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Dr Andrich sees patients with the following conditions:

Urethral Strictures

Urethral stricture is a common condition in older men, affecting approximately 229-627 cases per 100,000 males (0.2 – 0.6% of the male population).

If left untreated, urethral stricture disease can result in obstructed voiding, potentially causing acute urinary retention and irreversible damage to the urinary tract.

Patients with urethral strictures are prone to high rates of urinary tract infections (41%) and incontinence (11%) and reduced quality of life.

Dr. Andrich is an internationally renowned expert in the field of urethral reconstruction, specialising in the treatment of urethral strictures arising from various causes. With a commitment to driving innovation in research and disease prevention, she actively participates in lectures and conferences on a global scale.

Dr. Andrich’s expertise and dedication to advancing knowledge in this field contribute to the development of improved treatment strategies and the prevention of urethral strictures.

Urethral strictures can arise from different causes:
Traumatic urethral stricture (Pelvic fracture, Fall astride)

Traumatic urethral stricture is a condition characterised by a narrowing or blockage of the urethra, which is the tube that carries urine from the bladder to the outside of the body. These strictures are caused by trauma, particularly pelvic fractures or falls astride, where a person lands on a hard surface between their legs. The forceful impact can damage the urethra, leading to scar tissue formation and subsequent narrowing of the passage. This can result in difficulty urinating, weak urine flow, frequent urinary tract infections, and even urinary retention. Treatment options may include urethral dilation, urethroplasty (open surgical repair), or in severe cases, urinary diversion procedures.

How common are “Traumatic urethral stricture (Pelvic fracture, Fall astride)”?

Traumatic urethral strictures resulting from pelvic fractures or falls astride are relatively uncommon compared to other causes of urethral strictures. The prevalence of traumatic urethral strictures varies depending on the population studied and the specific trauma patterns. In general, they are more commonly seen in males due to the anatomical differences in the male urethra. The exact prevalence rates for traumatic urethral strictures are not well-established, but they are generally considered to be less common than other types of strictures. Prompt evaluation, diagnosis, and appropriate management, which may include surgical repair or reconstruction, are essential for optimal outcomes in cases of traumatic urethral strictures.

Hypospadias repair recurrent stricture

Hypospadias repair recurrent stricture refers to the development of narrowed or blocked areas in the urethra after surgical correction of hypospadias in childhood, a congenital condition where the opening of the urethra is located on the underside of the penis instead of at the tip. Despite initial surgical repair, some individuals may experience recurrent strictures, which are areas of scar tissue that cause narrowing of the urethra. These strictures can result in urinary flow problems, difficulty with urination, and increased risk of urinary tract infections. Treatment options for recurrent strictures may include repeat surgical interventions such as urethral dilation, buccal mucosa graft urethroplasty, or other reconstructive techniques to restore proper urethral function.

How common are “Hypospadias repair recurrent strictures”?

The occurrence of recurrent strictures after hypospadias repair varies depending on several factors, including the type and complexity of the initial hypospadias repair, the surgical technique used, and individual patient characteristics. While there isn’t a specific prevalence rate available for hypospadias repair recurrent strictures, it is recognised as a known complication. Studies have reported varying rates of recurrence, ranging from around 5% to 20%, with some cases requiring additional surgical interventions to address the recurrent stricture. Factors such as the presence of complications during the initial repair, the extent of the hypospadias, and the experience of the surgical team can influence the risk of recurrent stricture. Close follow-up and long-term monitoring of patients who have undergone hypospadias repair are crucial to identify and manage recurrent strictures promptly.

Bulbar stricture (idiopathic)

Bulbar stricture refers to the narrowing or blockage of the urethra in the bulbous segment, which is located towards the base of the penis beneath the skin of the scrotum. Idiopathic bulbar strictures are those where the cause is unknown or unclear. The stricture typically results from the formation of scar tissue within the urethra, leading to a reduced urinary flow and potential complications such as urinary retention, frequent urinary tract infections, and difficulty urinating. Diagnosis is usually made through imaging studies and urethroscopy. Treatment options for idiopathic bulbar strictures may include urethral dilation, or in more severe cases, urethroplasty, which involves surgical reconstruction of the affected urethral segment to restore proper urinary function.

