Sir Ganga Ram Hospital

Hi,

I am Dr. Sudhir Khanna, Urologist. Aaj mai aap se baat karunga Benign Prostatic Hyperplasia (BPH). BPH kya hai? Ye bahut common problem hai. Normally, 40-50 mariz humare paas is problem ke aate hain. In patients ko symptoms kya ho sakte hain? Inko jaldi jaldi peshab ke liya jana hota hai. Normal person ko 7 times ki toilet jana chahiyai. Agar person 7 times se jyada jaa rha hai iska matlab hai ki use BPH hai. Isi tarah 50-60 saal ki umar mein raat mein uthana nahi chahiyai. Agar koi person raat mein uth raha hai aur umar ke hisab se jayada uth raha hai toh use BPH hai and use urologist se consult karna chahiyai. Jab vo peshab karne jaate hain toh unhein thoda wait karna hota hai. Toilet mein burning ho sakti hai, ruk ruk ke aata hai toilet, toilet karne ke baad tasali na hona, peshab karne mein zor lagana, ye sare lakshan BPH ke hain. Agar kisi kisi ko lakshan jyada ho jaaye toh urinary tract infection bhi ho sakta hai.

Toilet mein blood bhi aa sakta hai. Situation kharab hone pe toilet band bhi ho sakta hai. Jaruri nahi hai ki patient ko sare symptoms hon. Agar inmein se koi bhi symptom hai toh person ko Dr se milna chahiyai. Kabhi kabhi urine aane pe tezi se bhagana bhi pad sakta hai. Ab next question hai ki bimari ka ilaj operation hai? Nahi, aisa nahi hai. 90% patient medicines se manage ho sakte hain. Aur baki cases mein hum operation suggest karte hain jahan medicines nahi di ja sakti hain. Patient mein ye bimari aane se iske kya diagnosis hain? Hum ek urine routine test karate hain jismein ye dekha jata hai ki koi infection ka element hai ya nahi. 2nd test mein hum patient ko kehte hain ki paani jyada pee ke aayen taki bladder full hona chahiyai and us se hum ek machine pe peshab karate hain jis se ki speed check ki jati hai and fir graph se pata chalta hai ki obstructive hai ya normal hai.

Agar obstructive hai toh hum medicines start karte hain. 3rd test hai ultrasound jismein kidneys chekc ki jaati hai ki koi swelling toh nahi hai. Bladder mein kitna urine reh jata hai peshab karne ke baad. Iske baad hum decision lete hain. Patient medicines se 90% thik ho jaate hain. Operation mein darne ki jarurat nahi hai. Koi tanka ya chira nahi lagta hai. Rid ki haddi ko hum sun karte hain aur durbin daal ke operation kiya jata hai. 24 hours ke baad hum patient ko discharge kar dete hain. Uske baad patient ke most of the symptoms thik ho jaate hain. Iske alawa laser se bhi operation ho sakta hai. But gold standard ko bola jata hai TORP. Ismein darne ki koi jarurat nahi hoti hai. Painless hota hai and patient ki sari problems khatam ho jaati hain.

Thank You!

Hi,

I am Dr. Sudhir Khanna, Urologist. Aaj mai aap ko urinary tract infection (UTI) ke baare mein btaunga. Ye bahut common problem hai. Ise neglect nahi karna chahiyai. Ye bimari kisi bhi age group and gender mein ho sakti hai. Ab iske symptoms kya hote hain? Kayi baar pateint ko peshab mein jalan ho sakti hai. And jab patient Dr ke paas jata hai toh Dr use anti-biotic deta hai. Ye kabhi nahi karna chahiyai Humein routine examintaion kar ke problem ka pata lagana chahiyai. Isliya humein bina urine routine karaye anti-biotic nahi khani chahiyai. Agar kisi ko peshab mein jalan hai aur ek din se jyada hai toh Dr se consult karna chahiyai. Female patient mein jab problem aati hai toh patient gynae ke paas chali jaati hai. Agar urine se related problem hai toh gyane ke paas jaane ki koi jarurat nahi hai. Aap ko urologist se hi consult karna chahiyai.

