The kidneys are a pair of organs located in the back of the abdomen. Each kidney is about 4 or 5 inches long -- about the size of a fist.
The kidneys' function are to filter the blood. All the blood in our bodies passes through the kidneys several times a day. The kidneys remove wastes, control the body's fluid balance, and regulate the balance of electrolytes.
Kidney disease is a general term for any damage that reduces the functioning of the kidney. Kidney disease is also called renal disease.
Urinary or Kidney stones are hardened mineral deposits that gather on the way from the renal pelvis in the kidney to the bladder. These originate as microscopic particles and over the course of time develop into stones. Medically this condition is known as nephrolithiasis, or renal stone disease. The kidneys filter waste products from the blood and adds them to the urine. When waste materials in the urine do not dissolve completely and the kidney is unable to evacuate them, crystals and kidney stones are likely to form. Some stones may pass out of the kidney or get lodged in the ureter (tube that carries urine from the kidney to the bladder), and cause severe pain that starts from the lower back and radiates to the side or groin.
Kidney stones can provoke a severe, sudden pain if they move along the ureter, the tube leading from the kidneys, and they can cause a lot of health problems if they block the flow of urine. The pain can often be accompanied by vomiting. If they move into the ureter (the tube from the kidney to the bladder) they cause intense pain and blood in the urine. A lodged stone can block the flow of urine and build a backpressure in the affected ureter and kidney. Increased pressure results in stretching and spasm, which cause severe pain.
Signs & Symptoms
Small and smooth kidney stones may remain in the kidney or pass without causing pain (called "silent" stones). Stones that lodge in the ureter (tube that carries urine from the kidneys to the bladder) cause the urinary system to spasm and produce pain. The pain is unrelated to the size of the stone. Other symptoms of kidney stones may include the following :
Blood in the urine.
Increased frequency of urination.
Nausea and vomiting.
Pain and burning during urination.
Fever, chills, loss of appetite.
Urinary tract infection.
Treatment of Kidney StonesExtracorporeal shock wave Lithotrispy (ESWL)
Extracorporeal shock wave Lithotrispy (ESWL) uses highly focused electro magnetic waves projected from outside the body to crush kidney stones anywhere in the urinary system. The stone usually is reduced to sand-like particles that can be passed in the patient's urine. Large stones may require more than one ESWL sessions. The procedure should not be done for pregnant women. It can be used for patients of all age groups and those who have heart and breathing problems. ESWL by 4th generation "Siemens Lithotriptor" with Ultrasound attachment helps to treat even Radioluscent stones, which are not visible in normal fluoroscopy Lithotriptors.Percutaneous Nephrostolithotomy (PCNL)
Percutaneous Nephrostolithotomy (PCNL) This minimal invasive procedure is performed under local anesthesia. Percutaneous (i.e., through the skin) removal of kidney stones (lithotomy) is accomplished through the most direct route. A telescope along with mechanical lithotriptor in inserted to break stone into fine particles to achieve stone-free status in large and complicated stones. This procedure usually requires hospitalization, and most patients resume normal activity within 2 weeks.Ureteroscopic Lithotrispy with Holmium Laser
This procedure is performed under Epidural and Spinal Anaesthesia to treat stones located in the middle and lower ureter. A small, fiberoptic instrument (ureteroscope) is passed into the ureter. Large stones are fragmented using 100-Watts Coherent Holmium Laser. The laser fragments stone into sand like particles, which are then flushed out through the natural urinary passage. The advantage of Holmium Laser is its ability to fragment stones of all compositions and precision. Thus, it is the most effective laser for the treatment of ureteric stones. Patients are generally admitted the same day of the treatment and are discharged next day, which means only 24 hours hospitalization.
Kidney cancer is a type of cancer that starts in the cells in the kidney.
The two most common types of kidney cancer are renal cell carcinoma (RCC) and urothelial cell carcinoma (UCC) of the renal pelvis. These names reflect the type of cell from which the cancer developed.
Signs & Symptoms
Blood in the urine (making the urine slightly rusty to deep red).
Pain in the side that does not go away.
A lump or mass in the side or the abdomen.
Feeling very tired or having a general feeling of poor health.
DiagnosisIf a patient has symptoms that suggest kidney cancer, the doctor may perform one or more of the following procedures:
Physical exam : The doctor checks general signs of health and tests for fever and high blood pressure. The doctor also feels the abdomen and side for tumors.
