Monday, March 8, 2021
Sunday, January 17, 2021
joshiundrologyblog: Advanced semen analysis
Advanced semen analysis
Advanced semen analysis : One of the main reasons for infertility in couples - in up to 50% of cases - is male infertility. Male infertility is not necessarily related to male health, as a healthy man can produce poor quality sperm that make conception difficult.
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| Advanced Semen Analysis in Bangalore |
It is therefore very important to perform a semen analysis to
determine the fertility potential of the man. A normal semen analysis or
seminogram looks at the concentration, motility and morphology of the sperm
cells in a semen sample.
While these factors are important in assessing basic sperm
quality, there are other components that are far more important in determining
the capacity of the sperm to create pregnancy. These other factors can give
patients a better insight into the diagnosis and thus a more appropriate
treatment plan. These evaluations are categorized as Advanced Semen Analysis.
In the Joshi's
Andrology & Urology Centre laboratory, it is possible to perform an
advanced Semen analysis.
Advanced semen analysis: DNA fragmentation index test for
sperm.
The presence of fragmented DNA in the nucleus of
sperm cells has a negative impact on reproductive results. The sperm DNA
fragmentation test measures the stability of the chromatin and estimate the
percentage of sperm cells that have fragmented DNA.
Any couple doing an assisted reproductive
treatment can take the DNA fragmentation test for sperm. This test is
especially recommended for men over 35 years of age, history of recurrent
miscarriages, history of failed IVF and IUI, history of exposure to gonadotoxins,
who have a genitourinary infection or who have received cancer treatment etc..
The DNA fragmentation test can be useful for couples who
have had multiple miscarriages, unsuccessfully completed multiple cycles, or
who cannot find a reason for their infertility.
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Advanced semen analysis: Apoptosis -Annexin V
test
Apoptosis or cell death plays an important role in
spermatogenesis by eliminating sperm cells with structural or functional
defects. The presence of an abnormally high level of dead sperm in the ejaculate
can adversely affect male fertility.
The Apoptosis -Annexin V test determines the number of
damaged sperm cells in the ejaculate and / or the sperm samples reserved for
assisted reproduction. The assay uses the Annexin V protein to mark the
damaged cells, which are then counted. The quality of samples with abnormally
high apoptosis can be improved by specifically removing damaged sperm cells,
using the Annexin V MACS Technique.
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Advanced semen analysis: Oxidative Stress
test (ROS)
The sperm cells produce small amounts of reactive oxygen
species (ROS, short for reactive oxygen species) that are essential for their
normal functioning. This amount of ROS is controlled by the antioxidants
present in the fluid from the prostate and seminal vesicles.
However, as the balance between reactive oxygen component
production and antioxidant activity shifts, ROS levels will increase. This
causes oxidative stress, which damages the sperm and decreases fertility. Increasing
the levels of ROS can be reduced through lifestyle changes and a diet rich in
antioxidants.
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Advanced Sperm Analysis: Y Chromosome
Microdeletion Test
The microdeletions in the AZF factor of the Y chromosome are
responsible for about 10-15% of azoospermia and 5-10% of oligospermia cases in
men. The Y chromosome microdeletion test examines parts of the Y chromosome by
PCR: AZFa, AZFb, AZFc. This identifies possible causes of male infertility.
Joshi's Andrology &
Urology Centre
Address: Neelamma Complex,
Opposite Unlimited mall, No 44/2 1st floor, 60 Feet Rd, G Block, Sahakar Nagar,
Bengaluru, Karnataka 560092
Appointments: https://joshiuroandrology.com/Pages/Contact-Us,
Phone: 080 4207 0577
Tuesday, December 29, 2020
Kidney stones | Kidney stone treatment in Bangalore
Kidney stones | Kidney stone treatment in Bangalore arise because crystals are formed in the urine. Not all kidney stones are painful. But when stones enter the ureter (kidney pipe) and make the flow of urine more difficult, they often cause severe pain called as a renal colic. Most of the patients we see report to the emergency department with severe pain, with or without nausea and vomiting.
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| Kidney stones | Kidney stone treatment in Bangalore |
Pain relief is the first step in treatment, often combined
with medication that can relax the muscles of the ureter. Fluid intake is
limited to limit the pressure on the drainage system. Further examinations are
then planned, on the one hand to determine the location and size of the stone,
and on the other hand to rule out complications.
