Category: Urologist

Urologist, Andrologist

Curvature of penis (Peyronie’s disease)

Dr Varinder Attri

What is Peyronie’s disease ?

Peyronie’s disease is the fibrous scar tissue of the penis which forms as a result of prior trauma to the outer layer of erectile body tissue. This leads to the bend or curvature of the penis. Short Frenulum (Tight Frenulum, Frenulum Breve)

What are the symptoms of Peyronie disease ?

The common symptoms includes curvature of the penis on erection (upward/downward or lateral direction), difficulty getting or maintaining erection (erectile dysfunction), pain while erection, feeling of lump in the penis, shortening of penis etc. Erectile dysfunction – causes, diagnosis and treatment

What is the cause of Peyronie disease ?

The exact etiology of this condition is not known. It is the repeated prior trauma by sexual acts, accident, athletic activities etc. to the penis which leads to formation of fibrous scar after healing. This leads to bending or curvature of penis.

How this condition is diagnosed ?

Peyronie’s disease is typically diagnosed with examining the scar tissue on palpation. The degree of curvature or bending is assessed on erection. Patient can self report with pics taken at home with penis in erect state or it can be assessed at hospital setting with intracavernous injection.

What is the treatment of peyronie disease ?

There are various oral and intralesional therapies available for this conditions though the therapeutic value of each is limited. Various oral agents include tamoxifen, pentoxyphylline, Vitamin E etc. Intralesional agents are injected into the scar tissue and helps loosening the scar and its size. Various intralesional agents which are commonly used are Collagenase injection (not available in India), verapamil injection, triamcinolone etc. Despite these therapies, there are large number of patients which need surgical treatment, whic include simple plication (placing suture to the opposite side of bending), partial or complete incision or excision of scar tissue followed by grafting. Penile implant is often required in patients undergoing excision of scar tissue with grafting.

Whom to meet if suffering from peyronie disease ?

You should meet your andrologist for management of peyronie disease.

Book your appointment @drvarinderattriurologist.bussiness.site

Urologist

5 tips for healthy prostate

Dr Varinder Attri

1. Do not let your bladder to overfill than its capacity. Go to washroom when you get first urge to void. Make sure you go once in 2-3 hours in daytime.

2. Do not take excessive caffeinated products and alcohol. These can irritate your bladder and can cause frequent urination.

3. Restrict fluid intake after evening and do not take any fluid atleast 2 hours prior to sleep, so as to avoid getting up in night for passing urine. Avoid taking large quantity of water at a time.

4. Certain anti hypertensive drugs increase urine production. Such drugs to be taken in morning time. Certain medicines for cough and cold can also aggravate urination problem. Consult your doctor before starting such medicines.

5. Make a habit of doing daily exercise for 30 minutes. Sedentary lifestyle increases urinary symptoms.

Urologist, Andrologist

Erectile dysfunction – causes, diagnosis and treatment

Dr Varinder Attri

What is erectile dysfunction?

Erectile dysfunction or otherwise called impotence, is the inability of achieving or maintaining hard enough erection of penis, that is required for sexual act. Persons with erectile dysfunction have either looseness of erection or have complete lack of erection. Read how it is different from premature ejaculation Premature ejaculation- causes, diagnosis and treatment

What are the causes of erectile dysfunction?

There are numerous causes of erectile dysfunction. It can be broadly divided into – Organic and non-organic causes. Organic causes are those where there is some underlying cause which leads to erectile dysfunction and non organic causes include those where no underlying cause is found.

Organic causes – Uncontrolled long term diabetes or hypertension, heart diseases, low testosterone levels, obesity, hypothyroidism, certain blood pressure medications, hyperlipidemia, prostate enlargement, chronic kidney disease, peyronie’s disease etc.

Non-organic causes- These includes stress, anxiety, relationship problems, depression etc.