Urine tests : Urine is checked for blood and other signs of disease.
Blood tests : The lab checks the blood to see how well the kidneys are working. The lab may check the level of several substances, such as creatinine. A high level of creatinine may mean the kidneys are not doing their job.
Ultrasound test : The ultrasound device uses sound waves that people cannot hear. The waves bounce off the kidneys, and a computer uses the echoes to create a picture called a sonogram. A solid tumor or cyst shows up on a sonogram.
CT scan (CAT scan) : An x-ray machine linked to a computer takes a series of detailed pictures of the kidneys. The patient may receive an injection of dye so the kidneys show up clearly in the pictures. A CT scan can show a kidney tumor.
Biopsy : In some cases, the doctor may do a biopsy. A biopsy is the removal of tissue to look for cancer cells. The doctor inserts a thin needle through the skin into the kidney to remove a small amount of tissue. The doctor may use ultrasound or x-rays to guidethe needle. A pathologist uses a microscope to look for cancer cells in the tissue.
Surgery : In most cases, based on the results of the CT scan, ultrasound, and x-rays, the doctor has enough information to recommend surgery to remove part or the entire kidney. A pathologist makes the final diagnosis by examining the tissue under a microscope.
Many people with kidney cancer want to take an active part in making decisions about their medical care. They want to learn all they can about their disease and their treatment choices. However, shock and stress after the diagnosis can make it hard to think of everything they want to ask the doctor. It often helps to make a list of questions before an appointment. To help remember what the doctor says, people may take notes or ask whether they may use a tape recorder. Some also want to have a family member or friend with them when they talk to the doctorâ€"to take part in the discussion, to take notes, or just to listen.
The doctor may refer the patient to a specialist, or the patient may ask for a referral. Specialists who treat kidney cancer include doctors who specialize in diseases of the urinary system (urologists) and doctors who specialize in cancer (medical oncologists and radiation oncologists).
Preparing for treatment
Treatment depends mainly on the stage of disease and the patient's general health and age. The doctor can describe treatment choices and discuss the expected results. The doctor and patient can work together to develop a treatment plan that fits the patient's needs.
The prostate is a gland about the size of a walnut that is only present in men. It is located just below the bladder and surrounds the urethra, the tube through which urine flows from the bladder and out through the penis. One of the main functions of the prostate gland is to produce prostatic fluid, one of the components of semen. A man's prostate gland usually starts to enlarge after he reaches 40 years of age. This condition is called benign prostatic hyperplasia (BPH). It is not cancer, and it does not raise your risk for prostate cancer.
Signs & SymptomsMany men with an enlarged prostate have no symptoms. Common symptoms may include the following:
Blood in the urine (i.e. haematuria), caused by straining to void.
Dribbling after voiding.
Feeling that the bladder has not emptied completely after urination.
Frequent urination, particularly at night (i.e. nocturia).
Hesitant, interrupted or weak urine stream caused by decreased force.
Leakage of urine (i.e. overflow incontinence).
Pushing or straining to begin urination.
Recurrent, sudden, urgent need to urinate.
Treatment for Enlarged Prostate
Men who have BPH with symptoms usually need some kind of treatment at some time. However, a number of researchers have questioned the need for early treatment when the gland is just mildly enlarged. The results of their studies indicate that early treatment may not be needed because the symptoms of BPH clear up without treatment in as many as one-third of all mild cases. Instead of immediate treatment, they suggest regular checkups to watch for early problems. If the condition begins to pose a danger to the patient's health or causes a major inconvenience to him, treatment is usually recommended.
Since BPH can cause urinary tract infections, a doctor will usually clear up any infection with antibiotics before treating the BPH itself. Although the need for treatment is not usually urgent, doctors generally advise going ahead with treatment once the problems become bothersome or present a health risk.
Self-Care at Home
Some precautions can help to avoid worsening of symptoms of prostate enlargement and complications. Do not delay to urinate once you experience an urge. Urinate as soon as you feel the urge, and empty the bladder completely. Avoid alcohol and caffeine, especially after dinner. Don't drink a lot of fluid all at once. Spread out fluids throughout the day. Avoid drinking fluids within 2 hours of bedtime. Keep warm and exercise regularly. Cold weather and lack of physical activity may worsen symptoms.