How common is bulbar (idiopathic) stricture?

Bulbar strictures, specifically those of idiopathic origin, are relatively common types of urethral strictures. The exact prevalence of idiopathic bulbar strictures can vary depending on the population studied and the criteria used for diagnosis. Studies have reported prevalence rates ranging from 32% to 41% among patients presenting with urethral strictures. However, it is important to note that the prevalence may vary in different geographic regions and populations. Diagnosis and management of idiopathic bulbar strictures typically involve urological evaluation, imaging studies, urethral dilation, or surgical interventions such as urethroplasty, depending on the severity and characteristics of the stricture.

Inflammatory (Lichen sclerosus / BXO) stricture

Inflammatory strictures, specifically lichen sclerosus (LS) or balanitis xerotica obliterans (BXO) strictures, are characterised by narrowing or scarring of the urethra due to chronic inflammation. Lichen sclerosus is a skin condition that primarily affects the foreskin and glans of the penis, leading to thinning, white patches, and itching. When LS affects the urethra, it can cause scarring and subsequent strictures. These strictures can result in urinary flow problems, urinary retention, and recurrent urinary tract infections. Treatment may involve topical corticosteroids to manage inflammation and, in severe cases, surgical intervention such as urethral dilation or reconstructive procedures like urethroplasty to alleviate the strictures.

How common is Inflammatory (Lichen sclerosus / BXO) stricture?

Inflammatory urethral stricture associated with conditions such as lichen sclerosus (also known as balanitis xerotica obliterans or BXO) is relatively uncommon compared to other types of urethral strictures. The exact prevalence of inflammatory strictures related to lichen sclerosus or BXO is not well-established, partly due to variations in study populations and diagnostic criteria. However, it is generally recognised as a less frequent cause of urethral strictures compared to other factors such as trauma, iatrogenic or idiopathic causes.

Iatrogenic urethral stricture (catheterisation / TURP / urological instrumentation)

Iatrogenic urethral stricture refers to strictures that are caused by medical procedures such as catheterisation, transurethral resection of the prostate (TURP), or other urological instrumentation. Catheterisation involves the insertion of a tube into the urethra to drain urine, but it can sometimes cause trauma and subsequent scarring, leading to strictures. TURP is a surgical procedure used to treat benign prostatic hyperplasia, and urological instrumentation refers to various procedures that involve inserting instruments into the urethra. These interventions can damage the urethral tissues, resulting in the formation of scar tissue and narrowing of the urethral passage. Treatment options for iatrogenic urethral strictures may include urethral dilation, urethrotomy (surgical incision to widen the stricture), or reconstructive procedures like urethroplasty, depending on the severity and location of the stricture.

How common is Iatrogenic urethral stricture (catheterisation / TURP / urological instrumentation)?

The exact prevalence of iatrogenic urethral strictures varies depending on several factors, including the specific procedure, patient population, and study design. However, it is recognised as a relatively common complication of these procedures. For example, in the case of TURP, studies have reported urethral stricture rates ranging from 1% to 10%, while urethral injury caused by catheterisation trauma ranges from 1% to 7%. It is important to note that repeated or improper catheter insertions, inadequate lubrication, forceful placement, or other factors can increase the risk of urethral trauma and urinary sepsis with subsequent stricture formation. Proper procedure and catheter insertion technique, use of appropriate-sized catheters, and regular monitoring of patients receiving catheterisation are crucial to minimise the occurrence of iatrogenic urethral injury. Prompt recognition of iatrogenic urethral injury and careful patient follow-up are important to promptly detect the development of iatrogenic urethral strictures.

