Max Hospital, Vaishali

Namashkar!

Main Dr. Shailendra Kumar Goel, Principal consultant in urology and renal transplant. Main aapko aaj kidney transplant ke baare mein batane ja raha hoon. Kidney transplant ki jarurat unn logo ko hoti hai jinki kidney permanently kharab ho chuki hoti hai. Aur wo ab dialysis pe hote hain and unko regular dialysis ki zarurat hoti hai. Kidney transplant mein sabse yeh zaroori baat hai ki patient ko sochna padta hai ki kidney ab kaun dega uske liye. Kidney dene ke liye kidney transplant hamare yahan kanoon se govern hota hai. Kidney, patient ka koi bhi relative, pehle toh yeh tha ki sirf first degree relative allowed the but ab any relative- maybe a cousin or maybe in-laws or maybe a distant relative, koi bhi patient ko kidney donate kar sakta hai.

Aur relative jo kidney donate karta hai uski surgery hum laparoscopy se karte hain. Jis mein pait mein bas 2-3 chote chote ched hote hain aur neeche ek chhota sa small incision hota hai ki jisse patient ko pain or recovery mein bahut aram milta hai. Aur dusra donation ka hota hai cadaveric donation ki jisme jahan koi patient yadi accident mein ya kisi bimari se patient ki death ho rahi hoti hai aur uska abhi heart chal raha hai lekin brain dead ho gaya hai. To hospital mein committees hoti hain jo declare karti hai ki patient is irreversibly a dead, ab vo jinda nahi ho sakta. Jo uska brain hai woh mrityu prapt kar chuka hai. Aise mei uski family decide karti hai ya mrityu hone wale vyakti ki antim ichha hoti hai to vo apne anng ko daan kar sakta hai.

Woh anng kahin na kahin dusre logon ki zindagi bachane mein use ho sakte hain. Jo bhi kidney donation aur kidney transplant centre hote hai wo wahan pe waiting list maintain karte hain. Aur jab kabhi bhi koi aisa cadaver donation hame prapt hota hai to woh waiting list ke accordingly hum in patients ko call karke unn patients mei brain dead patients se prapt kidney ko unmei lagaya jata hai. Yadi family ke donor ham lete hain to blood group matching hona chahiye. Jaise A ko A wala de sakta hai, ya AB kisi bhi group ka le sakta hai, O ko kewal O vala de sakta hai, B ko kewal B wala de sakta hai. Lekin yadi family mein koi matching donor available nahi hai to hamare paas option hota hai ki hum KBO incompatible transplant kare.

Us case mei patients ke blood group ki antibodies ko wash kiya jata hai jisse woh donor ki woh kidney jo doosre blood group ki hai usko woh reject na kare. Isme expenses almost double ho jata hai lekin yeh cheez ki ja sakti hai. Ya doosre upaay hota hai ki yadi do patients hote hain jinke relatives dono ke aapas mein mismatch hai lekin vo ek dusre ko yadi cross kare - kisi A patient ka jo donor hai vo B patient ke donor se match kar raha hai to B patient ke donor ko vo accept karle aur A patient ka donor B patient Ko dede. Isko hum swapping kehte hain. Iss tarike se ye vyavastha ki jati hai aur dono ka transplant saath saath karke aapas mein donors ko cross kar diya jata hai. Aur iss tarike se kidney transplant hota hai. Kidney transplant ke baad patient ki life bilkul normal ho jati hai. Usko immuno-suppressant, jo ki immunity ko suppress karne wali dawai hoti hai vo life long leni hoti hai. Aur regular usko apne transplant surgeon aur nephrologist ke contact mei rehna hota hai.

Dhanyavad!

Namashkar!

