Treatment of chronic testicular pain

Treatment of chronic testicular pain

As a best urologist in Palam, West Delhi, I have decided to write this post after having treated in my practice, in recent weeks, several patients who had this problem and had long been going around trying to solve without success. In general, the patients I see in the kidney hospital in Palam, West Delhi have been evaluated by a multitude of specialists, they have undergone all kinds of tests, they have undergone multiple treatments ... without solving chronic pain.

The first thing we should do with a patient who is consulting for chronic testicular pain is a good clinical history in which we value:

• Analysis of pain and its circumstances: from when you have it; possible causes (previous surgeries in the linguino-scrotal, abdominal or retroperitoneal area, traumatisms, infections or inflammations in these areas, etc.); characteristics and intensity of pain; irradiation thereof; triggering factors (when sitting, when urinating, when having an erection, when making a bowel movement, when the testicle is palpated, etc.); associated symptomatology (urinary frequency, urgency, nocturia, rectal or urinary tenesmus); etc.
• Physical examination:  of the testicle, epididymis, deferent, spermatic cord, inguinal canal (hernias), abdomen, fist, renal percussion, etc.
• Essential tests:  fractionated urine and semen culture, testicular eco-Doppler, abdominal and urological ultrasound. In some cases, it may be useful to perform Magnetic Nuclear Resonance of the pelvis.

With respect to treatment, our approach is as follows:

• First, treatment of any process that could have caused the pain: torsion of testicular appendix, varicocele, epididymitis, orchitis, inguinal hernia, testicular tumour, tension hydrocele, etc. One should not lose sight of the so-called referred pain, that is, when the pain is caused by problems in other abdominal viscera but the patient locates it in the testicle (for example, kidney or ureter stones, appendicitis, etc.).
• Second, use of analgesics. We use Paracetamol, Tramadol or the combination of both, depending on the intensity of the pain. In some cases, it is necessary to resort to specific treatments for what we call neuropathic pain (pain caused by disease or direct problem of the somatosensory nervous system). Among these neuropathic pain treatments, we have: carbamazepine, gabapentin, pregabalin, tricyclic antidepressants, etc.
• In many patients, especially if the pain is of moderate or severe intensity, very constant, long evolution, etc. it is advisable to resort to psychological or psychiatric support to avoid anxiety, depression, stress, etc. associated with this situation.
• If the pain does not remit with medication, we can resort to infiltration of the spermatic cord with anaesthetics and corticosteroids; radiofrequency; etc.

But in a high percentage of cases (possibly in more than 50% of patients) none of the above solves the problem. In these patients the only solution is surgery of denervation of the testicle. This is a technique that consists in sectioning all the nervous branches that collect the sensitivity of the testicle, thus avoiding the transmission of the painful sensation to the central nervous system. As a preliminary step, we should perform a cord block with local anaesthetics to confirm the possible efficacy of the subsequent surgical intervention. If the aesthetic block is effective, we will have a guarantee that the surgery will solve the pain. The surgical procedure must be performed by the best urologist in Janakpuri, West Delhi with the help of a surgical microscope that allows us to identify the arteries (testicular and deference); the veins; the lymphatics and the vas deferens, which will be the only structures that will be respected.

Urinary Incontinence in Male & Child

URINARY INCONTINENCE

IN THE MALE

Urinary incontinence in men occurs, in most cases, as a consequence of surgery on the prostate, urethra or bladder, says urologist in Palam.

The therapeutic options are multiple. The most common procedure performed by urologist in Janakpuri are the following:

• Rehabilitation of the perineal and pelvic muscles: Sometimes it is enough to resort to a good rehabilitation of the perineal and pelvic muscles to solve this problem. This is possible when the patient has residual muscle in the sphincter. On other occasions, rehabilitation should be used as a treatment associated with any of the surgical techniques described below. The results obtained with this type of treatment in our unit have been very satisfactory. The experience accumulated in this sense is broad and conclusive, being a reference centre for other urologist in West Delhi, who refer us to patients with this problem. In our unit, we recommend starting rehabilitation 4-6 weeks after having undergone radical prostate or bladder surgery.
• Injection of bulking substances: It is a very simple and effective technique in about 50% of cases. When we associate the injection of bulking substances with Rehabilitation, the percentage of improvements and cures exceeds 75%.
• Mesh placement: In males, meshes can also be used to correct certain forms of UI. The technique is not very complex and the results achieved can reach 70% cure / improvement says urologist in Dwarka.
• Incontinence prosthesis placement: The results obtained with its implantation are very satisfactory.

IN THE CHILD

The causes of urinary incontinence in children can be very numerous. However, it is usually a problem of uncontrolled urination.

