All posts by Dr Sunil Prakash

Urinary Incontinence in Female

The urinary incontinence is an involuntary loss of urine. It is a disease that affects one in three women of all ages, which means more than 30 million people in India and more than 350 million worldwide. It is not a normal process associated with aging, and it has a negative impact on the quality of life of women who suffer from it.

What is urinary incontinence?

The urinary incontinence is the involuntary loss of urine. Urine losses are not a normal process of aging, so it is advisable to consult an expert professional. In most cases, urinary incontinence has a solution and does not have to condition daily and social life.

uti in female

Types of Urinary Incontinence

There are different types of urinary incontinence that respond to different causes, so it is important to make a correct diagnosis to adapt to the treatment.

You may have symptoms that belong to one or several of the types simultaneously. The most frequent types of urinary incontinence in women are:

Urinary incontinence of effort. The loss of urine occurs when you laugh, sneeze, practice an exercise, gain weight or simply stand up.

The frequency and severity of losses vary greatly from one woman to another. Some have occasional leakage of urine and others, more often. The amount of urine that is lost is also very variable in each woman, from a few drops to a jet.

The origin of this type of incontinence occurs when making an effort increases the pressure in the abdomen and bladder. This causes the urine to exit involuntarily through the urethra (the tube where urine exits to the outside), especially when the support to the urethra is weakened.

Urinary incontinence of urgency. There are people who suddenly feel a strong urge to urinate without being able to control it (urgency). This symptom is usually accompanied by an increase in urinary frequency, both day and night (nocturia). The person who suffers urinary urgency is unable, in many cases, to retain urine before reaching the bathroom.

Mixed urinary incontinence. It is the association of symptoms of two types of incontinence: that of effort and that of urgency.

Overactive bladder. The main symptom of overactive bladder is the sensation of urgency, aggravated by an increased desire to go to the bathroom (increased urination frequency). It seems to have the same origin as urge urinary incontinence.

How many people does Urinary Incontinence affect?

It is estimated that between 30% -40% of women can have involuntary leaks of urine, even occasionally, even so, some are more likely to suffer urinary incontinence than others.

Risk factors of Urinary Incontinence

There are different risk factors that can precipitate or aggravate urinary incontinence:

Non-modifiable factors

Genetics. Some women are born with a pelvic floor musculature that is weaker or more susceptible to weakening. There is a greater chance of incontinence if there is a family history.

Pregnancy. The hormones released during pregnancy relax the tissues and produce stretching of the pelvic floor muscles. In addition, the increase in weight as the baby grows affects the pelvic floor musculature at the time of maintaining the continence function optimally.

Parto. During childbirth, the pelvic floor muscles that hold the bladder, vagina, and rectum, suffer the maximum stretch possible due to the pressure exerted on the head of the baby to descend to exit through the vagina. In some women, these muscles and the tissues that surround them, can be permanently laxer, and weaken these structures that lead to urinary and anal incontinence.

Menopause. In this stage of life, due to hormonal change, different changes can occur that precipitate or aggravate the symptoms of incontinence and other pelvic floor problems.

Gynecological surgery. A gynecological surgery, such as extirpation of the uterus (hysterectomy), or other therapeutic procedures at the pelvic level, such as radiation therapy, may cause alterations of the nerves or anatomical structures that maintain continence. These variations can precipitate or aggravate the symptoms of urinary incontinence or cause a feeling of a bulge in the genitals by the descent of the pelvic organs (prolapse).

Modifiable factors

Obesity. It is demonstrated that overweight and obesity are risk factors for stress urinary incontinence, due to the increase of pressure inside the abdomen and, therefore, over the bladder. This effect can also contribute to the appearance or worsening of other problems related to the pelvic floor, such as the descent of the pelvic organs (prolapse) or urge urinary incontinence.

Chronic constipation. The increase of the abdominal efforts to obtain the correct evacuation exerts pressure on the pelvic structures and distension on the pelvic floor musculature, which causes it to weaken.

Tobacco. There is evidence that tobacco is a risk factor for stress urinary incontinence since its habitual consumption favors the appearance of chronic cough and this causes an increase in abdominal pressure.

Bladder stimulants. The excessive intake of some substances (caffeine, alcoholic beverages, soft drinks, and sweeteners) produce an excessive stimulation of the bladder, which worsens the symptoms of urgency and increases the urge to go to the bathroom.

Drinking a lot. Excessive intake of fluids (more than 1.5 liters per day) can condition the onset or worsen of incontinence.

