Kidney Disease and Urology

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• QHow can I slow kidney disease caused by diabetes?

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  A National Kidney Foundation answered

  As your kidneys fail, your blood urea nitrogen (BUN) and blood creatinine levels will rise. You may also experience nausea, vomiting a loss of appetite, weakness, increased fatigue, itching, muscle cramps (especially in your legs) and anemia (a low blood count). You may find you need less insulin if you have diabetes. This is because diseased kidneys cause less breakdown of insulin. If you develop any of these signs, call your doctor.

  There are a number of things you can do if your kidneys are damaged and you have diabetes. First, the doctor needs to find out if your diabetes has caused the injury. Other diseases can also cause kidney damage. Your kidneys will work better and last longer if you:

  • Control your diabetes
  • Control high blood pressure
  • Get treatment for urinary tract infections
  • Correct any problems in your urinary system
  • Avoid any medicines that may damage the kidneys (especially over-the-counter pain medications)

  If no other problems are found, your doctor will try to keep your kidneys working as long as possible. The use of high blood pressure medicines called angiotensin converting enzyme (ACE) inhibitors has been shown to help slow the loss of kidney function.

  The kidney doctor, called a nephrologist, will plan your treatment with you, your family and your dietitian. Two things to keep in mind for keeping your kidneys healthy are controlling high blood pressure in conjunction with an ACE inhibitor and following your renal/diabetic diet. Restricting protein in your diet also might be helpful. You and your dietitian can plan your diet together.

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• QWhat can I do to prevent kidney damage from diabetes from getting worse?

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  A National Kidney Foundation answered

  If you have diabetes, it may be possible to prevent or delay the progression of kidney disease. It is important to control your blood sugar by following your diabetic diet and taking all your prescribed medication. Additionally, since high blood pressure is one of the major reasons diabetics will develop kidney disease, it is important to control blood pressure and take prescribed blood pressure medications.

  Your doctor may also recommend that you follow a low-protein diet, which reduces the amount of work your kidneys have to do.

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• QWhat is diabetes insipidus?

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  A American Diabetes Association answered

  Diabetes insipidus is a condition characterized by frequent and heavy urination, excessive thirst and an overall feeling of weakness. This condition may be caused by a defect in the pituitary gland or in the kidney. In diabetes insipidus, blood glucose levels are normal.

• QHow can kidney problems caused by diabetes affect my daily life?

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  A American Diabetes Association answered

  Serious kidney problems can bring many changes in your day-to-day life: how you feel, what you do every day, and how you take care of your diabetes.

  • Your schedule: If you choose hemodialysis, you'll be at the dialysis center three times a week for 3 to 5 hours at a time. While you're attached to the dialysis machine, you can read, sleep, or work. If you've chosen peritoneal dialysis, done at home, you'll still be on a schedule but you'll be able to move about and do your usual activities during the dialysis process. Some people do peritoneal dialysis overnight, while they're sleeping.
  • Your food and beverages: It's likely that your meal plan will change, depending on what type of dialysis you've selected. Because waste products can build up in the blood between dialysis sessions, you'll need a special diet to stay healthy. A dietitian will help you make a meal plan that provides optimal amounts of minerals (such as phosphorus, potassium, and sodium), fluids, and protein, based on your needs. If you're planning to get a transplant, you'll have different dietary needs.
  • Your physical activity: You can still benefit from physical activity, even with serious kidney problems. However, you'll want to talk with your health care team about what activities are best for you and when to do them.
  • Your diabetes care: Serious kidney disease can lead to changes in how you manage your diabetes. Because of changes in your blood, the results of your A1C may not be reliable.

  If you take insulin by injection, you may be at risk for low blood glucose (hypoglycemia). This can happen because part of insulin is broken down by the kidney. If your kidneys aren't working, the way your body processes insulin can become unpredictable. This can also happen with certain diabetes pills. Your health care team can advise you on how to avoid low blood glucose by adjusting your dosage of diabetes medication.

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• QWhat is a varicocele embolization?

