بهترین متخصص کلیه و مجاری ادراری در یزد

Urinary Tract

    Glomerulonephritis is a kidney disease caused by inflammation of the glomeruli. Glomerulonephritis or glomerular disease refers to the condition associated with the damaged glomeruli that cannot act as normal and if it continues, it may result in the kidney failure. Glomeruli are tiny filters responsible for removing waste and extra fluid from the blood. Glomerulonephritis may develop suddenly or gradually over the time.

Glomerulonephritis Types

    Glomerulonephritis or nephritis includes different types as following:

    • Acute glomerulonephritis;
    • Lupus nephritis;
    • Alport syndrome, or hereditary nephritis;
    • Chronic glomerulonephritis;
    • IgA nephropathy;
    • Interstitial nephritis.

Glomerulonephritis Causes

    It is not always clear to know about the causes of glomerulonephritis. There are many diseases that may lead to a damage to the glomeruli. The main causes of glomerulonephritis can be as following:

    • Some infections such as HIV and Hepatitis B or C;
    • The immune system diseases;
    • Family history and genetic factors;
    • Medical conditions and treatments;
    • High blood pressure;
    • A wide range of cancers.

Glomerulonephritis Symptoms

    When the glomeruli is damaged, following symptoms can be revealed:

    • Changes in urine color (pink or brown-colored urine);
    • Swollen hands and feet;
    • High blood pressure;
    • Headache;
    • Nausea and vomiting;
    • Rash, especially on the buttocks and legs;
    • Fever and chills;
    • Foamy urine;
    • Blood in the urine;
    • Difficulty in breathing.

Glomerulonephritis Treatment

    There are different treatments for glomerulonephritis depending on its cause and the type. However, the main treatments for glomerulonephritis include:

    • Medication such as blood pressure medicines, corticosteroids or immunosuppressive ones;
    • Diuretics (water pills);
    • Dietary restrictions on salt, fluids, protein, potassium and other substances;
    • Dialysis;
    • Plasmapheresis.

    Urinary-tract system refers to the path that urine passes from kidneys to the outside the body. Urine is produced in kidneys, passes through the narrow tubes and then, it is accumulated in the bladder. When the bladder fills, it is stimulated to drain urine. The urine is basically free from any infection. So, the urinary tract becomes infected if the bladder is a microbial environment. Infection affects the different parts of the urinary tract including bladder, urethra, kidneys and the connected tubes. Urinary tract infection (UTI) is usually caused by kidney or bladder problems.

Urinary Tract Infection Types (UTIs)

    There are different types of urinary-tract infections depending on the infected part. These types of UTIs include:

    • Urethritis: it is associated with the infection of the urethra;
    • Cystitis: it is associated with the infection of the bladder;
    • Pyelonephritis: it is associated with the infection of the kidneys;
    • Vaginitis: it is associated with the infection of the vagina.

Causes of Urinary Tract Infection

    Women are at higher risk of the bladder infections than men as they have shorter urethras. Bacteria are considered the most common source of urinary tract infections. The other effective causes of the UTI are:

    • Sexual intercourse;
    • Urinary catheters;
    • Holding in large amounts of urine for a long period of time.

    Other causes of the UTI can be some medical conditions such as:

    • Diabetes;
    • Pregnancy;
    • Having kidney stones obstructing the urinary tract;
    • An enlarged prostate gland in men;
    • Some structural problems in the urinary tract.

Candidates for UTIs

    Urinary tract infections are not regarded as contagious diseases. They are more common among young women in the following conditions:

    • Using spermicide plus a condom;
    • Having had a history of UTIs;
    • Using a diaphragm;
    • Having sexual intercourse;
    • Pregnancy.

UTIs Symptoms

    The symptoms of UTIs can include the following:

    • Urinating few drops even when the bladder is full;
    • Feeling pain or pressure in the back or lower abdomen;
    • Feeling pain or discomfort when urinating;
    • Cloudy, dark, bloody, or strange-smelling urine;
    • Urinating more than usual;
    • Fever and chills.

Tests and Treatments for UTIs

    In order to diagnose the urinary tract infections, patients should give a urine sample. Antibiotics are usually the main treatment for UTIs. Also, some medications can be prescribed to reduce the pain. It is also recommended to drink lots of fluids to flush the bacteria. As the urinary tract infections are very common, the treatment procedure is so simple. If the medications do not improve the conditions and the symptoms continue, it is necessary to visit to the GP.