There are two main classes of prescription medicines that are used to treat BPH: alpha-blockers and 5-alpha-reductase inhibitors. Alpha-blockers relax muscle fibres that control the tension in the prostate gland. They can reduce the pressure on the urethra and increase the flow of urine. They do not cure BPH but may help to alleviate some of the symptoms.
Though alpha-blockers are likely to help, they don't work for everyone. If your symptoms don't improve within a couple of months, your doctor may suggest trying an alternative treatment. There are several different alpha-blockers that may be prescribed for BPH. Some of these drugs can also be used to treat high blood pressure.
5-alpha-reductase inhibitors block production of a hormone called dihydrotestosterone (DHT). This can reduce the size of the prostate by up to 30 percent. Finasteride (Proscar) and dutasteride (Avodart) are examples of 5-alpha-reductase inhibitors. 5-alpha-reductase inhibitors are able to reverse BPH to some extent and so may delay your need for surgery.
Surgery for Enlarged Prostate
There are a number of surgical options for BPH. Generally, surgery is considered for men who don't get relief from symptoms using drug treatments.
Transurethral resection of the prostate (TURP) is the most common operation for BPH. Your surgeon inserts a thin, tube-like telescope (a resectoscope) into the urethra. The resectoscope includes a camera and specially adapted surgical instruments. This allows the surgeon to see the prostate clearly. A wire loop attachment that carries an electric current is used to "chip away" at the prostate. For further information, please see separate Bupa health factsheet, TURP.
Transurethral incision of the prostate (TUIP) may be appropriate for men who have a less enlarged prostate. It is a quicker operation than TURP and instead of "chipping away" a portion of the prostate, small cuts are made in the bladder neck and the prostate to improve the flow of urine.
Open prostatectomy is only recommended for men whose prostate is very large. It is a major operation carried out under general anaesthesia and may require up to a week in hospital. An incision is made in the lower abdomen in order to remove part of the prostate.
Urethral stricture is an abnormal narrowing of the urethra (the tube that releases urine from the body).
Signs & Symptoms
Dysuria (painful urination).
Slow urine stream (may develop suddenly or gradually).
Spraying of urine stream.
Decreased urine output.
Increased urinary frequency or urgency.
Lower abdominal pain.
Bloody or dark urine.
Discharge from the urethra.
Swelling of the penis, testes, scrotum.
Recurrent infections or urinary tract.
Placement of a suprapubic catheter, which allows the bladder to drain through the abdomen, may be necessary to alleviate acute problems such as urinary retention and infection. Surgical options vary depending on the location and length of the stricture. Visual internal urethrotomy may be all that is needed for small stricture. A urethral catheter is left in place after the procedure.
An open urethroplasty may be performed for longer stricture by removing the diseased portion or replacing it with other tissue. The results vary depending on the size and location of stricture, the number of prior therapies, and the experience of the surgeon. There are no drug treatments currently available for this disease. If all else fails, a urinary diversion - Appendicovesicostomy (Mitrofanoff procedure) - may be performed to allow the patient to perform self-catheterization of the bladder through the abdominal wall.
Results of treatment depend upon the characteristics of the stricture viz. its length, degree of fibres, associated infection, previous surgeries.
Renal failure (also kidney failure or renal insufficiency) is a medical condition in which the kidneys fail to adequately filter waste products from the blood. The two main forms are acute kidney injury, which is often reversible with adequate treatment, and chronic kidney disease, which is often not reversible. In both cases, there is usually an underlying cause.Acute renal failure has three main causes :
A sudden, serious drop in blood flow to the kidneys.
Damage from some medicines, poisons, or infections.
A sudden blockage that stops urine from flowing out of the kidneys.
Signs & Symptoms
Little or no urine when you urinate.
Swelling, especially in your legs and feet.
Not feeling like eating.
Nausea and vomiting.
Feeling confused, anxious and restless, or sleepy.
Pain in the back just below the rib cage. This is called flank pain.
Your doctor or a kidney specialist (nephrologist) will try to treat the problem that is causing your kidneys to fail. Treatment can vary widely, depending on the cause. For example, your doctor may need to restore blood flow to the kidneys, stop any medicines that may be causing the problem, or remove or bypass a blockage in the urinary tract.
At the same time, the doctor will try to :
Stop wastes from building up in your body. You may have dialysis. This treatment uses a machine to do the work of your kidneys until they recover. It will help you feel better.
Prevent other problems. You may take antibiotics to prevent or treat infections. You also may take other medicines to get rid of extra fluid and keep your body's minerals in balance.