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Urinary incontinence

What is Urinary incontinence?

Urinary incontinence happens when you lose control of your bladder. In some cases, you may empty your bladder’s contents completely. In other cases, you may experience only minor leakage. The condition may be temporary or chronic, depending on its cause.

Symptoms of urinary incontinence

Many people experience occasional, minor leaks of urine. Others may lose small to moderate amounts of urine more frequently.

Types of urinary incontinence include:

  • Stress incontinence. Urine leaks when you exert pressure on your bladder by coughing, sneezing, laughing, exercising or lifting something heavy.
  • Urge incontinence. You have a sudden, intense urge to urinate followed by an involuntary loss of urine. You may need to urinate often, including throughout the night. Urge incontinence may be caused by a minor condition, such as infection, or a more-severe condition such as a neurologic disorder or diabetes.
  • Overflow incontinence. You experience frequent or constant dribbling of urine due to a bladder that doesn’t empty completely.
  • Functional incontinence. A physical or mental impairment keeps you from making it to the toilet in time. For example, if you have severe arthritis, you may not be able to unbutton your pants quickly enough.
  • Mixed incontinence. You experience more than one type of urinary incontinence.

Causes of urinary incontinence

Urinary incontinence isn’t a disease, it’s a symptom. It can be caused by everyday habits, underlying medical conditions or physical problems. A thorough evaluation by your doctor can help determine what’s behind your incontinence.

Temporary urinary incontinence

Certain drinks, foods and medications may act as diuretics — stimulating your bladder and increasing your volume of urine. They include:

  • Alcohol
  • Caffeine
  • Carbonated drinks and sparkling water
  • Artificial sweeteners
  • Chocolate
  • Chili peppers
  • Foods that are high in spice, sugar or acid, especially citrus fruits
  • Heart and blood pressure medications, sedatives, and muscle relaxants
  • Large doses of vitamin C

Urinary incontinence may also be caused by an easily treatable medical condition, such as:

  • Urinary tract infection. Infections can irritate your bladder, causing you to have strong urges to urinate, and sometimes incontinence.
  • Constipation. The rectum is located near the bladder and shares many of the same nerves. Hard, compacted stool in your rectum causes these nerves to be overactive and increase urinary frequency.

Persistent urinary incontinence

Urinary incontinence can also be a persistent condition caused by underlying physical problems or changes, including:

  • Pregnancy. Hormonal changes and the increased weight of the fetus can lead to stress incontinence.
  • Childbirth. Vaginal delivery can weaken muscles needed for bladder control and also damage bladder nerves and supportive tissue, leading to a dropped (prolapsed) pelvic floor. With prolapse, the bladder, uterus, rectum or small intestine can get pushed down from the usual position and protrude into the vagina. Such protrusions can be associated with incontinence.
  • Changes with age. Aging of the bladder muscle can decrease the bladder’s capacity to store urine. Also, involuntary bladder contractions become more frequent as you get older.
  • Menopause. After menopause women produce less estrogen, a hormone that helps keep the lining of the bladder and urethra healthy. Deterioration of these tissues can aggravate incontinence.
  • Hysterectomy. In women, the bladder and uterus are supported by many of the same muscles and ligaments. Any surgery that involves a woman’s reproductive system, including removal of the uterus, may damage the supporting pelvic floor muscles, which can lead to incontinence.
  • Enlarged prostate. Especially in older men, incontinence often stems from enlargement of the prostate gland, a condition known as benign prostatic hyperplasia.
  • Prostate cancer. In men, stress incontinence or urge incontinence can be associated with untreated prostate cancer. But more often, incontinence is a side effect of treatments for prostate cancer.
  • Obstruction. A tumor anywhere along your urinary tract can block the normal flow of urine, leading to overflow incontinence. Urinary stones — hard, stone-like masses that form in the bladder — sometimes cause urine leakage.
  • Neurological disorders. Multiple sclerosis, Parkinson’s disease, a stroke, a brain tumor or a spinal injury can interfere with nerve signals involved in bladder control, causing urinary incontinence.

When to see a doctor

You may feel uncomfortable discussing incontinence with your doctor. But if incontinence is frequent or is affecting your quality of life, it’s important to seek medical advice because urinary incontinence may:

  • Indicate a more-serious underlying condition
  • Cause you to restrict your activities and limit your social interactions
  • Increase the risk of falls in older adults as they rush to the toilet
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Hydronephrosis treatments

What is Hydronephrosis?

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What is Hydronephrosis?

