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Male Infertility – Diagnosis, Causes and Treatment

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Advanced Urology Infertility

Male Infertility – Diagnosis, Causes and Treatment

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Infertility diagnosis is advised to a couple who do not conceive over the period of one year despite having a physical relationship. The problem of infertility has now become very common and is reported in one out of 6 couples. In case it is the male partner responsible for the condition, it is male infertility.

It is a problem of sperm movement and the production of sperm termed as male infertility. Out of all the infertility cases, over 30% of the cases are because of male infertility conditions. Most of the conditions that contribute to male infertility are preventable or treatable. The diagnosis of male fertility is however very complicated. Also, infertility is primarily considered to be associated with women and hence men do not feel concerned about them being infertile. It is important for both men and women to consult a doctor in case couples unable to conceive. However, in the case of a male, it is important to understand male fertility and related facts in detail, before consulting the doctor.

What are the causes of male fertility?

Male infertility can be understood as a problem of sperm movement and the production of sperm. Some of the common reasons for less sperm count or abnormal sperm movement can be:

  • Varicocele: This is a condition wherein a bulge of veins develops above the testicles. 38% of the cases of male infertility are because of this reason. Luckily, it is a controllable factor. A physician can best advise as to when the condition is treatable and when not.
  • Retrograde ejaculation: As the name suggests, in this condition, the sperm is reversely ejaculated into the bladder.
  • Absence of vas deferens, the pipeline that carries sperms.
  • An obstruction in the pipeline between the testicles and the penis.
  • Antibodies act against the sperms and kill them on their way to the egg.

What is the diagnosis of male fertility?

Identifying the causes of male fertility is intimidating and only a qualified physician can help. The physician will advise some tests, which may include:

  • Sperm and semen analysis: A fresh sample of the semen is taken for the test of sperm count. The experts may also examine the sperm for their shape and movement. A higher number of normal sperms indicate that the male is fertile and vice versa. The condition when there are no sperms in the semen is known as azoospermia, which means that there is a plumbing problem and surgery is the treatment.
  • Physical examination: A urologist performs a physical examination to identify varicocele as well as any underlying hormonal problem.
  • Hormonal evaluation: There are many hormones responsible for sperm production and movement such as testosterone. A hormonal test is done but in most cases, it isn’t the cause.
  • Testicular biopsy: In case the sperm count is very low, a testicular biopsy is performed. A needle biopsy is performed to check the production level of sperms.
  • Genetic testing: Through a genetic test, it is identified if the problems are related to genetics.

What are the treatments of male infertility?

Male fertility is treatable in most of the cases and the ultimate goal is to help couples conceive the most common infertility treatments include:

  • In the case of varicocele, it can be treated through surgery to unblock the abnormal veins. In most cases, this is the most common reason and the treatment is effective.
  • In the case of hormonal abnormalities, medicines are effective for treatment.
  • In the case of obstructions, surgery is performed to correct the plumbing.

Lately, many innovative and advanced treatments have come in a light that has helped in a range of male infertility cases. Assisted Reproductive Techniques (ARTs) are very powerful and result-oriented. Although a little expensive, this treatment has shown great results.

In the first step of ARTs, experts collect semen either with the help of a needle directly from the penis or through natural ejaculation. These eggs are then introduced to the eggs in one or many ways. These methods include:

  • Intrauterine insemination (IUI): The sperms are directly injected into the uterus when the ovulation happens. The woman is offered some medication that influences the higher number of egg production.
  • In-vitro fertilization (IVF): In this process, the sperms are fused with multiple eggs that are collected from the woman in a test tube. The eggs that fertilize are placed in the uterus for further process.
  • Intracytoplasmic sperm injection (ICSI): A needle is used to inject a single sperm into the egg. As soon as the egg is fertilized, it is transferred and implanted in the uterus. When the sperm count is extremely low, this procedure is performed.

Home remedies for male infertility treatment

There are a number of ways that can be used to increase the sperm count in the best possible way. One of the primary things is to avoid affecting the chances of sperm by avoiding marijuana, tobacco, and more than two alcoholic drinks in a day. Whirlpools and hot baths are also known to affect the chances of having viable sperm.

It is also recommended to avoid taking testosterone or any other androgen drug. Usually, these drugs are consumed for weight training.

How to prevent male infertility?