Preventing UTIs

    UTIs can be prevented by following the below notes:

    • Drinking lots of water and other fluids each day;
    • Repeated bathing;
    • Cleaning the genital area before and after sex;
    • Voiding the bladder as soon as you feel full;
    • Staying away from scented bath products;
    • Keeping the genital area dry;
    • Avoiding tight jeans and nylon underwear.

    A kidney transplantation or renal transplantation is considered one of the most common organ transplant procedures performed today. It refers to placing a healthy donor kidney from a living donor or the one declared brain dead into the patient’s body where the two kidneys do not work well. After the transplantation, the patient gets the normal condition and does not need any other treatments such as dialysis. However, it just can be performed before the kidney failure happens.

kidney Pain Causes

    Many different problems can cause pain in kidneys that is usually felt in back, the sides, abdomen or groin. As nephrons are responsible for purifying the blood from waste materials and making urine, any problem affecting them can result in kidney pain. The main common causes of painful kidney include:

    • Urinary tract infection (UTI);
    • Kidney infection;
    • Polycystic kidney disease (PKD);
    • Blood clots in the kidney(s);
    • Bleeding in the kidney(s);
    • Kidney cancer;
    • Kidney stones;
    • Polycystic kidney disease.

Kidney Transplantation Procedure

    In the normal condition, the transplanted kidney is considered an external tissue by the patient’s immune system and the system can reject it. So, the patients should take immunosuppressant or anti-rejection drugs to lower the body’s ability to reject a transplanted organ. The donor kidney is implanted in the opposite side of patient’s body, i.e. the donor’s right kidney is placed in the left side of patient’s body and vice versa.
    This allows the ureter to be connected easily to the bladder. The donor kidney’s renal artery and vein are attached to the external iliac artery and vein. Finally, the vessels’ functions and the blood flow are controlled in terms of bleeding at the suture lines. The unhealthy kidneys remain in the body. They will be removed if serious matters such as infection, high blood pressure, or cancerous tissue are caused.

Kidney Transplantation Requirements

    In order to perform the kidney transplantation surgery, both donor and the patient should be examined via 3 types of tests to assess the blood and antigen factors. These tests include:

    • Blood type matching;
    • Cross-matching;
    • Human leukocyte antigen (HLA) testing.

Before Kidney Transplantation

    The transplant team considers some factors for the patient before the procedure including:

    • NPO diet determined by the physician;
    • Explaining the procedure for the patient;
    • Asking patient’s contentment for the surgery;
    • Shaving the chest and abdomen;
    • Putting a catheter for the patient before the procedure;
    • Giving a feeling of peace to reduce patient’s stress.

After Kidney Transplantation

    After the kidney transplantation procedure, some activities should be done to control the patient’s status. These activities include:

    • Controlling urine production to check new kidney’s functions;
    • Taking blood tests to check the new kidney functions as well as other body parts like the liver, lungs, and blood system;
    • Taking the antirejection medicines;
    • Breathing deeply to prevent respiratory tract infection (RTI);
    • Moving around different times in a day;
    • Drinking liquids with some limitations at first until the new kidney is working fully;
    • Cleaning and caring the surgical incisions.

Kidney Transplantation Side Effects

    Sometimes the donated kidney may make urine immediately after surgery; however, it may take a few weeks for the kidney to make urine. In this case, the patient needs dialysis treatments to purify body’s wasted materials until it works. In addition, some problems may occur after the procedure. They may include the followings:

    • Transplant rejection;
    • The unpleasant reaction to the anesthesia;
    • Donor Kidney failure;
    • Bleeding;
    • Infection;
    • Pain or numbness.

Transplant Rejection Types

    Transplant rejection describes the condition in which body rejects the donor kidney. Generally, it may happen in three cases, including:

    • Hyper-acute: that occurs from the time of transplant to some hours after the operation;
    • Acute: it normally occurs during some days after the procedure;
    • Chronic: this type of rejection happens in long-term usually after one year.

    Kidney stones or urolithiasis refers to the procedure of stone formation in the urinary system including the kidneys and bladder that can affect all ages. It is regarded as the third most common urinary tract disease. There are five major types of urinary stones based on their chemical composition including calcium oxalate, calcium phosphate, struvite, uric acid, and cysteine.