Hydronephrosis is the swelling of a kidney due to a build-up of urine. It happens when urine cannot drain out from the kidney to the bladder from a blockage or obstruction. Hydronephrosis can occur in one or both kidneys.

Hydronephrosis may result in decreased kidney function. If not treated right away, permanent damage to the kidney or kidneys may occur, resulting in kidney failure.

How is Hydronephrosis Caused?

Hydronephrosis is usually caused by another underlying illness or risk factor. Causes of hydronephrosis include, but are not limited to, the following illnesses or risk factors:

  • Kidney stone
  • Congenital blockage (a defect that is present at birth)
  • Blood clot
  • Scarring of tissue (from injury or previous surgery)
  • Tumor or cancer (examples include bladder, cervical, colon, or prostate)
  • Enlarged prostate (noncancerous)
  • Pregnancy
  • Urinary tract infection (or other diseases that cause inflammation of the urinary tract)

What are the symptoms of hydronephrosis?

Symptoms of hydronephrosis usually depend on the cause. Often there are no symptoms. When symptoms occur, they can include:

  • Sudden or intense pain in the back or side
  • Nausea
  • Vomiting
  • Frequent or painful urination
  • Blood in the urine
  • Weakness or malaise
  • Fever due to a urinary tract infection
  • No major change in urine output although it may be decreased

How is hydronephrosis diagnosed?

Getting a diagnosis as early as possible is extremely important. Your kidneys could be permanently damaged if your condition is left untreated for too long.

Your doctor will likely begin by getting an overall assessment of your health status and then focus on any urinary symptoms you might have. They may also be able to feel your enlarged kidney by gently massaging the abdomen and flank area.

Your doctor may use a catheter to drain some of the urine from your bladder.

Your doctor may also want to perform a renal ultrasound or CT scan to get a closer look at the extent of the swelling and to possibly locate the area of the blockage.

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What is Diabetic Kidney Diseases?

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Diabetic kidney disease is a decrease in kidney function that occurs in some people who have diabetes. It means that your kidneys are not doing their job as well as they once did to remove waste products and excess fluid from your body. These wastes can build up in your body and cause damage to other organs.

Cause of diabetes kidney disease

High blood glucose, also called blood sugar, can damage the blood vessels in your kidneys. When the blood vessels are damaged, they don’t work as well. Many people with diabetes also develop high blood pressure, which can also damage your kidneys. Learn more about high blood pressure and kidney disease.

Symptoms of diabetes kidney disease

You are unlikely to have symptoms with early diabetic kidney disease – for example, if you just have microalbuminuria (defined above). Symptoms tend to develop when the kidney disease progresses. The symptoms at first tend to be vague and nonspecific, such as feeling tired, having less energy than usual and just not feeling well. With more severe kidney disease, symptoms that may develop include:

  • Difficulty thinking clearly.
  • A poor appetite.
  • Weight loss.
  • Dry, itchy skin.
  • Muscle cramps.
  • Fluid retention which causes swollen feet and ankles.
  • Puffiness around the eyes.
  • Needing to pass urine more often than usual.
  • Being pale due to anaemia.
  • Feeling sick (nausea).

As the kidney function declines, various other problems may develop – for example, anaemia and an imbalance of calcium, phosphate and other chemicals in the bloodstream. These can cause various symptoms, such as tiredness due to anaemia, and bone ‘thinning’ or fractures due to calcium and phosphate imbalance. End-stage kidney failure is eventually fatal unless treated.

Diabetic kidney disease diagnosis

Diabetic kidney disease is diagnosed when the level of albumin in the urine is raised and there is no other obvious cause for this. Urine tests are part of the routine checks that are offered to people with diabetes from time to time. Urine tests can detect albumin (protein) and measure how much is present in the urine.

The standard routine urine test is to compare the amount of albumin with the amount of creatinine in a urine sample. This is called the albumin:creatinine ratio (ACR). Creatinine is a breakdown product of muscle.

A blood test can show how well the kidneys are working. The blood test measures the level of creatinine, which is normally cleared from the blood by the kidneys. If your kidneys are not working properly, the level of creatinine in the blood goes up. An estimate of how well your kidneys are working can be made by taking into account the blood level of creatinine, your age and your sex. This estimate of kidney function is called the estimated glomerular filtration rate (eGFR).

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What is Dialysis?

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The kidneys filter your blood by removing waste and excess fluid from your body. This waste is sent to the bladder to be eliminated when you urinate.