Physical efforts. Some of the behaviors that are performed during the day involve repeated physical efforts, whether at work, hobbies, body posture, etc. This conditions an increase in abdominal pressure and overload of the pelvic floor structures, which can precipitate or aggravate the symptoms of stress incontinence. They have more risk, women who practice impact sports, stop and start sports, weights, push-ups, etc.

Treatment of Urinary Incontinence

Sometimes, women who experience urinary incontinence do not give importance because it occurs very occasionally, in very small amounts, or, it does not interfere with their well-being, so they do not need to consult or receive any treatment. In contrast, in other women, urinary incontinence is a detriment and, therefore, they need to know the treatment options available for each type of incontinence.

A high percentage of women with urinary incontinence who receive treatment, personalized and indicated by specialized professionals, achieve a cure or an important improvement of the symptoms.

There are multiple treatments for urinary incontinence. Depending on the characteristics of the patient, the symptoms and the severity of the incontinence, one or another treatment or the combination of several is chosen.

Conservative treatment

Conservative treatment includes a set of measures that do not require surgery or medication. It is recommended to all women, regardless of the type of incontinence they have.

Lose weight. In women who are overweight or obese, it is shown that a weight reduction of between 5 and 10% can reduce the episodes of weekly urinary incontinence by up to 50%. For this reason, it is recommended to lose weight with the help of diet and exercise.

Improve intestinal transit. Decrease the efforts to defecate with dietary guidelines that improve chronic constipation, avoid the weakening of the pelvic floor musculature.

Give up smoking. Chronic cough decreases, so episodes of urinary incontinence will be less frequent since there is less impact on the muscles of the pelvic floor. In addition, tobacco acts as a bladder stimulant, so it will also improve symptoms of urgency.

Reduce or eliminate the use of bladder stimulants. Coffee and tea, alcohol, soft drinks, sweetened drinks, energy drinks, etc., produce spasms in the bladder. Reducing its consumption is beneficial for those women who have symptoms of urgency and increased urination frequency.

Moderate fluid intake. The adequate consumption of liquids should be around 1.5 liters a day. It must be taken into account that a balanced diet already contributes a part of the necessary hydration. Therefore, people with urgency or nighttime incontinence should avoid drinking liquids after mid-afternoon.

Control of physical efforts. It is important to practice daily physical exercise. However, those women with stress urinary incontinence, or with significant muscle weakness, should avoid making physical efforts that pose a risk to the pelvic floor musculature. In this sense, exercises such as walking, swimming and all those that help to acquire a good physical shape without causing abdominal pressure are recommended.

As a precautionary measure, whenever physical exercise is practiced, a contraction of the pelvic floor muscles should be performed in order to counteract the abdominal pressures and avoid possible episodes of urinary incontinence.

Training program for the pelvic floor musculature. The objective of these exercises is to strengthen the muscles surrounding the vaginal and anal areas to increase control of urine losses in women. It is not recommended to perform the exercises of the pelvic floor musculature without prior advice from professionals.

Devices. There are other devices that help improve urinary incontinence such as cones and vaginal spheres, pessaries or tampons for urinary incontinence.

Pharmacological Treatment

Pharmacological treatment is useful for women diagnosed with urge urinary incontinence or overactive bladder. Currently, there are several drugs available that decrease the involuntary spasms of the bladder and relax the muscle that contracts the bladder. However, some drugs are contraindicated in patients with glaucoma, pyloric stenosis, severe bronchospasm, reflux esophagitis, intestinal ileus, severe ulcerative colitis, as well as in patients with hypertension. Not controlled. After starting a pharmacological treatment, it is advisable to go to a control visit after four weeks to assess the suitability of the treatment. If there is an improvement, continue with the drug and if there is not, or it is minimal, you can change the dose of the same drug or try a new one.

Surgical Treatment

Stress urinary incontinence

This type of treatment is indicated in women with severe or moderate urinary incontinence who do not want conservative treatment, or when this has not been effective.

Currently, the choice of surgical technique to correct the symptoms of stress urinary incontinence is based on the characteristics of each patient and the experience of the surgical teams that apply these treatments.

Tension-free band. It is the most widely used technique and involves placing a tape that passes under the urethra (urine outlet duct) to get more support during the efforts and avoid leaking urine.

Complications are minimal and recovery is rapid, so in most cases, it does not require hospital admission.

There are other less complex techniques that can be used, in case of not responding to the usual technique, or when the specialized professional considers that, given the characteristics of the patient, there may be another more appropriate.

Mixed urinary incontinence

The treatment of these women is complex and requires a very high degree of personalization, as well as a very complete study.