Kidney Stone Symptoms

    In most cases, it reveals no signs at all unless when it moves into the ureter. However, the main symptom of Kidney stone disease is the severe pain that usually happens with nausea or even vomiting as the stone travels from kidneys to the ureter. The other symptoms may include the following:

    • Fatigue;
    • Painful micturition;
    • Severe pain in the side and back, below the ribs, lower abdomen and groin;
    • Pain on urination;
    • Pink, red or brown urine;
    • Infection causes a fever and Chills;
    • Persistent urge to urinate;
    • Diarrhea.

Kidney Stone Causes

    Kidney stones can be formed due to different factors such as lifestyle factors, hereditary, metabolic disturbance, environmental etc. However, the main cause of kidney stones in the body is considered drinking not enough water. Lack of water leads to an increase in the level of uric acid in urine and the kidney stones may occur in an excessive acidic environment. Moreover, the possible medical conditions causing kidney stones include:

    • Crohn’s disease;
    • History of urinary tract infections;
    • Renal tubular acidosis;
    • Hyperparathyroidism;
    • Hypercalciuria;
    • Medullary sponge kidney;
    • Metabolic disorders;
    • Digestive diseases such as inflammatory bowel disease;
    • Overdose of vitamin C and calcium.

Kidney Stone Treatment

    Treatment for the kidney stone depend on the size of them. Usually, there is no special treatment for small kidney stones if there is no obstruction or infection in the urinary tract. In this case, patient is recommended to drink large amount of water to pass the kidney stones away through voiding urine. However, there must be used the medical treatments about the large kidney stones alongside infection or severe pain. The kidney stone crushing is used to break down them into small fragments. Also, some medicines such as lycopodium, sarsaparilla, and cantharis are prescribed to help removing them.

Kidney Stone Treatment Options

    As it is mentioned the large kidney stones need to be broken into small pieces to treat the disease. Currently, the treatment options include the following procedures:

    • Extracorporeal shock wave lithotripsy (ESWL)
    • laparoscopic ureterolithotomy.
    • Nephrolithotomy (PCNL)
    • Retrograde Intrarenal Surgery (RIRS)
    • Open Surgery

    It is important to know that choosing each procedure as the treatment method depends on the size and location of the kidney stones.

    The kidneys are responsible for cleaning the blood from the waste materials as well as making urine. Kidney cancer or renal cancer describes the growing of the abnormal cells forming a tumor or damaged tissue in the lining of tiny tubes inside the kidneys. It can also be formed due to a secondary tumor or metastatic cancer, spreading the cancerous cells to different areas of the body. Moreover, it can spread from one kidney to the another. Kidney cancer usually affects the adult people above the age of 60.

Types of Kidney Cancer

    There are different types of kidney cancer, including:

    • Renal Cell Carcinoma (RCC): it is considered the most common type of kidney cancer that develops in the tubules of kidney. It includes several subtypes such as clear cell RCC, papillary ;RCC, chromophore RCC, etc.
    • Transitional Cell Carcinoma: it is called the urothelial cancer or renal pelvis carcinoma. Transitional cell carcinoma is formed where the kidney and the ureters connect to each other. Mostly cells of this kind of kidney cancer may look more like bladder cancer cells;
    • Wilms tumor: this kind of kidney cancer affects children and it is considered one of the most common type of kidney cancer in children. Fortunately Wilms tumor is highly treatable.

Symptoms of Kidney Cancer

    Kidney cancer mostly reveals no obvious signs in the early stages and it can be diagnosed through the tests for the other diseases. Some possible symptoms of kidney cancer include:

    • Anemia;
    • Unexpected weight loss and feeling weak body strength;
    • Pain in sides or low back pain on the side/s;
    • Blood in the urine (hematuria);
    • A lump on the side or lower back or abdomen;
    • Fatigue;
    • Continuous headache;
    • Swelling feet and ankles;
    • Fever and Hot sweating;
    • High blood pressure;
    • Loss of appetite;
    • Bone pain;
    • Blood cough;
    • Shortage of breath.

Kidney Cancer Causes

    The exact cause of kidney cancer is not clear; however, some factors can develop it which can be listed as below:

    • Smoking;
    • Obesity;
    • High blood pressure;
    • Chronic dialysis treatment;
    • Exposure to chemicals such as Cadmium;
    • Family history of kidney cancer.