On the basis of the results of these examinations and in
consultation with the patient, the urologist
will decide what the Best Kidney stone treatment in Bangalore could be.
Pain relief and
waiting for the spontaneous expulsion of the stone: Especially for small
stones that are already at the end of the ureter, often the best option
Preparation for the ultimate stone treatment or approach for complicated stones:
Some stones cannot be treated in 1 time due to their
location, size or complications (infection, blockage in patients with only 1
kidney, ...). In these patients, a smooth passage of urine must first be
guaranteed before the actual treatment of the stone can be started.
Ureteric stent: A Ureteric stent aka DJ stent is a hollow plastic tube with curls on both
ends that helps to hold the stent in place. The stent is placed under anesthesia or sedation in the operating room. It passes through the ureter next
to the stone and serves to drain “dirty” urine and relieve pressure on the kidney.
Nephrostomy: If
placement of a DJ stent is not recommended or is not possible, a nephrostomy
must be inserted. This is a drain that is done through a small incision in the
back and into the kidney. This procedure can be done under local anesthetic at
the radiology department.
Surgical treatment:
For the definitive treatment of the stone, the urologist has 3 treatment
options available:
ESWL = extracorporeal shockwave lithotripsy
URS (Therapeutic ureterorenoscopy)
PCNL = percutaneous nephrolitholapaxia
ESWL or kidney stone pulverizer
Sound waves are aimed at a focal point. Via X Ray imaging or
Ultrasound imaging, the stone is searched and placed in the focus of the shock
waves. The purpose of this is to break the stone, so that the pieces of stone
can be discharged spontaneously.
Not all stones are equally hard, so that not all stones can
be treated in this way. Large, hard stones require more energy, so that
sometimes several treatment sessions are necessary. Stones in the ureter often
break less well, regardless of size and hardness.
Usually 3000 shock waves / session are administered. These
are rather painful and in order to focus properly, the patient must remain very
still. That is why the procedure is performed under sedation or anesthesia. The
patient enters the day hospital on an empty stomach for this purpose.
Although this procedure does not involve any cut on the skin,
the shock waves can in exceptional circumstances give rise to bruising. It is
therefore very important that the patient reports the use of blood thinners in
advance.
Blood in the urine can occur after this procedure.
The fragment of the stone that settles after the procedure
can give rise to a new renal colic. Measures here are similar to those for small stone treatment: pain relief as
prescribed by the doctor and fluidrestriction. In case of fever or unbearable pain, the emergency department
should be contacted immediately.
Ureterorenoscopy
(URS)
During this procedure, the urologist uses a small camera through which a working channel runs
through the urethra and the bladder to the ureter to search for the stone.
Small stones can be caught and removed with a pair of forceps or a basket.
Larger stones are fragmented with the laser into fine particles, which can
spontaneously wash out.
The procedure is always performed under general or regional
anesthesia in a day hospital or with 1 overnight stay in hospital.
After surgery, many patients might have blood in their
urine. Pain (colic pain) can also persist for several days due to swelling of
the ureter. Pain relief is prescribed for this.
If the stone or procedure causes damage to the ureter wall,
the urologist will leave a DJ stent until the ureter has healed. The stent
gives the feeling of frequent and urgent urination. It often also causes blood
in the urine (up to a few days after stent removal). The stent is removed after
a week in the OPD.
In case of fever or pain that is not controlled with classic
pain relief, you must report urgently, regardless of whether a stent was left
or not.
Percutaneous Nephrolithotomy
(PCNL)
This procedure is used less frequently than ESWL or URS. It
is a technique to remove very large stones (> 2cm) from the kidney or the
most upper part of the ureter.
During the procedure, a catheter with a balloon is first
introduced through the urethra and the bladder into the ureter. Afterwards, the
patient is turned on the stomach or on the side. The kidney is punctured
through an incision in the back or in the flank, guided by the ultrasound. The
resulting channel is stretched and a tube is pushed through which a camera with
working channel is inserted into the kidney. Here the stone is usually broken
into pieces with the laser or conventional lithotripter, which are then removed
from the kidney with forceps. At the end of the procedure, a drain or catheter
is inserted into the canal so that the bloody urine can drain properly. The
blood remains in the urine for several days.
The procedure is always performed under general anesthesia
and the patient is admitted to hospital for 3 to 4 days.
After the procedure, the patient is not allowed to do
strenuous exercise or exercise for 3 weeks.