The nephrologist in Delhi is responsible for assessing the characteristics of each woman and the severity of the symptoms. Based on this, sometimes, it begins with treating the symptoms of urgency, and other times, the symptoms of exertion. And, on other occasions, both symptoms are treated from the beginning.

nephrologist in delhi

Signs That My Kidneys Are Not Working Well

The kidneys are responsible for filtering our blood, helping to eliminate toxins and purify our body, which is why its proper functioning is fundamental to our health. But diverse conditions can compromise their well-being, detecting them in time is important to find the opportune treatment and guarantee that our body stays always healthy.

kidney disease

Conditions such as kidney stones, infections, nephritis or kidney failure can affect these important organs, compromising our health. Do you know how to detect that they are failing? In this article, we reveal some signs that your kidneys are not working well, pay attention to them!

What is the function of the kidneys?

The adequate renal function is very important to guarantee our general health since these organs fulfill important functions in the purification process of our organism.

Some of the functions of the kidneys are:

  • Purify the blood eliminating waste, toxins, excess water, medication, etc. All these elements are filtered and converted into a liquid that will be stored in the bladder and then expelled in the form of urine.
  • Regulate the amount of calcium in our blood as well as the production of vitamin D. When we eat a lot of calcium in the diet or through supplements, it is possible that the kidneys do not manage to eliminate it effectively, thus giving rise to the formation of kidney stones composed mainly of this mineral.
  • Regulate the amount of acids present in our bodies to prevent them from accumulating and causing health problems.
  • Release the hormone renin, responsible for regulating blood pressure.
  • Release erythropoietin, a hormone that stimulates the production of red blood cells.

Conditions that can affect our kidneys

Because they are one of the purifying organs of the body when the balance we need to function properly is lost we run the risk of suffering from various conditions that affect our kidneys and therefore our general health.

Some common kidney diseases are:

  • Kidney stones or stones occur when calcium, uric acid or struvite accumulate in the body and cannot be adequately eliminated through urine.
  • Infections in the urinary tract or pyelonephritis. The infection originates in the urethra or bladder and, if left untreated, goes up to the kidneys, affecting its functioning.
  • Renal insufficiency, a chronic disease through which the ability to filter blood by the kidneys is slowly lost.
  • Kidney Cysts
  • Cancer in the kidney.

Symptoms that your kidneys do not work well

Our body is a highly efficient machine, and when one of the components of the gear does not run properly the body begins to send small signals. Some of them can be ignored or confused with other conditions, however, if you present one or more of the following symptoms it is best to go to a nephrologist in Delhi for a review. A blood test and a urine sample are enough to detect kidney function problems.

Some signs that your kidneys do not work well are:

Important changes in urine

Because the kidneys are responsible for producing urine, when the operation of the kidneys is not adequate, it is common to notice important changes in urination. Conditions may vary depending on the problem, but some of the signs you may notice are:

  • Urinating much more frequently, it becomes common to get up at night to urinate and go to the bathroom very often during the day.
  • On the contrary, it may happen that you urinate less frequently and that the liquid has a very dark color or a cloudy appearance.
  • Blood in the urine.
  • Bad smell in urination.
  • A sensation that you do not completely empty the bladder.

Bloated body

Due to the fluid retention that occurs because the kidneys are not working properly, it is common to notice the inflamed body especially in areas such as the ankles, feet, abdomen, face or hands.

Pain in the lower back or side

This is one of the signs that the kidneys do not work well more common. It occurs in patients with conditions such as kidney stones, urinary infections, and even kidney failure.

Tiredness and unexplained fatigue

As we explained earlier, one of the functions of the kidneys is to produce erythropoietin, a hormone that interferes with the production of red blood cells. When there are problems in the kidneys the levels of this hormone are affected and therefore the number of red blood cells in the blood decreases, also reducing the oxygen that our organs receive including the brain. Patients begin to suffer from anemia, and this is the reason why they feel tired and have difficulty concentrating for no apparent reason.

Rashes and itchy skin

This can be a sign of kidney failure because the kidneys are responsible for eliminating toxins from the body, by not doing properly they happen to accumulate in the body affecting the appearance and health of the dermis.

Nausea and vomiting

It also happens due to the accumulation of toxins in the body, the body is unable to eliminate waste and tries to do it in other ways, for example through vomiting. This, in turn, causes loss of appetite and therefore involuntary weight loss.