Dialysis performs the function of the kidneys if they’ve failed. Dialysis is a treatment that filters and purifies the blood using a machine. This helps keep your fluids and electrolytes in balance when the kidneys can’t do their job.

A healthy person’s kidneys filter around 120 to 150 quarts of blood each day. If the kidneys are not working correctly, waste builds up in the blood. Eventually, this can lead to coma and death.

The cause might be a chronic, or long-term condition, or an acute problem, such as an injury or a short-term illness that affects the kidneys.

Dialysis prevents the waste products in the blood from reaching hazardous levels. It can also remove toxins or drugs from the blood in an emergency setting.

What does dialysis do?

When your kidneys fail, dialysis keeps your body in balance by:

  • removing waste, salt and extra water to prevent them from building up in the body
  • keeping a safe level of certain chemicals in your blood, such as potassium, sodium and bicarbonate
  • helping to control blood pressure

Types of dialysis

There are different types of dialysis.

The three main approaches are:

  • Hemodialysis
  • Peritoneal dialysis (PD)
  • Continuous renal replacement therapies (CRRT)

The choice will depend on factors such as the patient’s situation, availability, and cost.

Hemodialysis

Hemodialysis is the most common type of dialysis. This process uses an artificial kidney (hemodialyzer) to remove waste and extra fluid from the blood. The blood is removed from the body and filtered through the artificial kidney. The filtered blood is then returned to the body with the help of a dialysis machine.

To get the blood to flow to the artificial kidney, your doctor will perform surgery to create an entrance point (vascular access) into your blood vessels. The three types of entrance points are:

  • Arteriovenous (AV) fistula. This type connects an artery and a vein. It’s the preferred option.
  • AV graft. This type is a looped tube.
  • Vascular access catheter. This may be inserted into the large vein in your neck.

Hemodialysis treatments usually last three to five hours and are performed three times per week. However, hemodialysis treatment can also be completed in shorter, more frequent sessions.

Most hemodialysis treatments are performed at a hospital, doctor’s office, or dialysis center. The length of treatment depends on your body size, the amount of waste in your body, and the current state of your health.

Peritoneal dialysis

Peritoneal dialysis involves surgery to implant a peritoneal dialysis (PD) catheter into your abdomen.

The catheter helps filter your blood through the peritoneum, a membrane in your abdomen. During treatment, a special fluid called dialysate flows into the peritoneum. The dialysate absorbs waste. Once the dialysate draws waste out of the bloodstream, it’s drained from your abdomen.

This process takes a few hours and needs to be repeated four to six times per day. However, the exchange of fluids can be performed while you’re sleeping or awake.

Continuous renal replacement therapy (CRRT)

This therapy is used primarily in the intensive care unit for people with acute kidney failure. It’s also known as hemofiltration. A machine passes the blood through tubing. A filter then removes waste products and water. The blood is returned to the body, along with replacement fluid. This procedure is performed 12 to 24 hours a day, generally every day.

How do I prepare for dialysis?

Before your first dialysis treatment, your doctor will surgically implant a tube or device to gain access to your bloodstream. This is typically a quick operation. You should be able to return home the same day.

It’s best to wear comfortable clothing during your dialysis treatments. Also follow your doctor’s instructions. These may include fasting for a certain amount of time before the treatment.

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What Is Prostate?

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The prostate gland (the prostate) is an organ of the male reproductive system. It is about the size of a walnut and is found at the base of the bladder. The thin tube that allows urine and semen to pass out of the penis (the urethra) runs through the prostate gland. Alkaline fluid produced by the prostate gland helps to nourish sperm and leaves the urethra as ejaculate (semen). The prostate undergoes two main growth spurts. The first is fuelled by the sex hormones made by the testes during puberty. This prompts the prostate to reach an average weight of 20 grams. The second growth spurt begins when men are in their thirties.

Common Problems

Here are some examples of non-cancer prostate problems:

Benign prostatic hyperplasia, or BPH, is very common in older men. It means your prostate is enlarged but not cancerous. Treatments for BPH include:

Watchful waiting also called active surveillance. If your symptoms are not too bad, your doctor may tell you to wait to see if they get worse before starting treatment. Your doctor will tell you how often to return for check-ups.

Medications. Medicines can help shrink the prostate or relax muscles near your prostate to ease symptoms.

Surgery. If nothing else has worked, your doctor may suggest surgery to help urine flow.

Other treatments. Sometimes radio waves, microwaves, or lasers are used to treat urinary problems caused by BPH. These methods use different kinds of heat to reduce extra prostate tissue.

