DEPARTMENT OF URO GYNECOLOGY

CENTURY HOSPITAL

CENTURY HOSPITAL





 


Dr. Lalitha


MBBS, MD (Gynaecology) and Mch (Urology)


Dr. Lalitha has done her M.B.B.S. from kakatiya medical college from where she has passed out as the 'best outgoing student in the year 1987 with 10 gold medals in M.B.B.S


She Obtained Second Rank In Andhra Pradesh State Postgraduate Medical Entrance


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This affects millions of women in our country, BUT ONLY FEW OF THEM CONSULT A DOCTOR BECAUSE OF THE EMBARASSMENT OF BEING EXAMINED BY A MALE UROLOGIST.


Incontinence can seriously impair the quality of life of these women as they can leak urine while coughing, sneezing, sometimes on the way to the toilet before they could reach it.We do complete evaluation of these women by clinical and urodynamic investigations and offer a wide range of treatment options like medical or surgical based on the individual needs.


Dr.Lalitha is one of the first few urogynecologists in India to perform minimally invasive surgery for Stress Urinary Incontinence called TVT AND TVT-O.


URINARY INFECTIONS




  • Infections are common in women of all ages starting from young girls to newly married [HONEYMOON CYSTITIS] to elderly postmenopausal women.

  • In each group the cause may be different and requires thorough examination.

  • Some women also suffer from TUBERCULOSIS of urinary tract.



UROLOGICAL PROBLEMS IN PREGNANCY




  • Urinary infections during pregnancy may lead to abortions and preterm labour if not promptly treated.

  • Sometimes during pregnancy,there may be swelling of the kidneys called HYDRONEPHROSIS.

  • This could be because of stones or compression of ureter by enlarging uterus. In majority of patients this is managed conservatively but sometimes these women may require ENDOSCOPIC STENTING.

  • Dr. LALITHA BEING A GYNECOLOGIST AND UROLOGIST ,she would work in the best interest of a pregnant woman suffering from any urological problem.



KIDNEY STONES




  • Women may suffer from stones in kidney, ureter or bladder.

  • Dr.LALITHAis well versed with all ENDO-UROLOGICAL AND MINIMALLY INVASIVE procedures for stone removal including LITHOTRIPSY.



TUMORS IN KIDNEY AND BLADDER




  • Some of these women present with passage of blood in urine.

  • Bladder tumors can be removed by endoscopic method.



INTERSTITIAL CYSTITIS : (PAINFUL BLADDER)




  • This can severely impair a woman's quality of life.

  • This condition requires a thorough evaluation to rule out all other gynecological and urological causes and may require a cystoscopy [endoscopy for bladder]and biopsy.



OVERACTIVE BLADDER




  • Women with this problem will have increased frequency of urination and urgency and sometimes leak urine on the way to the toilet.

  • Many of these women respond to drugs.



PROLAPSE OF PELVIC ORGANS-CYSTOCELE-VAULT PROLAPSE




  • Some of these women require a combined approach by a gynecologist and urologist and Dr. Lalitha being a UROGYNECOLOGIST IS BETTER EQUIPPED TO DEAL WITH SUCH CASES.



VESICO-VAGINAL AND URETERO-VAGINAL FISTULA




  • Sometimes after difficult gynecological surgery there can be injury to bladder and ureter.

  • These women will have continuous leakage of urine.

  • These women need reconstructive surgey by a urologist.



FEMALE SEXUAL DYSFUNCTION




  • Women with sexual problems would definitely feel more comfortable discussing their problem with A LADY UROLOGIST AND UROGYNECOLOGIST.


"Female Urology or Urogynecology is a subspeciality in urology which deals with lower urinary tract problems and pelvic floor dysfunction in women. The field of urogynecology in India is still in its infancy and the awareness among the general public about female urology services is very low.


What are the common services offered by a urogynecologist?


TREATMENT OF URINARY INCONTINENCE


Millions of women in our country suffer from urinary incontinence in silence because they are not aware of the availability of treatment by a specialist dedicated to treat this problem. Many of these women don't like to consult a male urologist as they feel embarassed to discuss this problem with them.


URINARY INCONTINENCE may be of different types




  • URGE INCONTINENCE is generally treated with medicines.

  • STRESS URINARY INCONTINENCE may respond to pelvic floor muscle training in mild cases but in several cases it requires surgical treatment like mid-urethral slings [TVT/TOT].

  • TOTAL INCONTINENCE occurs due to surgical injury to bladder or ureter during gynecological surgery and requires surgical repair.

  • PELVIC ORGAN PROLAPSE & VAULT PROLAPSE wherein the uterus or the vaginal vault protrude through vaginal introitus also require the expertise of specialist trained in urology and gynecology.



RECURRENT URINARY TRACT INFECTIONS INCLUDING GENITO URINARY TUBERCULOSIS IS ANOTHER COMMON UROLOGICAL PROBLEM IN WOMEN.