Bad breath and a metallic taste in the mouth

Due to the accumulation of waste in the body, those who suffer from the kidneys usually perceive a metal taste in the mouth accompanied by bad breath. It may also be common to begin to repel foods such as meat.

Other symptoms that may indicate that your kidneys are not well are:

  • Feeling of frequent cold, even when it is hot. This is due to the anemia that patients with this condition usually suffer.
  • Feeling short of breath when performing simple activities such as walking a bit. This may be caused by the lack of cellular oxygenation.
  • Problems of concentration or lack of memory, also due to the lack of oxygenation of the brain.

If you notice several of these symptoms, it is best to go to a kidney specialist in Delhi for a general review that includes blood and urine tests, which will determine if there is any condition linked to the kidneys.

Six tips to take care of the kidneys

Nephrologist in Delhi suggests following basic care to avoid problems of diabetes and other kidney diseases that can be chronic.

The kidneys are a fundamental organ since they are responsible for filtering and detoxifying the organism. However, despite its importance for the health of our body, we do not give it the attention it deserves. Eating a balanced diet rich in vegetables and fruits is the first step in keeping them healthy. Pay attention to these simple tips, which will improve your quality of life.

  1. Balanced diet. Try not to eat processed foods (including sausages) as they come supersaturated with salt. Replace them with carrots and fruits such as peach, apple, melon, and grapes, which are diuretic.
  2. Drink a lot of water. This helps eliminate salts and toxins through the urine. It is recommended to drink a minimum of liter and a half a day. In the case of patients with kidney stones, the amount should be between 2 and 3 liters per day.
  3. Exercise. The important thing is to stay active, that’s why it’s important to walk, ride a bicycle or run, so blood pressure is kept under control, which is the main risk factor for suffering from chronic kidney disease.
  4. Eat salt in large proportions sediment the kidneys. So it is better to consume it in small quantities, maximum one teaspoon in each main meal.
  5. No smoking. Smoking decreases blood flow to the kidneys, which impairs their functioning and increases the chance of kidney cancer.
  6. Do not self-medicate. Aspirin and some anti-inflammatories can affect the kidneys if they are taken too often because it slows down to eliminate toxins and sugar. Control its use.

Determination of Urea in the Blood

Definition of Urea

The urea is a molecule which results from a process of protein degradation. It is the main form of elimination of nitrogenous waste by urine. It is the nitrogen of the proteins which, combined with molecules produced by the liver, constitutes the urea.

Why make dosage of urea?

The urea assay allows, along with other measurements, to evaluate renal function, especially the presence of renal failure. It is also prescribed to monitor the renal function of people with diabetes or having suffered a myocardial infarction. Indeed, when the kidneys are not functioning normally, there is an increase in the blood concentrations of urea, creatinine and uric acid. Some liver conditions can also affect the level of urea in the blood.

The dosage of urea alone in the blood is however not very informative, because the amount of urea produced each day varies according to the diet and its excretion by the kidneys is irregular. The determination of creatinine is therefore generally preferred or at least performed at the same time.

Urea can also be evaluated in the urine (“clearance” of urea). Urine urea/blood urea ratio can help the nephrologist in Delhi determine the cause of kidney failure. In addition, the urea assay can be used to evaluate the effectiveness of dialysis.

What results can be expected from a urea assay?

The dosage of urea in the blood (uremia) is performed on a blood sample, usually performed at the bend of the elbow.

It should preferably be fasting and avoid meals too rich in protein the previous days.

The urine urea (uricemia) dosage is 24 hours.

What results can be expected from a urea assay?

Normal values ​​for urea in the blood range from 2.5 to 7.6 mmol / L (or 0.10 to 0.55 g / L).

In children and pregnant women, these values ​​are lower.

In the urine, urea is found at 300 to 500 mmol / 24 hours.

The concentration of urea increases abnormally in various situations, including:

  • in case of kidney failure or kidney damage
  • in case of infections, cardiovascular accident, shock, stress, etc.
  • when taking certain medications
  • in case of very high protein diet

Decreased urea levels may be a sign of dietary protein deficiency, for example, gastrointestinal malabsorption, or severe liver disease.

When to Consult a Nephrologist in India?

When to Consult a Nephrologist in India?
A nephrologist in Delhi, India is a medical practitioner specialized in examining the kidneys and diagnosing the diseases related to them. “Nephros” is a Greek word which means kidney or renal, whereas, the term “ologist” refers to someone who studies the specific field of medical science. The Nephrologists complete their learning in internal medicine and then undergo a training session to enhance their skills to become a specialized doctor in diagnosing the kidney-related diseases. The common conditions that are examined and treated by the nephrologists are polycystic kidney disease (PKD), chronic kidney disease (CKD), kidney stones, acute renal failure, and high blood pressure. Some doctors also specialize in kidney transplantation and dialysis.