Children usually acquire daytime urinary continence around 2-3 years and nocturnal continence around 3-5 years. These ages are indicative and will depend, to a great extent, on the global maturity of each one.

Therefore, if a child is not able to contain urine during the day after 3 years or during the night after 5, he should consult with the specialist. Currently, most of the urologist in West Delhi think that it is better to value and treat these children from that age than to wait for their spontaneous evolution until they are older.

We, as a team of urologist in Hari Nagar, speak of enuresis when the child presents involuntary urine losses at an age when he should have already acquired control of urination. There are many different types of enuresis:

• Primary or secondary: depending on whether the child has had control over the pee on occasion or not
• Diurnal, nocturnal or mixed, depending on the time in which the enuresis occurs
• Monosymptomatic or complex
• Etc.

The most common form of presentation is usually monosymptomatic nocturnal enuresis. This clinical picture can appear as a consequence of multiple factors, such as:

• Neurological factors
• Psychic factors, critical emotional situations, etc.
• Sleep problems
• Hereditary factors
• Etc.

Although this problem usually resolves spontaneously with the passage of time, it is not advisable to ignore it for two fundamental reasons: firstly, because it can be a more serious problem that starts manifesting in this way; and, secondly, because of the possible psychological effects that this situation could cause the child.

The therapeutic options are numerous. It is usually convenient and necessary to associate several of them to achieve satisfactory results. The available treatments at the hospital of urologist in Uttam Nagar are:

• Behavioural measures: reduce the fluid intake before going to bed, urinate before going to bed, lift the child to urinate at night, motivate the child, not ridicule, etc.
• Medical treatments
• Use of alarms
• Rehabilitation and voiding re-education.

Habits Which Causes Kidney Stones

An expected 30 million Indians have kidney disease, with thousands all the more conceivably in danger for creating kidney issues. Kidney harm doesn't, for the most part, occur without any forethought. It is an unfaltering procedure that happens more than quite a while because of some poor way of life decisions and ill-advised administration of different conditions like diabetes.

As suggested by urologist in Janakpuri, the more unfortunate propensities you have, the more regrettable it gets. Specialists found that guineas pigs with 3 to 4 unfortunate propensities named "undesirable way of life practices," developed their danger of creating constant kidney sickness by 337 percent contrasted with individuals who had no negative behavior patterns.

Hitting the bottle hard

Kidneys enable your body to sift through destructive substances, including liquor. So when you drink intensely, your kidneys are under enormous weight. Doing this all the time can make harm the renal framework.

Liquor is to a great degree dehydrating, and an overabundance level in your body can make your organs be insufficiently hydrated and hamper their execution, says urologist in Dwarka. Liquor is likewise a reason for liver disease, which thusly meddles with the direction of the bloodstream to the kidneys.

Not Drinking Enough Water

Kidneys rely upon sufficient stream of liquids to work appropriately. Remaining hydrated is vital to help the kidneys legitimately flush out the poisons from your body. Urologist in West Delhi reference to lack of hydration as a reason for kidney harm and kidney stones.

Continually Holding It In

Not urinating frequently enough can be awful for your kidneys. Nature's call is intended to be replied in an ordinary, convenient way and in the event that you don't, your body and kidneys specifically hold every one of the poisons intended to be removed. After some time, this can really prompt incontinence and also kidney stones and different types of kidney harm say urologist in Palam.

Winging It With Medication

Adhering to the endorsed meds is vital. A certain prescription can cause kidney harm whenever taken inaccurately or not nearly observed. In the event that your specialist has proposed particular measurements for a settled length, take it just for that long and no more, suggests urologist in Uttam Nagar.

OTC agony prescriptions like headache medicine, ibuprofen, and acetaminophen are for the most part awful for your kidneys whenever taken frequently or every day. Certain anti-toxins (aminoglycosides, amphotericin B, cephalosporins, bacitracin, and vancomycin) can likewise be destructive on the off chance that you have fragile kidneys.

Reveling Your Sweet Tooth Too Often

Having overabundance sweet sustenances like deserts, sweets, and snacks and soft drinks can be awful for your kidneys. Urologist in Hari Nagar says that devouring excessively fructose could get an ascent uric corrosive levels and at last prompt cardiorenal sickness.

Those with diabetes are as of now at high danger of creating renal issues; a lot of sugar in your eating regimen can compound this circumstance. Make sure to peruse sustenance marks and pick nourishments that are low in sugar and high in fiber.

Not Monitoring Your Blood Pressure

It is vital to monitor your circulatory strain since hypertension is the main source of kidney harm, says best urologist in Dwarka. Keep to the suggested levels set by your specialist and take measures to control and hypertension. The level is normally set at under 140/90 mm Hg.