Catheter stricture

Catheter stricture, also known as catheter-associated urethral stricture, is a complication that can occur in individuals who require long-term or recurrent catheterisation. The catheter, a tube inserted into the bladder to drain urine, can cause trauma and irritation to the urethral tissues, leading to the development of scar tissue or inflammation. Over time, this can result in a stricture, which is a narrowing of the urethral passage. Catheter strictures can cause urinary flow problems, difficulty in inserting or removing catheters, increased risk of urinary tract infections, and urinary retention. Treatment options may include urethral dilation, or in severe cases, reconstructive procedures like urethroplasty.

How common is Catheter stricture?

The exact prevalence of catheter stricture is not well-established, as it can vary depending on various factors such as the duration and frequency of catheterisation, the type of catheter used, and individual patient characteristics. However, studies have suggested that the incidence of catheter stricture ranges from 1% to 30% among individuals requiring long-term catheterisation. Risk factors for catheter stricture include prolonged catheterisation, repeated catheter insertions, and inadequate catheter care. Proper catheter management, including regular catheter changes, maintaining cleanliness, and using appropriate catheter materials, can help minimize the risk of catheter stricture development.

Female urethral stricture

Female urethral stricture refers to the narrowing or blockage of the urethra in women. While less common than in men, it can still occur due to various factors such as inflammation, trauma, or previous surgeries. The condition can result in symptoms such as difficulty urinating, weak urine flow, urinary retention, recurrent urinary tract infections, and urinary incontinence. Diagnosis is typically made through medical history, physical examination, imaging studies, and urethroscopy. Treatment options for female urethral strictures may include urethral dilation, or urethroplasty, which involves surgical reconstruction of the narrowed urethral segment with buccal mucosal graft or vaginal skin flap technique. The choice of treatment depends on the severity and location of the stricture.

How common is Female urethral stricture?

The exact prevalence of female urethral stricture is not well-established, partly due to underdiagnosis and misdiagnosis. It is generally considered to be less common than in males. Female urethral strictures can occur due to various causes such as trauma, infection, inflammation, surgical procedures, or congenital abnormalities. Risk factors may include prior urethral surgery, childbirth trauma, pelvic radiation therapy, or certain medical conditions.

Prostate Cancer Survivorship

Dr. Andrich specialises in improving the functional outcome of prostate cancer survivors and is an expert in reconstructive surgery and continence rehabilitation within this field.

In the following links we will show you detailed information about:

  • Complications after Radical prostatectomy

  • Complications after External Beam Radiotherapy
  • Complications after Brachytherapy
  • Complications after HIFU-therapy
  • Complications after Cryotherapy

Female Urology

Dr. Andrich is passionate about providing care for women experiencing recurrent cystitis and strives to enhance the management of this prevalent condition. In cases of incontinence, a multidisciplinary approach is adopted, collaborating closely with skilled pelvic floor physiotherapists, before considering surgical interventions.

Symptoms and triggers of “Recurrent UTI”

The symptoms of recurrent urinary tract infections (UTIs) can vary but typically include frequent and urgent urination, a burning sensation during urination, cloudy or strong-smelling urine, and pelvic discomfort. In some cases, fever and lower abdominal pain may also be present.

Triggers for recurrent UTIs in otherwise healthy women can include sexual activity, hormonal fluctuations, impaired immune response and changes in the vaginal microbiome, which all can disrupt the balance of bacteria in the urinary tract.

During sexual activity, bacteria from the genital area can be introduced into the urethra, increasing the risk of developing a UTI. This is often referred to as “honeymoon cystitis” because it can occur more frequently in the early stages of sexual activity or after a period of sexual abstinence. It is recommended for women to urinate before and after sexual intercourse, practice good hygiene, and consider other preventive measures, such as drinking plenty of water and using appropriate lubrication, to reduce the risk of UTIs.