Mai Dr. Shailendra Kumar Goel, Principal consultant Urologist and Renal Transplant Surgeon, Sexologist and Enderologist. Mai aapko aaj sexual samasyaon ke baare mei thoda jaankari Dena chahta hun. Sexual samasya mostly hamare adhiktar iss wajah se hoti hain kyuki sex sambandhit samasyaein ham apni family mei apne parents ke sath koi discuss nhi karta hai. Aur hamare education system mei sex ke baare mei kuch padhaya nhi jaata hai. To mai ek common si chiz pehle bataunga ki urine ka aur sex ka kya sambandh hai. Jaise female patients hoti hai, mahilaon ko sex ke baad urine jana chahiye.

Kyuki hota kya hai ki sex vo karte hain to vagina mei normally bohot saare bacteria hote hain aur sex ke thrust ke dauraan, vo bacteria peshab ki thaili mei chale jaate hain. Aur yadi mahila sex ke baad urine kar le to vo bacteria almost saare bahar nikal jaate hain aur agar 1-2 bachta bhi hai to body ki immunity use cover kar leti hai. Lekin agar vo urine nhi karti hai to bohot saare jo ye bacteria bladder mei gye hai ye UTI kar dete hain jise hum commonly Honeymoon cystitis kehte hain. Kuch females hoti hain jinko baar baar UTI ki samasya hoti hai to unko bilkul ye chiz dhyan rakhni hoti hai ki sex ke baad urine jayein. Jabki Aisa males yani purushon Mei bilkul ulta hota hai. Hota kya hai ki jis samay unke sex gland open hote hain, kyuki usi peshaab ke raaste se peshaab bhi karte hain aur usi raaste se virye nikalta hai. Lekin dono kaam sath nhi ho sakte. Jaise ek hi gale se ham paani bhi peete hai, baat bhi karte hai, khana bhi khate hain lekin ek sath koi chiz nhi karte hain.

Yadi ham khana khate samay saans lete hain ya paani peete samay saans lete hain to agar paani ka 1 boond bhi saans ki nali mei jata hai to buri halat ho jati hai. Usi tarike se jab virye gland open hoti hain aur agar uss samay aap urine karenge to peshab, virye ki granthi mei jayega aur prostrate aur virye ki granthi mei infection karega. To purushon ko sex ke baad urine nhi jana chahiye atleast for 15-30 mins. Aur yadi unhe aisa lagta hai to unhe pehle jana chahiye. Dusri chiz ejaculation. Purushon ko apna virye regular intervals par nikalte rehna chahiye atleast hafte mei 1-2 baar. Kyuki agar vo virye ko bohot dino tak rokte hain ya brahmcharya ka palan karte hain to ye virye jo granthi mei andar ruko hua hota hai ye infect hone ke chance hote hain aur usmei sankraman ho jata hai. Isliye jawan ladko mei iss tarah ke infections bohot dekhne ko milte hain. Aur yadi vo virye regular nikaal rehte hain to iss tarah ke sankraman ke chances kam rehte hain.

Aur yadi koi shadi-shuda nhi hai aur sex nhi kar raha hai to masturbation yani hasth maithun unhein karna chahiye. Hamare yahan pranti hai ki haath maithun karne se kuch dikkat ho jaati hai but aisa kuch nhi hai. Hasth maithun ek sadharan jaivik prakriya hai aur isko karne se koi nuksaan nhi hota rather isse faeda hota hai. To hasth maithun karna chahiye. Aur virye ka nikal jana behtar hota hai chahe ye nightfall mei nikle. Nightfall koi bimari nahi hai. Ye jab virye apne aap jab zada ho jata hai to vo bahar nikal jata hai. To nightfall ya masturbation koi bimari nhi hai aur inse koi maansik tanav naa palein. Hamare yahan adhiktar jo yon samasyaein hoti hain vo ek maansik samasya zada hoti hain kyuki hame jo knowledge hoti hai vo hamare mitro se aur net se jo ham ulta seedha dekh lete hain unse hoti hai. To iske liye proper apne Sexologist ya Enderologist se milna chahiye.

Dhanyavad!

How to prevent kidney stones?