There isn’t much to be done to prevent male infertility that is caused by genetic disorders. But, there are certain ways to avoid the problem to some extent which includes:

  • Prevention from sexually transmitted diseases
  • No illicit drug usage
  • Avoid exposure to radiation
  • Limited use of alcohol
  • High personal hygiene practices
  • Loose-fitting undergarments

In case you experience the symptoms of male infertility or any discomfort while having sex, and not being able to conceive, you must consult the physician as soon as possible.

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Advanced Urology Kidney Diseases

Kidney Stone Home Remedies – Tips to help with the discomfort & pain

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With the rising rate of risk factors, one of the common diseases that has affected a lot of people is Kidney Stones. These stones are hard, a rock-like structure that forms inside the kidney when the malicious products do not completely drain out. The natural way of getting rid of these stones is passing them through urine. However, it is one of the most painful experiences. Also, the chances of their re-occurrence are also very high.

While kidney stone surgery is a great way to get rid of these stones permanently, you can always try some of the best home remedies to eliminate them in the first place. In this article, we have explained some of the proven kidney stone home remedies.

Drink plenty of water

Keeping yourself well hydrated is one of the best ways to get rid of kidney stones. This is not only care but also preventive measures from kidney stones. When you drink plenty of fluids, the water content in your body increases, which dilutes the stone forming contents. The body then releases the excess water, along with these contents, in the form of urine. While water along with beverages like coffee, tea, beer, wine, and orange juice is a great fluid to prevent kidney stones, soda and high carbonated drinks are considered contributing to the cause.

Add more citric acid to your diet

Citric acid works on calcium oxalate kidney stones. The two ways it is helpful are:

  • Avoid stone formation: Citric acid gets associated with the calcium in the urine and prevents the stone formation in the first place.
  • Reduce stone enlargement: In case you already have kidney stones, an increase in citric acid levels in the body means the excess calcium is being absorbed.

Some rich sources of citric acid are lemons, limes, oranges, and various other fruits and vegetables.

Limit oxalates intake

Oxalate, also known as Oxalic acid is found in various dietary items such as leafy greens, fruits, and vegetables. Our body also produces oxalate naturally. When the body gets richer with oxalate, they start showing in the urine. In case you tend to develop calcium oxalate stones, this can be an alarming condition for you.  However, before you avoid eating your leafy greens and vegetables, consult with your doctor first.

Limit your dose of Vitamin C

If you are taking vitamin D supplements you might be at a higher risk of developing kidney stones. This is because when you consume high Vitamin C supplement they trigger the production of oxalate in the urine. However, consuming Vitamin C rich food items does not cause any such problem.

Reduce your salt intake

Studies show that eating a diet high in salt can increase your risk of developing kidney stones. When you consume a lot of table salt, the sodium content in it works on your body resulting in calcium excretion in the urine.

Increase calcium intake

The more calcium-rich diet you will have, the lower are your chances of developing kidney stones. However, you must limit the intake of dietary calcium and increase the consumption of foods like milk, cheese and yogurt, and other good dietary sources of calcium. The recommended dose of calcium is 1000 mg per day.

Limit eating animal protein

Meat, fish, and dairy are a rich source of protein, but this animal protein is also associated with a higher rate of kidney stones. The animal protein can influence calcium excretion and have the opposite effects of citrate.

Make medicinal juices

There is a range of juices that act against the development of kidney stones. Some of the finest examples of such juices are Basil Juice, Lemon Juice, Apple Cider Vinegar Juice, Pomegranate juices, and more. These juices increase the fluid amount in your body and are also a rich source of citric acid.

Preventing and treating Kidney stones is possible. However, in case of a severe condition, it is important to consult the best surgeon for kidney stones first.

 

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Advanced Urology Minimal Invasive Surgery

Five Months Old Baby Operated Successfully with Holmium Laser

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Baby Manvi, a 5 months old female child was having a rare congenital anomaly of her left Kidney. There were two kidneys on her left side (called duplex kidney), both of which were opening separately in her urinary bladder, but the problem was that one of these two kidneys was having blockade of its ureter due to a condition called ureterocele (the dilated lower part of the ureter which blocks its own passage). A big ureterocele was obstructing the passage of the urinary bladder.

Dr. Anand Sehgal, Chief Urologist at RG stone & Super Specialty Hospital, Ludhiana performed this difficult surgery with the help of the holmium laser and a very small telescope on Thursday, 11th Feb 2010. This operation was done without any incision on the skin, with the help of laser, the dilated lower end of the blocked ureter was opened.

The baby was fine after 3 hours of surgery taking her mother’s feed and was discharged from the hospital on Friday. (within 36 hrs of admission)

Duplex Kidney is a very rare congenital anomaly. This defect occurs during the development of the kidney while the baby is in the mother’s womb.