Effect of oral antibiotics in disrupting vaginal microbiome

The use of oral antibiotics can have an impact on the delicate balance of the vaginal microbiome. Antibiotics work by targeting and killing harmful bacteria, but they can also inadvertently disrupt the beneficial bacteria that naturally reside in the vagina. This disruption can lead to a decrease in the population of beneficial bacteria, allowing opportunistic pathogens to overgrow and potentially cause infections, such as yeast infections or bacterial vaginosis. The suppression of protective bacteria can also make the vaginal environment less acidic, creating a more favourable environment for harmful bacteria to thrive.

Urinary microbiome rehabilitation

Urinary microbiome rehabilitation refers to a treatment approach that focuses on restoring a healthy balance of microorganisms in the urinary tract. It involves the use of probiotics and other supplements to promote the growth of beneficial bacteria and suppress the growth of harmful bacteria. This approach aims to enhance the natural defence mechanisms of the urinary tract and reduce the recurrence of UTIs.

How common is Recurrent UTI ?

Recurrent urinary tract infection (UTI) is a common condition, particularly in women. The prevalence of recurrent UTIs varies depending on factors such as age, sex, and underlying risk factors. In general, it is estimated that around 20-30% of women will experience at least one recurrence within six months after the initial UTI. Among those who have had a recurrent UTI, the likelihood of further recurrences increases. Some individuals may experience recurrent UTIs multiple times per year.

Certain risk factors, such as urinary tract abnormalities, urinary catheter use, and immunosuppression, can further increase the risk of recurrent UTIs.

Symptoms and duration of “Post-cystitis bladder irritation”

“Post-cystitis bladder irritation” are commonly encountered and refers to the symptoms and discomfort that persist after the resolution of a urinary tract infection (UTI). Common symptoms may include a frequent urge to urinate, a persistent feeling of bladder fullness, and a mild burning or stinging sensation during urination. Some individuals may also experience lower abdominal discomfort or pelvic pain. The duration of these symptoms can vary among individuals but typically lasts for a few days to a couple of weeks after the UTI has been treated.

Treatment options focus on relieving symptoms and promoting bladder healing. This may involve pain management techniques such as over-the-counter pain relievers, bladder analgesics, or urinary analgesics. In addition, drinking plenty of water, avoiding sex and bladder irritants (such as caffeine and alcohol), and using heating pads or warm baths can provide relief.

Symptoms of “Post-partum stress incontinence” and its treatment

Post-partum stress incontinence refers to the involuntary leakage of urine during activities that put pressure on the bladder, such as coughing, sneezing, or exercising, following childbirth. Common symptoms include urine leakage during these activities, a sudden and strong urge to urinate, and frequent trips to the bathroom.

Treatment options for post-partum stress incontinence may include pelvic floor muscle exercises (Kegel exercises) to strengthen the muscles that control bladder function. In some cases, physical therapy or the use of vaginal weights or cones may be recommended. If conservative measures with pelvic floor physiotherapy do not provide sufficient improvement, surgical may be considered.

How common is Post-partum stress incontinence?

Post-partum stress incontinence is a relatively common condition among women following childbirth. It is estimated that approximately 30-50% of women experience some degree of stress urinary incontinence after giving birth. The exact prevalence can vary depending on various factors such as the mode of delivery (vaginal or caesarean), the number of pregnancies, and individual factors such as age, pre-existing pelvic floor muscle weakness, and obesity. It is most commonly observed in the immediate post-partum period and may improve over time as the pelvic floor muscles regain strength. However, for some women, the symptoms may persist and require further evaluation and management.

What are the symptoms of “Bladder overactivity & urge incontinence” and its treatment

Bladder overactivity and urge incontinence refer to a condition characterised by a sudden and uncontrollable urge to urinate, often resulting in urine leakage. Symptoms include frequent urination, a strong and sudden need to urinate, involuntary urine leakage before reaching the toilet, and disrupted sleep due to nocturia (frequent urination at night). Treatment options for bladder overactivity and urge incontinence may include behavioural therapies such as bladder training, scheduled voiding, and pelvic floor exercises. Medications that help relax the bladder muscles or decrease bladder sensitivity may also be prescribed.

How common is Bladder overactivity & urge incontinence?