UROLOGICAL PROBLEMS DURING PREGNANCY ESPECIALLY URINARY INFECTIONS AND HYDRONEPHROSIS DURING PREGNANCY WILL REQUIRE SPECIAL CARE BY A UROLOGIST AND GYNECOLOGIST.

URINARY STONES


URINARY STONE DISEASE is a very common problem in our country. Urinary stones can be seen in all age groups, though it is more common in adults than in children. It is more common in men than in women though changing lifestyles have narrowed down this difference in incidence.


URINARY STONES CAN BE OF DIFFERENT TYPES


Calcium Oxalate, Calcium Phosphate, Uric Acid, Cystine, Triple Phosphate are the common types. Stones can be found in theKIDNEY, URETER(tube which carries urine from kidney to the bladder) or BLADDER itself.


CAUSES OF STONE FORMATION


The most common cause for formation of urinary stones is not drinking adequate water. This along with excessive perspiration in tropical countries makes the urine saturated with various crystals which eventually develop into a stone. Due to this reason stones are seen more commonly in summer.


Another common cause of urinary stone formation is taking diet rich in calcium (like milk and milk products) or oxalates (certain green leafy vegetables, soft drinks like cola) or purine rich diet (non-vegetarian diet).


Changing life-styles and westernization of eating habits like consuming lot of aerated soft drinks and eating fast foods like pizzas and burgers have definitely increased the incidence of stones.


Treatment of URINARY CALCULI


MEDICAL TREATMENT


MINIMALLY INVASIVE SURGERY like URS, PCNL, ESWL, LASER, LAPAROSCOPY based on the size, site and nature of the stone.


PROSTATE ENLARGEMENT


This is seen in men usually over 50 years of age. Patients suffering from this problem may have various symptoms like increased frequency of urination in both day and night, urgency, hesitancy, thin stream,straining to pass urine, sense of incomplete voiding and sometimes passing blood in urine or even sudden retention of urine.


TYPES OF PROSTATIC ENLARGEMENT




  • BENIGN ( NON-MALIGNANT)

  • CARCINOMA OF PROSTATE



TREATMENT


For benign enlargement of prostate there are a wide variety of DRUGS. Some patients require endoscopic resection of prostate, like TURP, LASER PROSTATECTOMY.


For CANCER PROSTATE, treatment is surgical in early stages and in delayed cases either hormonal,radiotherapy or chemotherapy may be required.


PEDIATRIC UROLOGY


Some congenital anomalies can cause urological problems requiring surgical intervention in infants and children.


PUJ OBSTRUCTION requires PYELOPLASTY operation.


VESICO-URETERIC REFLUX requires URETERIC REIMPLANTATION.


POSTERIOR URETHRAL VALVES requires VALVE FULGURATION.


MULTICYSTIC DYSPLASTIC KIDNEY.


LAPAROSCOPIC UROLOGY


Some urological procedures can be done by minimally invasive (key-hole) method.


LAPAROSCOPIC URETEROLITHOTOMY,LAPAROSCOPIC PYELOLITHOTOMY, LAPAROSCOPIC GUIDED PCNL FOR PELVIC KIDNEY,LAPAROSCOPIC NEPHRECTOM.


ANDROLOGY &MALE INFERTILITY


Male infertility and sexual dysfunction like impotence and premature ejaculation are evaluated and treated by a urologist and andrologist.


RENAL TRANSPLANT


For patients with renal failure due to end stage renal disease renal transplant is offered.

Urinary incontinence is the most common urological problem in women. It affects almost 50% of the women over the age of 40 years. But only 10% of these women seek medical advice because many of these women with incontinence, especially in a conservative e country like ours feel embarrassed to discuss this problem with their doctors or even with their family members.


Incontinence can affect every sphere of a woman's life, be it social, occupational, domestic, marital or even spiritual life. Women with severe incontinence do not like to attend any social gatherings because they live in a constant fear of wetting their clothes in public.


Working women with this problem really find it difficult to cope up and some of them may even quit their jobs.


Not only working women, even housewives find it difficult to do their routine activity as any act of bending or lifting any object from the floor can cause urine leak.


Sometimes urine leak may follow sexual intercourse in those with coital incontinence.


When these women want to find some solace in spiritual life the poor women start leaking urine as soon as they kneel down to offer prayers and in many religions it is not acceptable to offer prayers when the clothes are soaked in urine. Finally these women go into depression, suffer in silence and may even seek a psychiatrist's help.


Thus a seemingly trivial problem like incontinence can devastate a woman's life.


Incontinence may be different types.


The most common type is stress urinary incontinence which means leakage of urine during coughing, sneezing, laughing or lifting objects. Many of these women releif with kegel's exercises.


Some women may have urge incontinence which is most often cured with drugs.


Early medical advice and treatment will go a long way in bringing a smile back on these women who otherwise may suffer in silence.