Main Dr. Shailendra Goel hu, principal consultant urologist, enterologist and renal transplant surgeon. Main Vaishali, Delhi, Noida, NCR chhetra mein max hospital se sammad hoon aur meri training. MCS training jo hai, Sanjay Gandhi PGI Lucknow mein hui hai aur main Delhi rajdhani chhetra ke bade haspatal jis mein Maidanta haspatal, JP haspatal, Kailash haspatal Noida, Delhi aur Metro haspatal se sambandhit raha hoon.

Aaj mein aap ko iss video ke dwara, Prostate gland jo gadut kehlate hai jo ki ek common samasya hai uss ke brein mein thoda gyan aap se share karna chahta hoon. Prostate gland ek chhoti ya bade angur ya akhrot ke size ki ek granthi hoti hai jis mein vva banta hai aur yeh peshaap ki theli ke neeche body ke andar peshaap ke raste ke chaaro ore hoti hai. Aur yeh peshaap ke raste ke chaaro ore hota hai aur iss mein vva banta hai aur jab sex karte hai toh vva iss granthi se nikalta hai. Jab age jaise jaise progress karti hai to hiss ka size badhne lagta hai aur yeh peshaap ke raste ko dabane lagti hai toh uski wajah se peshaap mein dikkat hone lagti hai. Mostly patients jo prostate gland ke enlargement ke jo hote hai who mostly 40-50 saal ke baad ke umar ke hote hai. Aur dheere dheere yeh granthi jo badhti jaati hai aur raste ko abati jaati hai toh urine mein dikkat jo hoti hai. Uss mein dikkat kuch rukawat ki wajah se hoti hai, jese ki

• Dhara halki hona
• Ruk ruk ke hona peshaap hona
• Peshap ek baar mein poora na hona
• Baar baar peshaap jana
• Raat mein kahi baar uthna peshaap ke liye
• Peshaap jaldi lagna.
• Kahi baari itna jaldi peshaap lagna ki bathroom pahuchne se pehle hi nikal jana.

Toh yeh symptoms is baat ko indicate karte hai ki prostrate kuch trouble kar raha hai aur kahi baar jab yeh prostate zyada badh jaata hai toh kuch yeh dikkat ya complications karta hai jaise KI-

• Peshaap bilkul ruk hi jaata hai
• Peshap nikal nahi jaata
• Nail dalwane ki zaroorat parti hai
• Peshaap mein blood aane lagta hai
• Itni rukawat hone lagti hai ki kidney ko kharab karne lagta hai
• Pet mein itna jor lagana padta hai ki hernia ban jate hai ya rukawat ki wajah se kidney mein ya peshaap ki theli mein pathri ban jaane lagti hai.
• Kidney kharab ho jaane lagti hai toh yeh complications hote hai.

Jab yeh complications hone lagte hai tab toh operation bahut zaroori ho jaata hai. Shuruat ke stage mein jab yeh koi complications nahi hai toh prostate ki dikkat ko dawaiyon se treat kiya ja sakta hai. Usually jaise jaise age badhti hai waise prostate ki samasya badhti jaati hai. Yadi hum kahe ki 60 years ki age pe 50% logon ko prostrate ki problem hoti ha. 80 years ki age pe almost 70-90% patients ko prostate ki problem hoti hai.

Prostate ki samasya ka khaane se koi link nahi hai. Aap ko ek normal balanced diet leni chahiye aur aisa koi specific diet ya parihej nahi hoga jiss se hum kahein ki prostate ki samasya nahi hogi. Aur prostate ke check up ke liye jo aap urologist se ya jab aap salah karte hai ki iss mein kya dikkat hai toh uss mein hum jo test karate hai uss mein ek urine test hota hai , ultrasound hota hai ki jiss mein ultrasound peshaap karne se pehle aur peshaap karne ke baad mein dekhte hai, ye check karne ke lie ki kitan percent peshaap ruka reh jaata hai. Ek peshaap ke dhara ki jaach hoti hi jise hum uroflowmetry kehte hai yeh jaach hum usually karate hai aur kidney pe koi jor par raha hai ke nahi par raha hai uss ke liye kidney ka ek blood test, cretinin jiss ko kehte hai, who karaya jaata hai. aur ek prostate ke liye specific test hota hai PSA Test, Prostate Specific Antigen yeh ek test karaya jaata hai ki jiss se hum yeh check karte hai ki koi cancer ki sambhavna toh prostate mein nahi hai. Toh yadi PSA yadi badha hua aata hai, toh uss ke liye hum phir biopsy advise karte hai except ki kuch cases mein jahan humein lage ki infection hai ya koi aur chances ho sakte hai PSA badhne ke. Toh PSA ka badha hona apne aap mein indicate karta hai ki uss mein cancer ki shakh hota hai, cancer ko confirm nahi karta.