Bladder overactivity and urge incontinence are relatively common conditions, particularly among older adults. The prevalence of these conditions increases with age, affecting a significant portion of the population, especially women.

In women, the prevalence of bladder overactivity and urge incontinence is estimated to be around 10-30%, depending on the specific population studied. It is more common in postmenopausal women, but it can affect women of all ages.

Symptoms of “Female voiding dysfunction (Fowler’s Syndrome)” and its treatment

Female voiding dysfunction, also known as Fowler’s syndrome, is a relatively rare condition. It primarily affects young women, typically in their late teens to early thirties. The exact prevalence of Fowler’s syndrome is not well-established, but it is considered to be an uncommon disorder.

Fowler’s syndrome is characterized by urinary retention due to an inability to relax the muscles in the urethra during voiding. Women with this condition often experience difficulty initiating or maintaining urination, despite having a normal bladder capacity. It is commonly associated with non-obstructive urinary retention.

Diagnosis of Fowler’s syndrome is made through urodynamic testing, and treatment approaches typically involve a combination of behavioural and medical interventions. These may include pelvic floor muscle exercises, biofeedback therapy, and the use of alpha-blocker medications. In some cases, intermittent self-catheterization may be required to manage urinary retention. In some cases, sacral neuromodulation may be considered.

Role of physiotherapy in voiding dysfunction and incontinence management

Physiotherapy plays a crucial role in the management of voiding dysfunction and incontinence.

  1. Urinary Incontinence: Physiotherapy helps by providing pelvic floor muscle training, which strengthens the muscles responsible for bladder control. It also involves bladder retraining techniques and behavioural modifications to improve bladder function and reduce incontinence episodes.
  2. Voiding Dysfunction: Physiotherapy addresses symptoms such as difficulty initiating or maintaining urination, weak urine stream, or incomplete emptying. Techniques like pelvic floor muscle exercises, biofeedback, and relaxation techniques can improve muscle coordination, increase bladder capacity, and promote efficient voiding.
  3. Pelvic Pain: Physiotherapy techniques like manual therapy, stretches, and relaxation exercises can help alleviate pelvic pain associated with voiding dysfunction.
  4. Post-Surgical Rehabilitation: Physiotherapy is essential in the post-operative phase to enhance recovery, regain bladder control, and optimize voiding function.

By addressing these symptoms and providing tailored interventions, physiotherapy empowers individuals to regain control, improve voiding patterns, and enhance their overall quality of life.

“Psychosomatic urinary manifestation” and its treatment

Psychosomatic urinary manifestations refer to urinary symptoms that arise from psychological or emotional factors. These symptoms may include frequent urination, urgency, urinary hesitancy, pain or discomfort during urination, or a sense of incomplete emptying of the bladder. The exact cause of psychosomatic urinary manifestations is not fully understood but is believed to involve the complex interaction between the mind and body.

Treatment typically involves a multidisciplinary approach, addressing both the psychological and physical aspects. This may include cognitive-behavioural therapy, relaxation techniques, stress management, and medications to manage underlying anxiety or depression. The goal is to alleviate psychological distress, improve coping mechanisms, and subsequently reduce or eliminate the urinary symptoms. Collaborative care between urologists and mental health professionals is essential to ensure comprehensive and effective treatment.

How common is Psychosomatic urinary manifestation?

The prevalence of psychosomatic urinary manifestation can vary depending on the specific condition being considered. It is important to note that psychosomatic factors can play a role in various urinary disorders, including functional urinary disorders, overactive bladder, interstitial cystitis, and non-specific urinary symptoms. The exact prevalence is challenging to determine due to the complex nature of the condition and the overlap with other urological disorders. However, it is recognized that psychosomatic factors can significantly impact urinary symptoms and quality of life for some individuals.

Role of meditation in psychosomatic urinary manifestations

Meditation plays a significant role in reducing stress and anxiety associated with psychosomatic urinary manifestations. By practicing meditation, individuals can cultivate a state of relaxation and mindfulness, which helps in calming the mind and reducing emotional distress. Meditation techniques, such as deep breathing, focusing attention, and guided imagery, can promote a sense of inner peace and improve overall well-being.