Erectile dysfunction can be caused by any one of above factors or these factors can be present together in some patients. ED patients usually also suffer from premature ejaculation.

How to diagnose erectile dysfunction?

History and examination is most important parameter in diagnosis of ED. It include detailed questionnaire pertaining to erection After history, if required doctor may order few investigations in search of underlying causes leading to erectile dysfunction. Blood tests to check for diabetes, kidney disease, hypothyroidism, hypogonadism (Testosterone and Testosterone deficiency syndrome), PSA (PSA testing) etc are done. Doctor may do oral phosphodiesterase test after giving either sildenafil or tadalafil orally and checking the erection achieved. Sometimes your doctor may order penile doppler ultrasound after applying injection in penis to check penile vessels and hardness of penis.

What are the treatment options for ED?

There are various treatment options for ED. The underlying cause need to be addressed along with the ED treatment.

Psychological counselling- Psychological counselling is done in patients with anxiety, stress or depression or patients having relationship tension.

Oral therapy – There are multiple drugs in market which are used for ED such as Sildenafil, tadalafil, avenafil etc which are usually prescribed by andrologist for ED treatment.

Intra penile injections- Sometimes doctor may prescribe you with intra-penile injection (also called Intracavernous injection). These injection therapy is more beneficial in patients which are primarily having psychogenic erectile dysfunction with failed response to oral therapy.

Vacuum erection device – These devices help in achieving erection with the help of pump action. These can be particularly useful for elderly people or patients in whom other therapies are contraindicated.

Penile prosthesis (Penile implant) – Penile implant placement is the last resort for patients with erectile dysfunction who do not respond to oral or intra cavernous injections. There are variety of penile prosthesis in market (malleable, 2 piece, 3 piece implant). These implants are placed if patient has failed other therapies mentioned above. After implant surgery, the ED patient usually have high satisfaction rate.

Which doctor to meet for treatment of ED?

You should meet your nearby andrologist for treatment of erectile dysfunction.

Urologist

Minimal invasive laser treatment for kidney stones

Dr Varinder Attri

Kidney stones are most common urological disease. Over the course of years, treatment for kidney stones has drastically improved. Open surgery for kidney stone is nearly obsolete these days after the introduction of minimal invasive surgery (PCNL).

With the recent advancement in technology, the armamentarium of the kidney stone removal have become more sophisticated and kidney stone removal can be done with minimal invasive approaches. Laser treatment in stone disease has shifted the paradigm of stone treatment. The patients experience much better outcome in terms of post operative pain, minimal risk of bleeding with early recovery and resumption to work.

RIRS (retro grade intrarenal surgery) and mini PCNL are being performed regular basis at our Sacred Heart Hospital, Maqsudan, Jalandhar. Currently we are using Holmium laser for the stone fragmentation and dusting. Here are few of the kidney stones done recently with mini PCNL and RIRS laser lithotripsy with complete stone free rates.

Book your appointment today or visit us if looking for laser treatment of stone disease.

Uro-oncology, Urologist

Bladder cancer awareness month 2022

Dr Varinder Attri

‘ Blood in urine is ominous sign.’

Bladder cancer is 10th most commonly diagnosed cancer. Nearly 570,000 cases of bladder cancer are diagnosed annually worldwide. Majority of these patients present with blood in urine at the initial presentation. Smokers have higher risk of being diagnosed with bladder cancer than non- smokers.

Gross, Painless passage of blood along with clots in urine could be early symptom of bladder cancer.

Bladder cancer awareness month is a global campaign and is held every year in month of May to create attention regarding the bladder cancer, its symptoms and signs, to underline the importance of early detection and treatment, share the treatment stories of patients and to improve the quality of life of patients.

Smoking is the single most common preventable cause of bladder cancer.

Any person passing blood in urine should immediately get him/herself tested to a urologist. Early detection of bladder cancer or any other urological cancer leads to better survival and outcome.

Bladder cancer awareness month (1st-31st May)