Acute bacterial prostatitis usually starts suddenly from a bacterial infection. See your doctor right away if you have fever, chills, or pain in addition to prostate symptoms. Most cases can be cured with antibiotics. You also may need medication to help with pain or discomfort.

Chronic bacterial prostatitis is an infection that comes back again and again. This rare problem can be hard to treat. Sometimes, taking antibiotics for a long time may work. Talk with your doctor about other things you can do to help you feel better.

Chronic prostatitis, also called chronic pelvic pain syndrome, is a common prostate problem. It can cause pain in the lower back, in the groin, or at the tip of the penis. Treatment may require a combination of medicines, surgery, and lifestyle changes.

Be sure to talk with your doctor about the possible side effects of treatment.

The three most common types of prostate disease are:

  • Benign prostatic hyperplasia
  • Prostatitis
  • Prostate cancer

Symptoms of Prostate Problems

See your doctor right away if you have any of these symptoms:

  • Frequent urge to urinate
  • Need to get up many times during the night to urinate
  • Blood in urine or semen
  • Pain or burning urination
  • Painful ejaculation
  • Frequent pain or stiffness in lower back, hips, pelvic or rectal area, or upper thighs
  • Dribbling of urine

Diagnosis of prostate disease

Prostate disease is diagnosed using a variety of tests, including:

  • physical examination, including digital rectal examination (DRE), where the doctor inserts a gloved finger into your rectum to check the size of your prostate
  • blood test for prostate specific antigen (PSA test; discuss this with your doctor)
  • mid-stream urine (MSU) tests to look for infection or blood in the urine
  • ultrasound scans and urinary flow studies
  • biopsies of the prostate.
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What is Adrenal Cancer?

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Adrenal cancer is a rare cancer that begins in one or both of the small, triangular glands (adrenal glands) located on top of your kidneys. Adrenal glands produce hormones that give instructions to virtually every organ and tissue in your body.

Adrenal cancer is a condition that occurs when abnormal cells form in or travel to the adrenal glands. Your body has two adrenal glands, one located above each kidney. Adrenal cancer usually occurs in the outermost layer of the glands, or the adrenal cortex. It generally appears as a tumor.

A cancerous tumor of the adrenal gland is called an adrenal cortical carcinoma. A noncancerous tumor of the adrenal gland is called a benign adenoma.

If you have cancer in the adrenal glands, but it didn’t originate there, it’s not considered an adrenal cortical carcinoma. Cancers of the breast, stomach, kidney, skin, and lymphoma are most likely to spread to the adrenal glands.

Symptoms of adrenal cancer

Signs and symptoms of adrenal cancer include:

  • Weight gain
  • Muscle weakness
  • Pink or purple stretch marks on the skin
  • Hormone changes in women that might cause excess facial hair, hair loss on the head and irregular periods
  • Hormone changes in men that might cause enlarged breast tissue and shrinking testicles
  • Nausea
  • Vomiting
  • Abdominal bloating
  • Back pain
  • Fever
  • Loss of appetite
  • Loss of weight without trying

Causes of adrenal cancer

It’s not clear what causes adrenal cancer.

Adrenal cancer forms when something creates changes (mutations) in the DNA of an adrenal gland cell. A cell’s DNA contains the instructions that tell a cell what to do. The mutations can tell the cell to multiply uncontrollably and to continue living when healthy cells would die. When this happens, the abnormal cells accumulate and form a tumor. The tumor cells can break away and spread (metastasize) to other parts of the body.

How is adrenal cancer diagnosed?

Diagnosing adrenal cancer usually begins with your medical history and a physical exam. Your doctor will also draw blood and collect a urine sample for testing.

Your doctor may order further tests such as:

  • an image-guided fine needle biopsy
  • an ultrasound
  • a CT scan
  • a positron emission tomography (PET) scan
  • an MRI scan
  • an adrenal angiography

Treatments Options for adrenal cancer

Early treatment can sometimes cure adrenal cancer. There are currently three major types of standard treatment for adrenal cancer:

Surgery

Your doctor may recommend a procedure called an adrenalectomy, which involves removing the adrenal gland. If the cancer has spread to other parts of the body, your surgeon may also remove nearby lymph nodes and tissue.

Radiation therapy

Radiation therapy uses high-energy X-rays to kill cancer cells and stop new cancer cells from growing.

Chemotherapy

Depending on the stage of your cancer, you may need to undergo chemotherapy. This form of cancer drug therapy helps stop the growth of cancer cells. Chemotherapy can be administered orally or injected into a vein or muscle.