Regular meditation practice has been shown to decrease stress hormones, lower blood pressure, and enhance emotional resilience. It can also help individuals develop a better awareness of their thoughts and emotions, allowing them to manage stress triggers more effectively. Incorporating meditation into the treatment of psychosomatic urinary manifestations can provide a valuable tool for stress and anxiety reduction, improving the overall management of the condition.

Symptoms of “Vesico-vaginal fistula” and its treatment

Vesico-vaginal fistula (VVF) is a condition characterised by an abnormal connection between the urinary bladder and the vagina, resulting in continuous or intermittent leakage of urine through the vaginal opening. The main symptom is urinary incontinence, accompanied by a persistent often foul-smelling vaginal discharge. Patients may also experience recurrent urinary tract infections and irritation of the vaginal and perineal areas.

The treatment of VVF typically involves surgical repair. The surgical procedure aims to close the fistula and restore normal anatomy. The specific surgical approach depends on the size, location, and complexity of the fistula. Additionally, supportive measures such as bladder training, pelvic floor exercises, and use of absorbent pads may be recommended to manage urinary incontinence before and after surgery.

General Urology

Dr. Andrich provides comprehensive, patient-centred care for various general urological conditions, considering the overall well-being of each individual. She addresses all aspects of the condition, including diagnosis, treatment, and long-term management, with a focus on improving urological health and promoting optimal outcomes.
  • Haematuria (blood in the urine)
  • Haematospermia (blood in the semen)
  • Epididymal cyst
  • Testicular pain
  • Testicular mass requiring diagnosis
  • Hydrocele
  • LUTS (voiding dysfunction related to benign prostatic enlargement)
  • LUTS (voiding dysfunction related to bladder neck dyssynergia)
  • Renal colic diagnostics due to kidney stones
  • Phimosis (tight foreskin)

Symptoms of “non-visible haematuria” and its treatment?

Non-visible haematuria refers to the presence of blood in the urine that is not visible to the naked eye but is detected through urine dipstick testing or microscopic examination. Unlike visible haematuria, there are usually no visible changes in urine colour. Non-visible haematuria is often an incidental finding during routine health screenings or diagnostic tests. It can be an indication of an underlying condition such as urinary tract infections, kidney stones, kidney disease, or even bladder or kidney cancer.

The treatment of non-visible haematuria depends on the underlying cause and may involve addressing the specific condition causing the blood in the urine, such as treating an infection, managing kidney stones, or further investigating potential underlying diseases through imaging or other diagnostic tests.

Symptoms of “visible haematuria” and its treatment?

Visible haematuria refers to the presence of blood in the urine that is visible to the naked eye, giving the urine a pink, red, or brown colour. The most common symptom of visible haematuria is the discoloration of urine. However, it is important to note that visible haematuria itself is a symptom rather than a specific condition. Underlying causes can vary and may include urinary tract infections, kidney stones, bladder or kidney infections, trauma, or even certain medical conditions like kidney disease or cancer.

The treatment of visible haematuria depends on the underlying cause, and it is essential to identify and address the specific condition causing the blood in the urine. This may involve treating infections with antibiotics, managing kidney stones, or undergoing further diagnostic tests, such as imaging or cystoscopy, to investigate potential underlying conditions.

It is crucial for individuals experiencing visible haematuria to seek medical attention promptly to determine the cause and appropriate management.

Symptoms of “Haematospermia (blood in the semen)” and its treatment

Haematospermia, also known as blood in the semen, refers to the presence of blood in ejaculated semen. The most common symptom is the discoloration of semen, giving it a reddish, brownish, or pinkish appearance. In most cases, haematospermia is a self-limiting condition that resolves without treatment. However, if the symptoms persist or are accompanied by other concerning symptoms such as pain during ejaculation, urinary difficulties, or blood in urine, further evaluation is necessary.