Previously this condition used to remain undiagnosed until the child grew up and the disease had caused complications. Thanks to the ultrasound modality which now helps us to diagnose this condition even before the baby is formed and timely action can be taken to preserve the kidney from further damage. Such highly advanced procedure requires a combination of modern technology and the exclusive skill of the surgeon.

The facility of such advanced urological procedures is available in very few centres in India.

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Advanced Urology Kidney Diseases Minimal Invasive Surgery

Laparoscopic Pyeloplasty to cure Horse Shoe Kidney with PUJ Obstruction

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A young female patient named Mrs. Tripta Goel age 25 years from Mandi Gobind Garh (Punjab) India, presented with pain in the left flank. Her initial investigations showed that she was having an anomaly in her kidney, which is called the horseshoe kidney. In addition, she was having obstruction at the junction of pelvis and ureter (PUJ Obstruction). This problem requires surgery (Pyeloplasty).

The chief urologist at RG Stone, Ludhiana, Dr. Anand Sehgal (Mch, Urology) performed the procedure of laparoscopic pyeloplasty on 29th October 2009. Conventionally, this surgery is being done through a large incision in the abdomen which requires prolonged hospitalization and painful recovery. However, surgery at our center was done laparoscopically through three small holes. Mrs. Tripta was discharged from hospital on 4th day in satisfactory condition. This is a technically demanding procedure and is considered to be an advanced laparoscopic urological procedure that is being done in very few centers in India.

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Advanced Urology Minimal Invasive Surgery

Kudos for the team RG

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Me & my wife came to India for the holiday. Before coming here, I was suffering from hernia & my wife had a sinus problem. Therefore, while on the tour we decided for the surgery. I searched on the web about the best hospital for the hernia treatment. We found so many hospitals but after going through several inquiries, we both decided to go for a specialty hospital that is RG Stone, Ludhiana. We were warmly welcomed by its medical superintendent & his core team. It was a pleasant experience of getting expert treatment from Dr. H.S. Jolly (Laparoscopic Surgeon), Dr. S.V. Gupta (ENT Surgeon) & their team. After the surgery, within two days we were feeling much more comfortable.

All in all, we are really impressed by the facilities provided by the hospital & pleasing behavior of staff. Thanks to the entire RG Stone family. Keep it up…

Mr. & Mrs. Peter T. Sweka
Directorate of Youth & Sports, Sudan

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Advanced Urology

Kidney Stone Treatment without Surgery

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RG Stone And Super Speciality Hospital organised a free check-up camp for patients suffering from kidney stones from April 4 to 10. A team of doctors, headed by Dr. Anand Sehgal, M.Ch. (Urology) and Chief Endoscopic & Laparoscopic Urologist at RG Hospital, conducted the free check-up.

Hospital provided kidney stone treatment without surgery by siemens lithotripsy. The siemens lithotripsy is a highly advanced non-invasive procedure done with the help of the 4th generation siemens lithotriptor with ultrasound attachment that uses highly focused electromagnetic waves projected from outside the body to crush kidney stones in the urinary system.

Addressing a press conference, Dr. Chan Bir Singh, Director, RG Stone And Super Speciality Hospital, said, “RG Hospitals are known all over India for the best treatment, highly-trained doctors and surgeons, state-of-the-art equipment and risk-free procedures. With this free check-up camp, it is our endeavor to bring the best in the medicine to the masses who under normal circumstances cannot afford such check-ups.”

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Advanced Urology Minimal Invasive Surgery

RG hospital gives new life to two despondent patients

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RG Stone And Super Speciality Hospital, India’s only chain of super speciality hospitals for advanced urology and laparoscopic surgeries, at Model Town, Ludhiana, announced the success of the operations on two patients for their disease, prostate enlargement or benign prostatic hyperplasia (BPH) leading to blockage of the urinary passage. This is because both the patients were unsuitable candidates for surgery under previous techniques for the treatment of BPH. One of the patients, Mr. Sohan Singh, is 90 years old and is anemic. The second patient, Dr. HS Sandhu, is 69-year old and had hypertension, stroke & cardiac problem. It is well to note, too, that Dr. Sandhu himself is an ophthalmologist and a retired CMO.