Urine culture ki aar jarurat hogi toh ye aap ko baad mein btaya jayega but urine routien test important hai. Agar urine mein pus cells aayenge to hum use urine culture ke liya sample dete hain. Patient se pucha jata hai ki agar jalan hai toh kya peshab jaldi jaldi aa raha hai? Agar urine infection hota hai toh patient ko 10-15 minutes pe hi toilet jana hota hai. Patient ko ye problem din raat ho sakti hai. But agar ye problem sirf din mein hai raat mein nahi toh chances hain ki patient ko UTI nahi hai. Tisri problem hoti hai urge incontinence where patient will run for the toilet but he/she can piss in the pants only. Patient ko urgency ho sakti hai jahan pe patient ko saare kam chor ke toilet ke liya bhagna pad sakta hai. Iske sath hum patient ka fever hi check karte hain ki kahin use high grade fever hai ya nahi. Patient ko sardi lagtti hai. Toh ye saare symptoms UTI ke hain. Agar UTI ki problem jyada badh jaaye toh toilet mein blood bhi aa sakta hai.

Ek baar jab UTI confirm ho jaat hai toh hum patient ka HB TLC and DLC karna hota hai. Is se pata infection ki severity ka pata chalta hai. Aise patient ko hum oral tablets nahi de sakte hain, humein injection dena hota hai. Tisra test hai serum creatinine ka. Kyuki agar kisi ko urine infection hua hai aur kuch medicines hum patient ko dete hain toh vo kidney ko bhi damage kar sakti hain. Isliye hum patient ko modify kar ke injections dete hain. Patient normally treatment leke bhul jaate hain. But agar patient ko infection hua hai toh uska karan janna bhi bahut jaruri hai. Ultrasound se hum check karte hain ki kidney mein koi stone toh nahi hai. Check kiya jata hai ki bladder thik se khali ho raha hai ya nahi.

Tisra test hai uroflowmetry jismein hum patient ko bladder full kar ke clinic aane ke liya bolte hain jis se hum patient kaek machine ke through toilet flow check karte hain. Agar ultrasound mein sojish aati hai toh humein uska CT scan karna padta hai to know ki kya severity hai aur iska reason kya hai. Agar stone hai toh stone nikala jata hai. Agar peshab karne mein koi rukavat hai toh use thik kiya jata hai. Otherwise, infection baar baar hota rahega and problem jad se solve nahi hogi. Infection ke sath sath kidney bhi dheere dheere damage hone lagti hai. Agar patient medicines leke hi use thik karne ki koshish karta hai toh bimari dheere dheere badhne lagati hai. Isliya karan ka pata hona bahut jaruri hai. Ye responsibility ek Dr ki hai.

Agar jalan hone pe urine routine jab kiya jata hai aur usmein koi pus cell and infection nahi hai toh means patient ko UTI nahi hai. Toh humein dusra karan dekhna hota hai. Agar uroflow mein koi kharabi hai toh uski medicine deke use thik kiya jata hai. AGar patient ka sab normal hai test mein but fir bhi patient ko buring hai toh hum use interstitial cystitis kehte hain. AIse case mein hum durbin daal ke bladder ko andar se dekhte hain aur uski biopsy lete hain and agar koi problem hai toh iski alag medicines hain. Toh kisi bhi bimari ko jad se janna jaruri hai. Aur fir diagnose kar ke ilaj karna jaruri hai.

Thank You!

I am Dr. Sudhir Khanna, Urologist, Sir Ganga Ram Hospital. Me last 30 years se practice kar raha hun.

Aaj main aapko frequency of urination ke baare mein baat karunga. Normal frequency 5-7 times in a day honi chahiye. Agar aapki age 60 years above hai and aap raat ko 1 se zyaada baar toilet jaate hain to vo abnormal condition hai. Iske alag alag causes hain. Jaise ki hum check karte hain ki aapka water intake per day kitna hai? Agar aapko stones nahi hai to aapke liye 1.5 litre water is sufficient for you.

Isko diagnose karne ke liye hum urine routine test karte hain. Check kiya jaata hai ki urine infection to nahi hai. Hum patient se puchte hain ki urination burning to nahi hai. Urine pass karte time urine rukta to nahi hai. Patient ko urination ke baad satisfaction hai ya nahi. Incomplete evacuation ka problem to nahi hai patient ko. Patient ko urge incontinence ka problem to nahi hai. Patient ka pus cells ka test kiya jaata hai. Patient ka uroflowmetry ka test kia jata hai. Check kia jata hai ki patient ka bladder me urine to nhi deposit ho rha hia. Iske liye residual urine test kia jata hai.

Agar ye problem treat nahi ho raha hai to humein catheter daalna padta hai. Patient agar zyaada paani pita hai to hum uska water intake kam kara dete hain. Jyada flow hone se hum patient ko medicines se treat kr dete hain. Prostate bhi check kia jata hai ki badha to nhi hai. Urine ke infection hone pe hum use treat krte hain. Agar hum frequency ko neglect karte hain to patient ka urine band ho sakta hai. Urine me blood bhi aa sakta hai and fever ho sakta hai. Isliye timely urologist se treatment lene se problem ko khatam kiya ja sakta hai. Thank You.