The treatment of haematospermia depends on the underlying cause. It may involve addressing any underlying infections, inflammation, or structural abnormalities. In some cases, no specific treatment is required, and reassurance and observation are sufficient.

Symptoms of “Epididymal cyst” and its treatment

Epididymal cysts are fluid-filled sacs that develop within the epididymis, a coiled tube located behind the testicles. These cysts are typically painless and are often discovered as a painless lump or swelling in the scrotum. They can vary in size and may feel firm or tender to the touch. Epididymal cysts usually do not cause any significant symptoms or complications, and treatment is not always necessary. However, if the cyst becomes large, causes discomfort, or affects fertility, surgical removal may be considered.

Treatment options include aspiration (draining the fluid with a needle) or surgical excision of the cyst.

Symptoms of “Hydrocele” and its treatment

A hydrocele is a condition characterised by the accumulation of fluid in the sac surrounding the testicle, leading to scrotal swelling. The main symptom is the painless enlargement of the scrotum, which may be accompanied by a feeling of heaviness or discomfort. The swelling may vary in size and can be present in one or both testicles.

Treatment may be required if the hydrocele causes discomfort, affects daily activities, or becomes large. Treatment options include observation, aspiration (draining the fluid with a needle), or surgical intervention to remove or repair the hydrocele.

Symptoms of “Testicular mass” and its treatment

Testicular mass presents as a lump or swelling in the testicles. Symptoms include painless lumps, testicular or scrotal discomfort, heaviness, enlargement, changes in shape or texture, and fluid accumulation. Prompt medical attention is crucial.

Treatment depends on the cause: Testicular cancer is diagnosed on ultrasound and tumour type is confirmed histologically after radical inguinal orchidectomy. Tumour markers and staging body CT scan is performed prior surgery.

Non-cancerous conditions testicular swelling due to infection (epididymo-orchitis) is treated with appropriate antibiotics, anti-inflammatory medications and scrotal support and underlying factors are investigated.

Symptoms of “LUTS (voiding dysfunction related to benign prostatic enlargement)” and its treatment

LUTS (Lower Urinary Tract Symptoms) related to benign prostatic enlargement (BPE) refer to urinary difficulties caused by an enlarged prostate gland. Common symptoms include frequent urination, urgency, weak urinary stream, incomplete emptying, nocturia (waking up at night to urinate), and urinary incontinence. Other signs can include straining during urination and a feeling of bladder fullness.

Treatment options for LUTS related to BPE include lifestyle modifications, medications (such as alpha-blockers or 5-alpha-reductase inhibitors), minimally invasive procedures, or surgery (such as transurethral resection of the prostate or prostatectomy). The choice of treatment depends on the severity of symptoms, prostate size, and individual patient factors.

Symptoms of “LUTS (voiding dysfunction related to bladder neck dyssynergia)” and its treatment

LUTS (Lower Urinary Tract Symptoms) related to bladder neck dyssynergia (BND) refer to urinary difficulties caused by abnormal coordination between the bladder and the muscles around the bladder neck. Symptoms include hesitancy (difficulty starting urination), weak urinary stream, intermittent flow, straining to urinate, incomplete emptying, and a sensation of incomplete bladder emptying. Some individuals may also experience urinary incontinence or frequent urinary tract infections.

Treatment for LUTS related to BND typically involves a combination of behavioural therapies (such as pelvic floor exercises and bladder retraining), medications (such as alpha-blockers or anticholinergics), and in some cases, botulinum toxin injections or surgical procedures to relieve bladder neck obstruction.

Symptoms of “Testicular pain and the role of pelvic floor hypertonicity” and its treatment

Testicular pain can be associated with pelvic floor hypertonicity, which refers to increased muscle tension and tightness in the pelvic floor muscles. Symptoms may include testicular pain or discomfort, heavy sensation in the testicles, pelvic pain, urinary urgency or frequency, pain with urination or ejaculation, and difficulty relaxing the pelvic floor muscles.