In case of pain, excessive blood flow or fever, the patient
should immediately go to the emergency department
For more information about kidney stones, please consult Dr.
Praveen B Joshi.
Tuesday, December 22, 2020
Reduced fertility in men | Male infertility treatment in Bangalore
Reduced fertility in men| Male infertility treatment in Bangalore
Fertility disorder is on the rise and about 35- 40% of cases male factors may be the cause. Many factors influence male fertility. Often these are due to abnormalities in the sperm cells.
Causes
Fertility problems in men are often related to
abnormalities in the sperm cells. These are related to disorders in:
- Production of sperm cells
- Transport of sperm cells
- Hormones that stimulate sperm production
Nevertheless, it is important to realize that in at least
half of the cases a good medical explanation cannot be found for reduced fertility in men.
Production of sperm cells
Problems in the production of sperm cells can lead to
a reduced number, reduced mobility or an abnormal shape of the sperm cells.
Numerous factors can cause this:
- ·
Infection or inflammation of the testes
- · Twisting (torsion) of the testes, cutting off blood flow to the testes
- · Undescended testes or other abnormal positions
- · Genetic abnormalities
- · Damaged secretions between seminal ducts and blood vessels
- · Medicines that (sometimes temporarily) reduce fertility (e.g. anabolic steroids)
- · Chemotherapy and radiation
- · Pesticides and chemicals
- · Transport of sperm cells
If the sperm cells are of good quality, they still
have to get to the egg. Sperm transport disorder is another cause of reduced
fertility in men.
Possible reasons for a disturbance in transport:
Erectile dysfunction, in which the penis is not rigid
enough or is not rigid long enough for normal sexual intercourse.
Premature ejaculation, where the semen is ejaculated
very early may not be introduced into the vagina.
Retrograde ejaculation, where the semen enters the male's
bladder. Some of the causes for this are diabetes and prior surgeries on bladder
neck.
Obstruction of the sperm ducts, so that there are no sperm cells in the ejaculate (eg with cystic fibrosis or after sterilization)
Hormones that stimulate sperm production
Sometimes the body does not make enough hormones that stimulate
sperm production.
Such a disorder therefore leads to reduced fertility in men.
Investigations and diagnosis
In a suspected case, we may have to perform a few tests.
Semen Analysis
Blood test for male fertility problems
Male blood tests that screen for infectious diseases,
genetic abnormalities and other factors that can lead to reduced fertility. The
blood test is a standard test for fertility problems.
Examination of the quality of sperm cells and the amount of
sperm cells.
Andrological examination
Consultation with the Uro-andrologist Dr. Praveen Joshi,
who examines the male reproductive organs.
Scrotal scan may have to be done in some of the cases in order to evaluate the testicular conditions and other details like varicocele.
Therapy
Here are some possible treatments for this condition. After
the diagnosis, your doctor, together with you and the other doctors on the
team, will choose the best solution for you. Your Male infertility treatment may
need a team effort.
Lifestyle modification
Varicocele correction by microsurgical procedure
Testicle aspiration, biopsy, microsurgical procedures for
sperm retrieval in cases of azoospermia (Sperm count is zero). This type of
sample can be stored. The frozen material can later be used for fertilitytreatment.
Hormonal treatment
Hormonal or drug treatment for hormonal disorders.
We, Joshi’s Andrology and Urology Centre have more 10 years of experience in treating men with various fertility problems. In fact, it has become an important specialty. We see positive results in many patients. We don’t give up on any of our patient no matter how bad the condition might appear.
Make an appointment
Would you like an appointment or would you like to meet?
Call 080 – 42070577, +918197371247 or Submit your e-mail address or telephone
number on Website Enquiry page Male infertility treatment in Bangalore, and
we will email or call you when it suits you.
Wednesday, December 9, 2020
Urological center | URINARY TRACT INFECTION TREATMENT IN BANGALORE
Welcome to the Urological Center of reconstructive urinary treatment in Bangalore. You can contact us
for all urological care and treatment. We help you as quickly and as well as
possible, with innovative equipment and the latest techniques, at a high
scientific level.
Urinary tract
The urinary tract performs an important task for the health
of our body: they filter the blood and ensure the excretion of waste products
and toxic substances. The urinary system or urinary tract consists of several
organs: kidney, adrenal gland, ureter, bladder and urethra. In those organs,
just like in other places in our body, complaints or problems can arise.