Shuruat mein prostate ki samsya ko hum dawai se treat kar sakte hai jiss mein do tareeke ki dawai hoti hai alphablocker aur 5ARI inhibitors. Toh jab bada prostate hota hai toh yeh do dawaiya di jaati hai aur inn do dawaiyon ka long term mein koi major side effect nahi hota hai aur yeh dawai prostate ke patients ko lambe samay tak leni hoti hai. Beech beech mein check up karana hota hai. Aur yadi check up mein humein lagta hai ke dawaiyon se proper result nahi mil rahe hai ya humein lagta hai ke prostate badh raha hai aur dikkat kar raha hai, andar complications jaise rukawat ke, kidney kharab hone ke, kidney mein swelling ke ya peshaap zyada rukne ke ya dhaar achhi na hone ke persist kar rahe hote hai toh uss mein operation ki salah di jaati hai.

Aaj ki tareekh mein operation bhi minimal invasive technique se hota hai ki jiss mein koi chira fadi, kaata, kaati nahi hoti even jaise laproscopy mein do teen chhed karte hai toh koi chhed nahi kiya jaata. Yeh keval peshaap ke raste pe kiya jaata hai jiss mein commonest operation jo aaj ki tareekh mein jo hota hai woh TURP kehlata hai jiss mein peshaap ke raste se doorbeen se prostate ko operate kar diya jaata hai. Ab aur zyada advanced technique available hai jise hum bipolar TURP kehte hai. Iss mein risk kam ho jaata hai ya isme laser se kiya jaata hai. Aaj ki tareekh mein laser best technique kehlati hai jo ki jiss mein old age mein hote hai patients ko heart problem hai ya lungs ki problem hai ya woh blood thinner le rahe hote hai ya aur bimaariya hai , diabetes hai, toh uss mein ya sodium kam ho jata hai body mein toh un cases mei laser bahut helpful hota hai uss mein complications kaafi kam ho jata hai. Lekin ye hai ki in ke operations kaafi successful hai. Otherwise yadi aap iska illaj nahi karte hai toh yeh kidney kharab kar sakta hai ya aur dikkat kar sakta hai.

Toh yeh kuch baat mein prostate cancer ke barein mein aur kehna chahunga ki prostate cancer bhi ek samasya hai. PSA tests se iss ko diagnose kiya ja sakta hai. Lekin cancer ke barein mein yeh hai ki prostate cancer ka ilaaj sambhav hai. Chahe yeh advanced stage mein bhi hai toh bhi iss ka bahut accurate ilaaj available hai. Aur yeh saal do saal ilaaj ke baad bhi patients ko koi dikkat nahi hoti hai. Toh woh prostate ki samasya se mera yeh ek salah rahegi jiss ke koi urine mein dikkat hai woh urologist se salah zaroor le aur apna ilaaj karaye aur in sab dikkato se ya apne zindagi ko swasth rakhe.

Dhanyavaad. Aur mein Dr. Shailendra Kumar Goel aap ke liye, salah ke liye lybrate par available hoon ya aap DF-10 Duplex Flora, Sector-108 mein mere Goel Urology clinic mein aap mere se sampark kar sakte hai.

Aur lybrate ki website par ya meri apni website Drshailendragoel.com par mere se appointment ya salah le sakte hai. dhanyavad.