When to see a Kidney Specialist in Delhi?

A person is said to be a candidate to consult a kidney doctor in Delhi when he is experiencing or having:

  • Acute renal failure
  • Augmented drop in kidney function
  • Chronic kidney disease reached to stage 4 or 5
  • Chronic urinary tract infections
  • Frequent urinary tract infections even after certain medications
  • A Glomerular Filtration Rate (GFR) at a level of 30 or below
  • Reoccurrence of kidney stones after the complete treatment
  • High blood pressure not responding to certain medications
  • Blood clots in the urine
  • Protein loss in the urine

Types of Kidney Disease Increasing the Risk of Kidney Failure

Types of Kidney Disease Increasing the Risk of Kidney Failure

Kidney disorders are largely categorized into acute kidney injury and chronic kidney diseases.

Acute kidney injury is the sudden impairment happened to the kidneys. Usually, the cases are short-term based, but, in rare cases, the condition may last longer. The chief causes of acute kidney injury are:

  • damage to the definite kidney tissue triggered by a severe infection, drug or radioactive dye
  • Blockage in urination due to kidney stones or an enlarged prostate, for example.
  • According to the best Nephrologist in Delhi, India chronic kidney disease can also contribute to the risk of acute kidney injury.

On the other hand, chronic kidney disease occurs over several years of malfunctioning of the organ. Sometimes, it can lead to End-Stage Kidney Disease for which a patient is kept on dialysis or else suggested for a kidney transplant to live an active life. There are different factors that contribute to chronic kidney disease, these include:

  • Damaged blood vessels to the kidneys because of medical conditions like high blood pressure and diabetes
  • Outbreaks of the kidney tissue due to a certain disease or weak immune system (glomerulonephritis)
  • Progressing or growing cysts on the kidney, known as polycystic kidney disease)
  • Destruction due to reverse flow of urine back into the kidneys. The condition is called reflux nephropathy.
  • Congenital abnormalities of the urinary tract.

According to healthcare professionals, if any time a person experiences or observes the signs and symptoms of chronic kidney disease (CKD), it is best to consult the best Nephrologist in Delhi, India as soon as possible to prevent the condition from getting worse. Early diagnose and treatment of CKD can lower the risk of end-stage kidney failure. Knowing the body and consulting the kidney specialist in Delhi, India is the best way to prevent severe kidney disorders in the future. The conditions may include:

  • Blood in urine
  • Kidney stones
  • Protein in urine
  • Acute kidney injury
  • Kidney infection

Choosing the Kidney Specialists in India

Choosing the Kidney Specialists in India - Dr. Sunil Prakash

In the hustle clamor of life, individuals more than times don’t discover time to consider their general wellbeing which makes their body as a place of different maladies. With the rise of restorative innovation, a large portion of the general population are these days getting appropriate consideration with solid lungs, kidney, heart and different others. With the regard respects of innovation, a kidney transplant is turning out to be entirely prevalent and the vast majority of the general populations are heading off to their home to experience their treated and all around mended life. Kidney transplant in Delhi, India is the most ideal approach to treat kidney failure. The advantages of a damaged kidney transplant are such a large number of. The vast majority discover they have expanded stamina and vitality. They can come back to a more typical way of life, and the individuals who were reliant upon dialysis can appreciate recently discovered opportunity.

Deciding ahead of time whether a kidney is prone to be endured by your body is critical to the achievement of your transplant. It is vital that your blood classification and the contributor’s blood classification be perfect. Your tissue sort and the giver must likewise be perfect. Whole kidney transplantation procedure includes putting a solid kidney into the body where it can perform the majority of the capacities that a coming up short kidney can’t. As a rule, the ailing kidneys, situated in the back territory, stay undisturbed. The new kidney is situated in the pelvic territory where it is surgically associated with adjacent veins.

India itself is accepting massive prominence with the best kidney specialist in Delhi, India. Individuals all through the world are these days moving towards India for therapeutic tourism because of the accessibility of top of the line advances and minimal effort. Being the valley of wellbeing and health, everybody can discover the top of the line patient consideration and clinical coordination groups positioned at doctor’s facility whether in Bangalore, Mumbai, Delhi or different ranges of India. All these empower a patient to recuperate at soonest with colossal fondness and all it makes security between the top of the line well being and minimal effort in a single spot.