Treatment for testicular pain related to pelvic floor hypertonicity often involves pelvic floor physical therapy, which focuses on releasing tension and improving muscle function in the pelvic floor.

Techniques such as relaxation exercises, manual therapy, biofeedback, and stretching are used to alleviate symptoms and restore proper muscle balance.

Role of physiotherapy in voiding dysfunction and incontinence management

Physiotherapy plays a crucial role in the management of voiding dysfunction and incontinence. The goal of physiotherapy is to strengthen and improve the function of the pelvic floor muscles, which are essential for bladder control. A physiotherapist specialising in pelvic health can assess the individual’s condition and develop a personalised treatment plan. This may include pelvic floor muscle exercises, biofeedback techniques, electrical stimulation, and bladder training. Physiotherapy helps individuals regain control over their bladder function, reduce incontinence episodes, and improve voiding patterns. It is a non-invasive and conservative approach that empowers individuals to actively participate in their own recovery and enhances their overall quality of life.

“Psychosomatic genital manifestation” and its treatment

Psychosomatic genital manifestation refers to the presence of physical symptoms in the genital area that are primarily driven or influenced by psychological factors. These symptoms can vary widely and may include pain, discomfort, itching, burning sensations, or alterations in genital sensation. The symptoms often persist despite medical examinations and tests showing no underlying organic cause.

Treatment for psychosomatic genital manifestation typically involves a multidisciplinary approach. It may include psychotherapy, such as cognitive-behavioural therapy or psychodynamic therapy, to address the underlying psychological factors. Additionally, stress reduction techniques, relaxation exercises, and self-care strategies may be employed. Collaboration between healthcare professionals, including psychologists, psychiatrists, and gynaecologists/urologists, is essential to ensure comprehensive and effective management of the condition.

Role of meditation in stress and anxiety reduction

Meditation plays a significant role in reducing stress and anxiety by promoting relaxation and cultivating mindfulness. Through focused attention and deep breathing, meditation helps calm the mind and activates the body’s relaxation response. Regular practice can lower stress hormone levels, reduce heart rate and blood pressure, and enhance overall well-being. By increasing self-awareness, meditation allows individuals to observe their thoughts and emotions without judgment, fostering a sense of inner peace and detachment from stressors. It also helps build resilience, improving the ability to cope with anxiety-provoking situations. Incorporating meditation into daily routines can provide a powerful tool for managing stress and anxiety, promoting mental clarity, emotional balance, and overall psychological well-being.

Symptoms of ” Renal colic due to kidney stones” and its treatment

Renal colic refers to severe pain caused by the presence of kidney stones, which are solid mineral and salt deposits that form in the kidneys. Symptoms of renal colic include sudden and intense pain in the back or side, radiating to the lower abdomen and groin. The pain may come in waves and be accompanied by nausea, vomiting, blood in urine, and increased frequency of urination.

Treatment options for renal colic due to kidney stones depend on factors such as the size and location of the stone. It may involve pain management with medications, such as nonsteroidal anti-inflammatory drugs (NSAIDs) or opioids, to relieve discomfort.

Other treatments include hydration, the use of alpha-blockers to relax the ureter and facilitate stone passage, or more invasive procedures like extracorporeal shock wave lithotripsy (ESWL), ureteroscopy, or surgery to remove or break up larger stones.

Symptoms of “Phimosis (tight foreskin)” and its treatment

Phimosis refers to a condition where the foreskin of the penis is tight and cannot be easily retracted over the glans (head of the penis). Symptoms of phimosis include difficulty or pain when retracting the foreskin, redness, swelling, and inflammation. In severe cases, it can lead to urinary problems or recurrent infections.

Treatment options for phimosis include conservative measures such as gentle stretching exercises, topical steroid creams to reduce inflammation and promote elasticity, and proper hygiene practices. In some cases, surgical interventions like circumcision or preputioplasty (a procedure to widen the foreskin opening) may be necessary.