Namaskar! Mai Dr. Sudhir Khanna, chairman, senior consultant, department of urology, Sir Ganga Ram Hospital, New Delhi, mai pichle 29 saalon se kam kr rha hun.

Apko, public ko main urine problem ke baare mein awagat krana chahunga. Jo sabse common problem hai urine ki, usay BPH kehte hain. Ye normally 60 saal se upar vale logon ko affect karti hai or isme symptoms bahut kisam ke ho sakte hain. Sabse common symptom hota hai peshab jaldi jaldi aana. Next question ye hota hai ki logon ko ye nahi maloom ki normal kis ko kehte hain. 7 baar tak peshab karna din me, is normal. Or ratri me kisi bhi vayakti ko peshab karne ke lia uthna nahi chaiye. Agar vo ek baar se zyaada uth raha hai, to vo disease ka indication hai.

Or din mein 7 times se jyada agar peshab kar rha hai, to usko bhi problem ho sakti hai. Vyakti ko agar peshab karne jana hai to usko wait nahi karna chaiye. Agar usko wait karna pad raha hai or peshab ki dhaar patli hai, peshab me zor lagana pad raha hai ya peshab aant me boond boond kar ke aata hai ya peshab karne ke baad me usko tasli nahi ho or usko lage ki humein thoda peshab or aa jaata hai , to ye BPH ke symptoms hain. Kisi vyakti ko peshab mein jalan hona, peshab aaye to uska dood ke jana, ya jaate jaate kuch boond nikal jana, ye bhi isi bimari ke lakshanon me ata hai.

Or agar bimari apki badh jayegi, to apko peshab me khoon bhi aa skta hai or fever bhi ho skta hai jisko hum UTI bolte hain or rya vayakti ka peshab bhi band ho skta hai. To in symptoms me se apko agar ek bhi symptom ho to aap apne urologist se mile. Investigation pe hum sabse pehle uske urine ka test krte hain ki usme infection to nhi hai. Urine culture test nhi krana hota hai, urine routien krana hota hai. Fir hum ek ultrasound krte hain jisme kidney, ureter or bladder ko dekhte hain, prostate ka size dekhte hain or sabse important chiz hai ki peshab krne ke baad me uske bladder me kitna urine ruk gya, isko hum ultrasound ke madhyam se pta lgate hain. Or teesra test hai uroflammatory. Ek machine hai jisme us vyyakti ko peshab karna hota hai or us se hum dekhte hain ki raaste me rukavat to nahi hai.

Quki ye ek mithya hai ki ultrasound thik hai to sab thik hai. Kareeb 60K marij hmare pas hai jisme ki 54K dawaiyon se hi kam kr rhe hain or pichle 30 saal se vo dawaiyon p acha perform kr rhen hain. To operation kewal 10% ka hi hota hai. Operation durbin se hota hai, koi tanka nhi lgta. Or usko hum behosh bhi nhi krte. Rid ki haddi me ek tikka lgate hain. Pain nhi hota or durbin se hum catheter daal dete hain. 3-4 din ke baad jab hum catheter nikalte hain, to uske bad pateint ki sari taklif thil ho jati hai or vo apna normal work pe ja skta hai. Isme patient ko ek or precaution lena hota hai ki usko kabzi nhi honi chaiye. Quki is s bleeding shuru ho skti hai. Isi me ek ciz or hoti hai, cancer prostate.

Jab hum rectal examination karte hain patient ka or hume aisa lagta hai ki prostate ki feeling normal nhi hai, to hum ek test karate hain PSA or agr PSA jyada hai to hume uska MRI krna pdta hai, or agar usme cancer milta hai to hume uski biopsy krni hoti hai. Cancer prostate me ghabrane ki avshakta nhi hoti hai. To main udeshaye ye hai ki agar apko zara bhi urine me koi symptom ho to aap apne urologist se milen, vo in tests ko krega or apko rai dega ki apko dawayi se thik kia ja skta hai ya agar operation krna hai to operation krenge. Or agar biopsy krni hai to vo ki jayegi. But kisi bhi trha se chinta nhi krni hai, ghabrana nhi hai quki agar aap ghabrayeinge to bimari badhegi. Or fir ilaj thoda advance ho jayega. Or ultimately apko suffer karna hoga. To ghabrane ki zarurat nhi hai. Doctor ko dikhayein or treatment len or shighar hi thik ho jayen. Thank You!