Eating Too Much Protein

Inordinate protein, particularly from red meat sources, in your eating routine builds the danger of kidney harm. The kidney is in charge of sifting through poisons, similar to nitrogen and smelling salts discharged from a protein source. When you eat a great deal of protein, the kidney goes into an overdrive mode and starts hyperfiltration. This prompts kidney harm, says best urologist in West Delhi.

Skipping Exercise

Exercise is useful for the body's flow and can enable you to oversee conditions like circulatory strain and diabetes. Overweight or large individuals can cut the heap on their body by working out.

As one investigation appeared, weight reduction can emphatically affect renal capacity in extremely large people. For every other person, practice helps keep the body and cardiovascular framework in a great working condition.

Not Eating Right

Eating well may not constantly mean you're eating right when you have kidney inconvenience. On the off chance that your kidneys are as of now stressed, things change a bit. Best urologist in Dwarka may propose an eating regimen that has less potassium and phosphorus. This implies generally "terrible" sustenances like white rice, white bread, and pasta all of a sudden turn out to be beneficial for you.

What shouldn't you eat?

·         Whole-grain forms that are high on phosphorus

·         Phosphorus-rich oats, nuts, lentils, wheat grains, fish, meat, and poultry

·         Colas

·         Vegetables and organic products like tomatoes, potatoes, bananas, and oranges

What would you be able to eat?

·         Plenty of new vegetables and natural products (particularly apples, peaches, green beans, and carrots)

·         Rice drain rather than dairy

·         Corn and rice-based grains

·         Protein in moderate amounts

Additionally, plant protein sources and certain creature protein sources like chicken and fish are less demanding on your kidneys. Heart-sound nourishments are a smart thought by and large since they additionally help deal with your weight, diabetes, and pulse. Certain supplements like magnesium and nutrient B6 are useful for averting kidney stones.

Going Heavy On The Salt

Elevated amounts of sodium in your eating routine, regardless of whether as salt in your cooking or all the more generally through shrouded sources, are possibly tricky, particularly on the off chance that you have an inclination for hypertension.

Numerous snacks, junk, canned, and bundled sustenances contain high measures of sodium, so cut down on these. Decide on a crisp cut natural product, vegetables, nuts, or custom made snacks. Farthest point sodium admission to under 2,300 mg daily.

Not Treating Infections Quickly

Whenever you get this season's cold virus, make a point to treat it and take the entire course of anti-toxins. Best urologist in Janakpuri explains that untreated viral contaminations could hurt your kidneys. The infection could spread and harm the kidney. Likewise, not taking rest on the off chance that you have this season's cold virus, chilly, tonsillitis, or pharyngitis could affect your kidney work.

Being Deficient In Vitamins And Minerals

Research asserts a lack of nutrients B6 and D builds the danger of kidney harm and stones. Magnesium is an imperative mineral for your body. Without it, the body can't dispose of overabundance calcium and this causes kidney stones, says best urologist in Uttam Nagar.

Drinking Excessive Caffeine

One examination demonstrated that long haul drinking of a lot of caffeine would prompt perpetual kidney disappointment since it builds circulatory strain and puts a great deal of strain on the organ. Another investigation uncovered exorbitant caffeine could prompt kidney stones as it discharged a ton of calcium in the pee.

Not Sleeping Well

Rest is crucial for any individual. It is amid this time your body recuperates and recharges itself, including kidney tissues. In the event that you aren't resting enough or the nature of your rest is terrible, it could hinder your conduits. This raises your circulatory strain. Anything that raises your pulse can harm your kidney. Along these lines, get a decent 7-8 hours of rest each day.

Smoking

Smoking antagonistically impacts your circulatory strain. You additionally increment cardiovascular hazard since smoking builds your pulse, limits the veins in your kidneys, harms blood vessel branches, and causes arteriosclerosis in the renal supply routes. These, thus, stack the chances against you for kidney harm.

Smoking is dangerous for those with diabetes since it builds the odds of kidney issues. Smokers risk losing kidney work quicker than non-smokers. Be that as it may, stopping smoking will essentially diminish any future dangers.

Utilizing Excess Artificial Sweeteners

Can't quit drinking misleadingly improved soft drink? One examination uncovered individuals who have ordinary measures of falsely improved beverages have a two-overlap expanded hazard for kidney decrease.

Eating Genetically Modified Foods

Studies have discovered eating GMO products could effectively affect the kidney and liver. Indeed, even the littlest measure of GMO sustenances negatively affected the organs. Decide on naturally developed deliver and maintain a strategic distance from basic wellsprings of GM fixings, for example, prepared and prepackaged nourishments.