test can also confirm if it is a urinary tract infection, says the Best Urologist in Greater Noida.

The Urologist in Vaishali may also order other tests, such as a blood test to check for abnormal liver or kidney function, anaemia, etc .; an abdominal x-ray; or an ultrasound to rule out an obstruction of the bile duct or a liver disorder.

According to the Best Urologist in Vaishali, the treatment will vary depending on the diagnosis. If it is a bladder infection, one of the most frequent causes along with kidney stones, the doctor can prescribe antibiotics. But if the cause is more serious, such as a tumour, it may require surgery, for example.

Once the problem is solved, the urine will normalize, says Urologist in Sector 108 Noida.

Kidney transplant: what it is, benefits, possible complications and more

What is a Kidney Transplant in Delhi?

A Kidney Transplant in Noida is an operation to transfer a kidney from one person (donor) to another (recipient).

In certain cases, kidney transplantation is the best treatment for people who have kidney failure, says Best Urologist in Noida.

What are the benefits of surgery?

You should feel better and be able to have a more normal lifestyle.

Is there an alternative to surgery?

The only alternative is to continue with dialysis and medication treatment.

What does the operation imply?

The operation is performed under general anaesthesia and normally takes about two hours, but in some cases, it can take more time, says Best Urologist in Ghaziabad.

How it is performed?

Your surgeon will make a cut in the groin and make a space for the kidney transplanted between the muscle layer and the peritoneal cavity.

Your surgeon will join the artery and vein connected to the kidney to the main artery and vein that supply the leg. They will attach to your ureter to the top of your bladder. Your surgeon can insert a stent (tube) into the ureter to protect the union.

What complications can occur?

1 INFECTIONS

This risk of infection varies depending on the post-transplant time the patient is in. In general, it is greater during the first 6 months of the Kidney Transplant in Greater Noida and then it is progressively reduced until it becomes similar to the rest of the population after the first year of the transplant.

Thus:

Infections are frequent complications after kidney transplantation
It is very important to make an early diagnosis
Through the application of the timely treatment they are solved without leaving sequels

2 THE REJECTION

According to Best Urologist in Greater Noida, after one or several days you will be transferred to the hospitalization facility where you will remain until you are discharged. The average duration of admission will depend on the type of transplant and the evolution of the patient.

On the floor everything will be different. You can be with your family members, although you must follow rules of conduct for your own safety.

There are several types of rejection:

HIPERAGUDO REJECTION. It involves the immediate loss of the graft. It is quite uncommon at the present time in kidney transplantation.
ACUTE REJECTION. When it occurs, it usually occurs between the first days or the first months of the Kidney Transplant in Ghaziabad. Thanks to immunosuppressants, it tends to be milder and have a better prognosis. The symptoms and clinical manifestations will depend on the type of transplant. With adequate medication, acute rejection is usually reversed in most cases.
CHRONIC REJECTION. Occurs in some patients several months or years after the transplant, when it occurs, usually has a slow evolution.

When do I recover?

You should be able to go home after 5 to 10 days.

It usually takes around two to three months to return to normal activities. During this time, you will be at an increased risk of infection.

Regular exercise should help you return to normal activities as soon as possible. Before you start exercising, ask the health care team or your family doctor for advice.

For a small number of people, the original kidney disease may recur.

Symptoms of kidney problems

The symptoms of kidney problems are rare, however, when there are the first signs are usually decrease in the amount of urine, exaggerated swelling of the legs and constant tiredness.

However, not all people have symptoms, so the best way to know if there is a problem with the kidneys is to have regular urine and blood tests and, if necessary, an ultrasound or a CT scan. These tests are especially important if the risk of kidney problems is high, as in the case of diabetic people, elderly women with high blood pressure or a history of kidney failure in the family, says Best Urologist in Ghaziabad.

If there are more than 2 symptoms, it is important to consult a urologist in Ghaziabad or a general practitioner to carry out diagnostic tests, in order to identify if there really is a problem in the kidneys. See the main causes of kidney pain.

Most common problems of the kidneys

The most common problems affecting the kidneys are:

Stone in the kidneys: consists of the accumulation of small stones inside the kidney, which can hinder the passage of urine to the bladder;
Cysts in the kidneys: they are frequent as they get older but when they are very large, they can cause kidney pain;
Polycystic kidney disease: which leads to the emergence of several cysts in the kidney that can hinder its functioning;
Hydronephrosis: arises when the urine cannot reach the bladder, accumulating inside the kidney;
Renal insufficiency: it occurs due to progressive lesions in the kidneys that impede its functioning.

In addition to this, people with chronic uncontrolled diseases such as high blood pressure or diabetes, can also develop a chronic kidney disease that is causing small injuries to the kidneys over time, and may end in kidney failure, says best Urologist in Noida.

Kidney cancer is also quite common, mainly in men over 60 years old, and can manifest with symptoms such as: presence of blood in the urine, frequent tiredness and constant fever, for example.

How to treat kidney problems?

According to Best Urologist in Greater Noida, the treatment in case there is any alteration in the kidneys should be adapted to the problem that is affecting the organ, but in milder cases such as the presence of kidney stones or cysts, the symptoms can be alleviated with simple changes in the diet such as increasing water consumption, avoiding salt intake and increasing calcium intake, for example.

In the most serious cases, such as acute renal failure or chronic kidney disease, treatment should always be guided by a nephrologist in Noida, as it may be necessary to control the amount of water ingested, avoid the intake of certain foods, take specific medications, dialyze or even involve surgery to treat kidney injuries.