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  A Dr. John C. Lipman, MD , Vascular & Interventional Radiology, answered

  Varicocele embolization is a non-surgical procedure performed by an Interventional Radiologist (IR). It is an outpatient procedure performed under local anesthesia, thus avoiding the risks and complications from surgery and general anesthesia. A tiny catheter is placed in to a vein of the right neck or right groin and advanced under x-ray guidance in to the spermatic vein on the side of the varicocele (typically left but can be both). A contrast injection (venogram) is obtained during a Valsalva (bearing down) maneuver to document the reflux of contrast down the incompetent spermatic vein to the scrotum. It also depicts the collateral channels that may be present, and is the reason why the embolization procedure has a lower recurrence rate compared with traditional surgery (i.e. these collaterals cannot be seen during the surgery). Either a series of metallic coils or a sandwich of coils surrounding an injection of a sclerosant is used to close the spermatic vein as well as any collateral channels. 
• QHow are varicoceles treated?

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  A NewYork-Presbyterian Hospital answered

  The most common form of treatment for varicoceles is varicocelectomy, which is the removal of the veins that are widened. In this technique, a surgeon will make a cut in the groin (transinguinal), abdomen (retroperitoneal), or area below the groin(infrainguinal/infrapubic) and remove the problematic veins. The surgeon will then redirect the blood flow to other veins in the area. This is usually an outpatient procedure.
  A microscopic approach, known as microsurgical varicocelectomy, is also available. This technique involves use of a microscope to help a surgeon find the veins that need to be removed while preserving the tiny arteries that bring blood to the testes. Magnification also allows identification and preservation of the lymphatics, the vessels that drain fluid from the space between the testes and the surrounding sac. This is believed to reduce the risk of hydrocele (an accumulation of fluid around the testis) after surgery. Microsurgical varicocelectomy is done through tiny cuts (one inch or less) in the skin typically as an outpatient procedure.
  An alternate technique is called an embolization, which involves insertion of a small tube inserted into a vein in the neck or groin that reaches down to the dilated veins. A coil or balloon is then passed through the tube and is placed in the enlarged veins to block them. The blood from the testes then drain through smaller veins in the surrounding area.

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• QCan kidney cysts be treated with surgery?

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  A Dr. Timothy H. Atkinson, MD , Urology, answered on behalf of Frankfort Regional Medical Center

  

  If there's potential for cancer or they're particularly sizeable, kidney cysts can be treated with surgery, says Timothy Atkinson, MD, from Frankfort Regional Medical Center. Watch him describe why surgery is the best option in this short video.

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• QWhat causes hematuria?

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  A Dr. Jill Rabin , OBGYN (Obstetrics & Gynecology), answered

  Hematuria, or blood in the urine, almost always indicates an abnormality, unless atrophic vaginitis and cystitis (thinning of the vaginal and bladder tissues due to a lack of estrogen) is the culprit, or unless menstrual blood happens to accidentally get into the urine. Hematuria is generally caused by a bladder infection and is easily cured with the proper dosage of antibiotics.

  Blood in the urine, however, may also indicate more severe problems, such as bladder cancer or kidney cancer. If you suspect blood in your urine, see a doctor immediately.

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• QWhat is urethritis?

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  A RealAge answered

  Urethritis is an infection that causes swelling and irritation of the urethra, the small tube that carries urine from your bladder out of your body. In men, the urethra also carries semen. Urethritis can be caused by infection with bacteria or viruses, including those that cause sexually transmitted diseases (chlamydia, gonorrhea, syphilis, HIV/AIDS, herpes simplex). In women, it can also be caused by bruising during sexual intercourse.
  
  Symptoms of urethritis in both men and women may include:

  • burning or pain during urination
  • frequent or urgent urination
  • pain with intercourse
  • fever

  Additional symptoms in men may include:

  • pus or white discharge from the penis
  • itching, tenderness or swelling in the penis
  • swelling in the lymph nodes of the groin area
  • pain with ejaculation

  Additional symptoms in women may include:

  • abdominal pain
  • unusual vaginal discharge

  Urethritis can often be treated successfully with antibiotics and by avoiding sexual contact until the infection has cleared completely.

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• QHow is urethritis treated?

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  A Dr. Kyle K. Himsl, MD , Urology, answered on behalf of Los Robles Regional Medical Center

  

  Depending on the cause, urethritis may be treated with antibiotics or pain medications. Watch this video with urologist Kyle Himsl, MD from Los Robles Hospital & Medical Center to learn more.