Kidney Cancer Treatment

    Treatments for kidney cancer depend on various conditions such as tumor stage, patient’s age, overall health and health history, etc. The treatments may include:

    • Nephrectomy is a surgical treatment performed in two ways that refer to the procedure of removing the affected kidney, known as complete nephrectomy and partial nephrectomy that is about removing the tumor from the kidney.
    • Embolization is the procedure to block the blood vessel to the cancer.
    • Radiotherapy describes the procedure of using high-energy radiations X-rays, to kill cancer cells and relieve the symptoms.
    • Biological therapies refer to the condition in which medications are used to control kidney cancer and help the immune system stop growing and spreading of the cancer.
    • Chemotherapy is connected with the treatment the anti-cancer drugs enter the blood and spread through the body.

    Benign prostatic hyperplasia is about the prostate enlargement. All men experience the natural process of the prostate enlargement during their life. The prostate grows and gets bigger twice through a man has aged, in puberty and around the age 25. Also, it should be known that it may continue to grow as the man ages. However, the enlargement sometimes results in benign prostatic hyperplasia or BPH referring to the condition that the prostate is larger than the normal and cause some problems to urine. It is usually seen among the old people. BPH is not cancerous and doesn’t cause the risk for prostate cancer but it may cause some sexual disorders.

Prostate

    The prostate is a small gland and an organ of the male reproductive system, located between the bladder and the penis and in front of the rectum. It carries/passes out the urethra as well as sperm from the testicles during ejaculation.

Benign Prostatic Hyperplasia Synonyms

    The symptoms for BPH may include the following:

    • Dribbling at the end of urination
    • A weak or intermittent urination stream
    • A trouble starting to urine
    • Urinating often and waking up several times at night to urine
    • Feeling to urine the bladder is full, even right after urinating

Benign Prostatic Hyperplasia Diagnosis

    The doctor may diagnose the disease by asking the patient about his medical history, the symptoms as well as some physical examinations. Also, it may be used:

    • Some urine test (urinalysis)
    • The digital rectal examination (DRE)
    • Ultrasound of the prostate

Benign Prostatic Hyperplasia Treatment

    Generally, there is no need to treat BPH unless the serious problems such as bladder infections, and bladder stones happen. There are various treatments for BPH changes from lifestyle habits to surgery and depend on some factors including the enlargement, age, pain severity as well as the overall health of the patient. They may include the following:

    • Medicine: usually, medicine is used to treat mild to moderate BPH.
    • Transurethral resection of the prostate (TURP): the prostate is removed through by inserting a visual instrument through the urethra.
    • Transurethral incision of the prostate (TUIP): through TUIP procedure, some incisions are made in the prostate to flow the urine out of the bladder.
    • Transurethral microwave thermotherapy (TUMT): TUMT refers to the procedure that an instrument producing the microwave energy is placed in the prostate through the urethra. The Microwave energy is used to damage the prostate tissue. TUMT usually is used to treat moderate-sized prostates.
    • Transurethral needle ablation (TUNA): TUNA refers to the procedure that a visual instrument is inserted into the urethra to insert small needles into the prostate tissue. The needles pass radio waves to make some scars that decrease prostate tissue, open the urinary channel to flow urine easily.
    • Lizard Therapy: this procedure uses the high-energy laser to open that part of the prostate tissue blocking the urine stream.
    • Open Prostatectomy: Open prostatectomy or Simple prostatectomy refers to the traditional ‘open’ surgical procedure that the prostate tissue is removed by an incision on the abdomen.

    Prostate refers to a small gland, between the bladder and the penis and in front of the rectum. Prostate cancer is considered one of the most common cancer among men. It usually spread from the prostate to other parts of the body. Prostate cancer usually forms gradually. Actually, if the prostate cells grow in an abnormal way and do not disappear after the death, it will lead to the prostate cancer and spread to the other tissues such as the Lymph nodes and bones. However, it can often be treatable.  Here, it is explained all about prostate cancer.

Prostate Cancer Causes

    It is not clear what causes prostate cancer exactly however some factors may be effective to develop it, including:

    • Age: The risk of prostate cancer increases as one gets older. It is more common in men over the age of 50.
    • Race: Prostate cancer is more common among black people. Also, it is least likely to happen among Asian men.
    • History of family: The prostate cancer is considered one of the heritable cancers. So, if one of family members have prostate cancer, it may increase the risk of prostate cancer.
    • Lifestyle: Scientists believe that there is a strong connection between developing of prostate cancer and the lifestyle including obesity, diet as well as doing regular exercise. These are considered the important factors that may increase risk of developing prostate cancer.