In cancer cases, it is almost always necessary to perform surgery to remove the tumour and to resort to chemotherapy or radiotherapy to eliminate the remaining cancer cells and in critical case, urologist may suggest you to go for kidney transplant in Ghaziabad.

In addition to this, if there is another disease that is causing the kidney problem such as diabetes or high blood pressure, it is also important to perform your treatment properly to prevent further kidney damage.

What tests should be done?

Tests that can be used to identify the problem that is affecting the kidneys are:

Blood tests: to evaluate the levels of substances that are normally eliminated through the kidneys such as urea and creatinine;
Urine test: the presence of proteins or blood in the urine are changes that may indicate problems in the kidneys;
Ultrasound or tomography: they help to identify alterations in the shape of the kidneys, allowing to observe the presence of cysts or tumours;
Biopsy: normally used when cancer is suspected, but can be used to identify other problems.

These exams can be requested by the urologist in Vaishali, so whenever there is suspicion of the existence of a problem in the kidneys it is important to go to the doctor to be requested and confirm if there is any alteration.

Kidney Transplant

The kidneys are organs of vital importance that filter the blood to eliminate waste products, excess fluid and salts from the body. When the kidneys stop working, this is known as kidney failure. A person with kidney failure should undergo dialysis or a kidney transplant in Delhi.

What is a kidney transplant?

A kidney transplant is an operation where urologist in Ghaziabad places a new kidney in the body of a person whose kidneys have stopped working. A single healthy kidney will perform the function of the two kidneys that have stopped working.

Since people can live with a single kidney, a living person can give a healthy kidney to another person who has kidney failure (called a donation). A kidney can also come from a donor who has died recently, but the wait in this type of kidney donation can usually be a year or more.

Most kidney transplant in Ghaziabad gives good results. People who undergo a kidney transplant will have to take medication for the rest of their lives to prevent their body from rejecting the transplanted kidney. Rejecting a kidney means that the body's immune cells destroy the transplanted kidney because they perceive it as "strange" or unfit for the body.

But, apart from this, many adolescents who undergo kidney transplants lead normal, healthy lives after recovering from the operation.

What are the different types of kidney transplants?

There are two types of kidney transplants, depending on who donates the kidney.

A living donor transplant is that the person receives a kidney from a living person. Living donors are usually relatives or very good friends of the recipient of the transplant, but sometimes there are living donors who do not know the recipient.

A dead donor transplant occurs when a deceased person donates their kidneys. This type of transplant requires that people who need a kidney be placed on a waiting list of kidneys until a suitable donor is found.

What happens before a kidney transplant?

If your urologist in Noida thinks you should have a kidney transplant in Noida, the first thing you should do is visit a transplant centre. A medical team will do a medical evaluation to make sure you are healthy enough to undergo the operation and take the medications you should take after the transplant. This will include blood tests, x-rays, and other tests, which may take a few weeks or months.

If the medical team decides that you are a good candidate to undergo a transplant, the next step will be to look for a kidney. In most cases of living donor transplantation, the donated kidney comes from a close relative or from a friend who has a blood group compatible with that of the recipient.

If you cannot find a living donor, your name will be placed on the kidney waiting list until a kidney from a dead donor is found that is compatible with you. The number of kidneys that are needed is much higher than the number of kidneys that are donated, so the wait can be long.

If your name is inscribed on the waiting list for kidney transplants, you will have to keep in direct contact with your doctors and the rest of the medical team that treats you. Make sure the team knows how to contact you at all times.

While you wait for the arrival of an adequate kidney, do what you can to keep yourself as healthy as possible. Thus, you will be prepared to receive the transplant when the time comes. To do this, make sure:

Take a healthy diet and follow any special dietary recommendations given by your doctor, nurse or dietitian
take the medication following the medical instructions.
attend all scheduled medical visits.

Tell your best urologist in Noida and the transplant centre immediately if there is any change in your health status.

What happens during a kidney transplant?

Most likely, urologist in Greater Noida will take a blood sample for a cross-matching test and antibody test. This test is done to see if your immune system will accept the donated kidney. If the test offers a negative result, it means that the kidney is compatible and that you can accept it. Other blood tests, x-rays and an ECG will be done before the transplant.

In the operating room, you will receive general anaesthesia to remain asleep throughout the operation. The best urologist in Greater Noida will make a small incision in your lower belly, just above your hips. It will place the new kidney in its place and will join the blood vessels (arteries and veins) of the kidney to those of the lower part of your trunk. It will also connect the ureters of the new kidney (the tubes that carry urine) to your bladder.

In most cases, the patient's kidneys are left in place. They are not removed, unless they can cause problems such as hypertension (high blood pressure), protein loss or infection. Kidney transplant operations usually last between 3 and 4 hours. If you need more than one organ (as in a combined liver and kidney transplant), the operation will last longer.

What happens after a kidney transplant?

After undergoing a kidney transplant in Greater Noida, you will spend a week or two in the hospital to recover. During this period, your medical team will watch you closely to make sure you do not have complications after the operation, such as bleeding or infections.

You will also learn what medications you need to take to prevent your body from rejecting your new kidney. These medications are called immunosuppressants. The fact of taking this type of medication will predispose you to get infections, especially during the days immediately after the operation. Therefore, make sure you stay well away from sick people. Everyone who lives with you should wash their hands thoroughly and frequently.

During the first couple of months after the operation, you will need to see your urologist in Vaishali often to make sure your new kidney is functioning well. If you have a fever or discomfort in the area of the transplant, inform your doctor immediately. They could be indicators that your body is rejecting the kidney or that you have an infection.

But, when a person undergoes a kidney transplant and is medicated with immunosuppressants, the success rate of kidney transplant in Delhi is very high.