Diseases
Kidneys:
Kidney cyst
A kidney cyst is a bubble filled with fluid, typically
located on the outer edge of the kidney. It's a benign condition.
Kidney stone
A kidney stone is deposition of salts and crystal formation that
forms in one of the kidneys. In the first instance, this stone is located in
the kidney: you usually cannot feel such a kidney stone.
Ureter
Ureter stone
A painful renal colic occurs when the kidney stone 'breaks
off' and falls from the kidney into the ureter (ureter = ureter), blocking the
normal passage of urine. A ureteric stone is therefore a kidney stone that
moves out of kidney at some point and then gets stuck in the ureter.
Bladder
Bladder infection
A bladder infection is most common form of UTI across all
age groups. Most people experience burning urination and increased frequency
and urgency sometimes associated with fever.
Bladder pain syndrome
When the bladder pain syndrome causes a defect at the level of the bladder causing chronic irritation with reduced capacity of the urinary bladder. Bladder pain syndrome is associated with lower abdominal pain and 'small bladder' symptoms like urgency and frequency.
Bladder stone
A bladder stone usually forms when the urine from the bladder can’t get emptied freely. A bladder stone that remains in place can grow in the bladder and make urination difficult.
Loss of urine
Incontinence is the same as involuntary loss of urine.
You can contact joshi's andrology & urology centre for the diagnosis and treatmentof disorders of the urinary and reproductive health. Here you will find
practical information about urological symptoms disorders and the different
treatment methods.
Make an appointment: https://joshiuroandrology.com/Pages/Contact-Us
Address:
Joshi's Andrology & Urology Centre
Contact Number:
Phone-Number : 080 - 42070577
Mobile-Number : +91-8197371247
Tuesday, December 8, 2020
Progress in Prostate Cancer Diagnosis: Clinic for Prostate Therapy
Progress in Prostate Cancer Diagnosis: Clinic for Prostate Therapy
The Prostate disease treatment in Bangalore has specialized in the careful diagnosis and treatment of prostate diseases for nearly ten years. This includes both benign changes and cancerous changes as prostate carcinoma (CaP). However, prostate cancer is difficult to diagnose because it is very small in the early stages and is therefore difficult to recognize. Even a blood test done to detect prostate cancer namely prostate-specific antigen (PSA value) may be inconclusive in the beginning. Additional tests such as the elastography method and the PCA3 gene test will confirm the suspicion of cancer to a great extent before a biopsy is performed. The biopsy of the prostate has one major drawback: it could be falsely negative and many tumors may remain hidden. If a biopsy is actually recommended, one should perform it correctly and with as little punching as possible. To this end, the Prostate disease treatment urologists combine highly accurate MRI scans of the prostate with ultrasounds also known as the fusion technique. This allows them to locate tumors with high accuracy. With a fusion of MRI and Transrectal Ultrasound and MRI guided biopsy, suspicious tissue is specifically punctured and removed.
And what is the advantage of the new diagnosis method? "Think about how a biopsy is generally done. Usually, about 10 - 12 undirected and blindly divided tissue samples are taken from the prostate through the rectum. The probability of detecting a prostate carcinoma is at most 35%. Detection of clinically insignificant cancer is high by this technique. So repeat biopsies are needed later in many patients to detect a clinically significant tumor. The main advantage of the combined method lies in the fact that by merging the information from the MRI scan and the ultrasound, suspicious areas can be accurately targeted. An internal evaluation showed a detection rate of about 90 percent in suspected cancer cases.
Sampling via the rectum also has a higher chance of transferring germs from the rectum to the prostate. In some cases, it might even lead to significant infection and Sepsis. It has been identified that biopsies could be performed through the perineum, which can be properly disinfected prior to the biopsy.
Once diagnosed accurately the prostate cancer in its very early stages with localized disease targeted high-intensity ultrasound waves (HIFU) can be applied to treat only the cancerous part thus sparing the functions of the non-cancerous prostate tissue. "Low-burden therapy and accurate diagnosis go hand in hand. In this way, treatment can be limited to the areas where tumor cells have actually been detected. Tumor-free parts are not affected so that under certain conditions the prostate functions can be preserved.
Joshi's Andrology & Urology Centre
Address: Neelamma Complex, Opposite Unlimited mall, No 44/2 1st floor, 60 Feet Rd, G Block, Sahakar Nagar, Bengaluru, Karnataka 560092
Appointments: joshiuroandrology.com
Phone: 080 4207 0577