Prostate Cancer Symptoms

    In most cases, prostate cancer does not usually reveal any symptoms in the early stages. The symptoms may be different for each patient. The most common symptoms of prostate cancer may include the following:

    • Pelvic or rectum pain
    • Blood in urine
    • Blood in semen
    • Some sexual difficulties
    • Painful ejaculation
    • Trouble urinating
    • A weak urination stream
    • Urinating often
    • Swollen feet

Prostate Cancer Diagnosis

    The doctor detects the cancer according to asking some questions about the medical history of the patient, the symptoms as well as any changes happened in the pattern of urinating. Moreover, there are different tests to detect the prostate cancer. They can include:

    • Digital rectal exam (DRE)
    • PSA test
    • Ultrasound
    • MRI
    • Biopsy

Prostate Cancer Treatments

    There are a various range of treatment options for prostate cancer that are used depend on the patient’s conditions:

    • Radiotherapy: refers to a treatment using high-energy rays to kill cancer cells. It should be known that it is done in most cities of Iran with a low cost in comparison to the other treatments for prostate cancer.
    • Hormone therapy: it stops or slows the prostate cancer that use testosterone to grow.
    • Provenge vaccine: it is used in advanced stages to extend the patient’s life.
    • Chemotherapy: it is used to the anti-cancer drugs to shrink prostate cancerous cells in advanced cases.
    • Brachytherapy: it means placing seeds, ribbons or capsules containing the radioactive sources inside the patient’s body at the vicinity or in the tumor to damage the cancerous cells.
    • Cryotherapy: the treatment is about killing the prostate cancerous tissue by freezing it.
    • High-intensity focused ultrasound (HIFU): it explains the procedure of using heat to kill the cancerous cells in the prostate.
    • Radiofrequency Ablation (RFA): it uses the radiofrequency to reduce pain in patients with prostate cancer.
    • Radical prostatectomy: the prostate gland is removed Surgically.
    • Focused Ultrasound Therapy: this radiation-free method is used to destroy prostate tissue.

    Azoospermia, referred to a no-sperm-count condition, is one of the major reproductive disorders that describes an abnormal situation about the men in which there is not any sperm in seminal fluid. It is known as the main reason for male infertility and there is not any symptom to detect it unless the pregnancy doesn’t happen after one year of unprotected sex explaining there may be a fertility problem no sperm count the woman. As sperm contains only 1% of the semen, the absence of it does not cause any serious problem. It may be considered a congenital problem or develops during the life. However, the men with azoospermia should be treated to help them return the fertility.

Azoospermia Types

    Azoospermia includes two types, obstructive and non-obstructive azoospermia, according to/depend on what causes it. They are:

    • Obstructive azoospermia refers to the condition that the sperm is produced normally and the reproductive tract is blocked to carry the sperm to semen.
    • Non-obstructive azoospermia happens in the cases that there is no obstruction but the problem is about the amount of sperm production in the semen which is poor.

Obstructive Azoospermia Treatment

    According to the patient conditions, one of the following treatments may be used to treat; the microsurgery and endoscopic surgery. Two types of surgical procedures including microsurgery and endoscopic surgery are used to open the blockage.

    • Microsurgery: the microsurgery surgery is recommended for obstructive azoospermia. It is used to unblock the reproductive tract. The patient is given general anesthesia and sleeps during the surgery. A small incision is made on the scrotum to correct the obstruction. A microscope is used through the procedure.
    • Endoscopic surgery: A smaller incision is made during the endoscopic surgery. Under the general anesthesia, a special scope is sent to the urethra to fix the obstruction. This procedure is used for problems associated with the ejaculatory duct that allowing sperm enters the seminal fluid.

Non-obstructive azoospermia Treatments

    In non-obstructive azoospermia, sperm production cannot occur. However, today it may be possible to restore sperm to the patients due to some new treatments. Moreover, the lifestyle changes or even taking medications can be effective in returning/producing sperm.

Azoospermia Diagnosis

    Since the absence of sperm in semen does not reveal any physical symptoms for the patient, there are some procedures to detect / diagnose the azoospermia.
    The diagnosis may include the following:

    • Physical examination
    • Blood test
    • Biopsy
    • Hormone testing
    • Imaging scans of the reproductive tract such as ultrasound, MRI or CT scan

Urologists in Yazd

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