With the availability of the latest holmium laser enucleation of the prostate (HOLEP) technique, Dr. Anand Sehgal was able to successfully operate on the two patients and give new life to them. Dr. Anand Sehgal is M.Ch. (Urology) and chief endoscopic & laparoscopic urologist at RG Stone And Super Speciality Hospital. HOLEP is a minimally invasive surgery, for treatment of BPH using the state-of-the-art 100-watt holmium laser. Mr. Singh was operated on December 16, 2006, and Dr. Sandhu on January 6, 2007.

Dr. Chan Bir Singh, partner, RG Stone And Super Speciality Hospital, also informed that the RG Hospital chain is the first to introduce holmium laser in India and that the RG Stone and Super Speciality Hospital, Ludhiana is currently the only institution possessing the holmium laser, not only in entire Punjab but in entire region up-north Delhi.

The prostate is part of a man’s genitals. The prostate is a walnut-sized gland located beneath the bladder and in front of the rectum. For men over 50, the most common prostate problem is prostate enlargement. This condition is also called benign prostatic hyperplasia or BPH.

BPH occurs in older men; the prostate often enlarges to the point where urination becomes difficult. If the prostate grows too large it may constrict the urethra and impede the flow of urine, making urination difficult and painful and in some cases completely impossible. As men get older, their prostate keeps growing. As it grows, it squeezes the urethra making urination difficult since urine travels from the bladder through the urethra. There is no cure for BPH once it reaches a stage where urination is completely blocked and once prostate growth starts, it often continues, unless medical therapy is started.

Once a BPH patient reaches a stage where urination has completely blocked the bladder has to be emptied using a catheter. The patient is forced to carry the catheter inside his body and an external pouch carrying the drained urine.

Holmium Laser Enucleation of Prostate (HOLEP) is the latest modality used in the management of enlarged prostate. In this procedure, a 550-micron fibre attached to a 100-watt holmium laser machine is used to remove obstructive prostatic tissue and seal blood vessels. The enucleated gland is then pushed into the bladder, which is later sucked out through the urinary passage with the help of equipment called Morcellator. The Morcellator shreds the large pieces of the prostate into small pieces and simultaneously sucks these pieces out. The whole procedure takes around 45-90 minutes, depending on the size of the gland. This procedure is nearly bloodless as the laser beam when cuts the gland also seals the blood vessels.

Mr. Sohan Singh, 90, developed blockage of urinary passage two months ago. A catheter was put in his urine passage by his local doctor to help him pass the urine. The ultrasound revealed that the prostate size was 80 grams, which was abnormally large and had no cure but surgery. He was on anti-depressant drugs for the last many years and was also anemic. We thoroughly evaluated him and took him up for HOLEP surgery. The surgery was absolutely bloodless and uneventful. His catheter was removed within 24 hours of surgery and he started passing urine normally. Mr. Singh stayed in the hospital for only one night and went home without any catheter. After one month of the surgery, the patient is feeling absolutely fine and passing urine without any residue in his urinary bladder.

Dr. Sandhu, 69, was having obstructive urinary symptoms for the last year and developed acute urinary retention on December 30, 2006. He too was catheterized for the evacuation of his urinary bladder. Dr. Sandhu was on anticoagulant therapy due to past cardiac and stroke problems. In consultation with the RG Stone And Super Speciality Hospital, his prostate was found to be 45 grams in size. He, too, was assessed fit for HOLEP surgery. The 100 Watt Holmium Laser was used to remove the prostate and the surgery was completed without significant blood loss. The color of urine, after surgery, was absolutely clear (bloodless). Dr. Sandhu’s catheter was removed the next morning and he passed urine naturally. He was discharged the same evening. His total stay in the hospital was only 33 hours and he is doing well now.

Speaking on the success of the operations, Dr. Chan Bir Singh said, “It is always our endeavor to bring the best in technology, equipment, international quality standards and full-time dedicated doctors and surgeons, who possess the best know-how in the industry to our patients so as to help them achieve the best treatment, relief, and succor that medical science can provide. We are very pleased that with the help of the latest technology and highly trained doctors, many of our patients now look at their life with new hope. We pledge ourselves to continue to drive the limits of excellence in the field of urology and stone management.”

RG Hospital Chain, an ISO 9001:2000 certified organization, was established in 1986 with its foundation in Mumbai. The group opened its sixth and latest hospital at Model Town, Ludhiana, in November 2006. This is India’s only chain of super speciality hospitals for urology, joint replacement, ENT, and laparoscopy offering all available modalities of stone disease management and prostate disease management under one roof. The hospital uses US FDA approved, state-of-the-art equipment and modular operation theaters with lamina flows. RG hospitals have treated over 40,000 patients at their branches all over India including 6,500 patients from abroad.

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