Your doctor may combine chemotherapy with other types of cancer treatments.

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What is Creatinine?

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Creatinine is a waste product of creatine, which is a chemical that the body uses to supply the muscles with energy. Creatinine is formed as a result of the natural breakdown of your muscle tissue and can then enter the blood.

Under normal conditions, your kidneys filter creatinine from your blood. Creatinine leaves the body through urine.

Normal and high ranges

Creatinine levels can be determined using a blood test or a urine test.

Blood creatinine test

You may also see this test referred to as a serum creatinine test. During this test, blood is collected from a vein in your arm and is then sent to a lab for further analysis.

Urine creatinine test

Your doctor may collect a random (single) urine sample for this test, but they’ll more likely request a 24-hour sample. A 24-hour urine sample involves collecting your urine over a period of 24 hours.

What your high results could mean?

Generally speaking, high levels of creatinine can indicate that your kidneys aren’t working well.

There are many possible causes of high creatinine, some of which may be a one-time occurrence. Examples can include things such as dehydration or intake of large amounts of protein or the supplement creatine. All of these can be temporarily hard on your kidneys.

However, other causes of high creatinine may point to a health condition. Many of these conditions can cause damage or disease that impacts kidney function. They can include:

  • drug toxicity (drug-induced nephrotoxicity)
  • kidney infection (pyelonephritis)
  • glomerulonephritis
  • diabetes
  • high blood pressure
  • heart disease, such as atherosclerosis or congestive heart failure
  • blockage of the urinary tract
  • kidney failure, both acute and chronic

High Creatinine Symptoms

The disturbing symptoms of high creatinine in blood include:

  • Swelling or edema
  • Shortness of breath
  • Nausea and vomiting
  • Changes in urination
  • Dehydration
  • Muscle cramps and chest pains
  • Fatigue
  • High blood pressure
  • Confusion

Diet tips to lower creatinine levels

A person may be able to reduce their creatinine levels by making some of the following changes to their diet.

  • Reducing protein intake
  • Increasing dietary fiber intake
  • Avoiding dehydration
  • Supplement and medication use

Lifestyle tips

People who exercise strenuously and have a risk of kidney disease may benefit from checking with a doctor about whether their exercise routine is safe.

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Urinary Tract Infection

A urinary tract infection (UTI) is an infection in any part of your urinary system — your kidneys, ureters, bladder and urethra. Mostly infections occur in the lower urinary tract — the bladder and the urethra.

Compare to Men, Women are at greater risk of developing a UTI. Infection limited to your bladder can be painful and annoying. However, serious consequences can occur if a UTI spreads to your kidneys.

Symptoms

  • A burning sensation when urinating
  • A frequent or intense urge to pee
  • Cloudy, dark, bloody, or strong-smelling pee
  • Passing frequent, small amounts of urine
  • Feeling tired or shaky
  • Fever or chills (a sign that the infection may have reached your kidneys)
  • Pain or pressure in your back or lower abdomen

Types of UTIs

An infection can happen in different parts of your urinary tract. Each type has a different name, based on where it is.

Cystitis (bladder): You might feel like you need to pee a lot, or it might hurt when you pee. You might also have lower belly pain and cloudy or bloody urine.

Pyelonephritis (kidneys): This can cause fever, chills, nausea, vomiting, and pain in your upper back or side.

Urethritis (urethra): This can cause a discharge and burning when urinating

Reasons for UTI

Large numbers of bacteria live in the area around the vagina and rectum, and also on your skin. Bacteria may get into the urine from the urethra and travel into the bladder. They may even travel up to the kidney. But no matter how far they go, bacteria in the urinary tract can cause problems.

Some factors that can add to your chances of getting a UTI are:

Body Factors

Some women are genetically predisposed to UTIs and have urinary tracts that make it easier for bacteria to cling to them. Sexual intercourse can also affect how often you get UTIs.

Birth Control

Women who use diaphragms have also been found to have a higher risk of UTIs when compared to those who use other forms of birth control.

Abnormal Anatomy

Anatomical abnormalities in the urinary tract may also lead to UTIs. These abnormalities are often found in children at an early age but can still be found in adults. There may be structural abnormalities, such as outpouchings called diverticula, that harbor bacteria in the bladder or urethra or even blockages, such as an enlarged bladder, that keep the body from draining all the urine from the bladder.

Immune System

Issues such as diabetes (high blood sugar) also put people at higher risk for UTIs because the body is not able to fight off germs as well.

Contact your doctor if you have any signs and symptoms of a UTI.

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