Urology - Best Private Hospital in Dubai Al Mankhool | IMH Dubai

It Is Good To “Hydrate Wisely” for Healthy Kidneys.

Keep your kidneys healthy by taking adequate amount of liquids. This means drinking the right amount of water for you. A common misconception is that everyone should drink eight glasses of water per day, but since everyone is different, daily water needs will vary by person. How much water you need is based on differences in age, climate, exercise intensity, as well as states of pregnancy, breastfeeding, and illness.

About 60-70% of your body weight is made up of water, and every part of your body needs it to function properly. Water helps the kidneys remove wastes from your blood in the form of urine. Water also helps keep your blood vessels open so that blood can travel freely to your kidneys, and deliver essential nutrients to them. But if you become dehydrated, then it is more difficult for this delivery system to work. Mild dehydration can make you feel tired, and can impair normal bodily functions. Severe dehydration can lead to kidney damage, so it is important to drink enough when you work or exercise very hard, and especially in warm and humid weather.

Here are 6 tips to make sure you’re drinking enough water and to keep your kidneys healthy:

  1. Eight is great, but not for all. There is no rule that everyone needs at least 8 glasses of water a day. This is just a general recommendation, because we continually lose water from our bodies, and that we need adequate water intake to survive. It is estimated that men need approximately 13 cups (3 liters) of fluid daily, and that women need approximately 9 cups (2.2 liters) of fluid daily on an average.

  2. Less is wise, if you have kidney failure (end stage kidney disease). When the kidneys fail, people don’t excrete enough water, if any at all. For those who are receiving dialysis treatment, water must actually be strictly controlled.

  3. It’s possible to drink lots of water. hydrate_for_healthy_kidneyAthletes and sportsmen / sportswomen may drink large amounts of water and thereby dilute the sodium level in their blood, resulting in a dangerous condition called hyponatremia which may even cause rapid brain damage.

  4. Your urine says it all. Drinking enough water or other healthy fluids, such as unsweetened juice or low fat milk to quench thirst will keep your urine light yellow or colorless. When your urine is dark yellow, this indicates that you are dehydrated. In the ,idle east, especially in hot and humid conditions, one should be making at least 2 liters of urine daily.

  5. H2O helps prevent kidney stones and UTIs. Kidney stones and urinary tract infections (UTIs) are two common medical conditions that can hurt the kidneys, and for which good hydration is very much essential. Kidney stones form less easily when there is sufficient water available to prevent stone-forming crystals from sticking together. Water helps dissolve the antibiotics used to treat urinary tract infections, making them more effective. Drinking enough water also helps produce more urine, which helps to flush out infection-causing bacteria.

  6. Beware of medications. Drinking extra water with certain medications or before and after procedures with contrast dye may help prevent kidney damage. Read medication labels and ask questions before undergoing medical procedures involving contrast dyes. Always consult with your healthcare provider first though, especially if you are on a fluid restriction.

Self-Examination.. an easy tool for early detection of testicular cancer

Testicular cancer is the most common cancer for men aged between 15 and 45 Fortunately, it’s one of the most treatable cancers and with good survival rates. The incidences of testicular cancers are increasing in incidence worldwide. It is important to identify testicular cancer early to improve the chances for successful treatment.

This cancer may not cause noticeable symptoms until a late stage. That is why self-examination is so important – it is often the only way to catch testicular cancer at an early stage .

The most common symptom is

  • a painless lump
  • swelling appearing on the testicles.


Until proven otherwise, any lump or firm part of the testicle should be considered a potential tumor. The testicle may also seem to be larger than usual. Other symptoms include a dull ache or a feeling of heaviness in the scrotum. Unfortunately, it is common for men not to reveal about these signs for up to an average of 5 months. Since the tumor can spread during that time, it is vital to reach out to your doctor right away.


The factors that increase the risk of testicular cancers are

  • Undescended testicles
  • Family history
  • previous history of testicular cancer


Men with undescended testicles are about three times more likely to develop testicular cancer than men whose testicles descend at birth or shortly after. Generally men are unaware about the disease and they have a psychological inhibition for self-examination. Monthly testicular self-examination helps us to Identify changes in testicle early and should be done after a warm shower,when the skin of the scrotum is relaxed. Stand in front of the mirror and look for any swelling on the skin of the scrotum and then examine each testicle separately.

Hold your testicle between your thumbs and fingers and roll it gently between your fingers.

Look and feel for any hard lumps or nodules or any change in the size,shape, or consistency of your testicles.
It’s normal for one testicle to be slightly larger than the other, and for one to hang lower than the other. If you have any concerns, get an expert opinion from your specialist.

Testicular cancer is diagnosed by

  • the physical examination
  • ultrasound
  • blood tests that measure tumor markers.


Surgical removal of the involved testicle is the first line of treatment followed by chemotherapy and radiotherapy depending on the stage of the disease. Around 95 % of all men with testicular cancer make a full
recovery after receiving treatment. Testicular cancer treatment can cause infertility. Patients may consider sperm banking (freezing sperm and storing it) if they want children after their testicular cancer treatment. Other
side effects are due to radiation and chemotherapy.

Follow-up is necessary because testicular cancer may recur. Follow-up treatment involves regular tumour marker blood tests and possibly CT scans.A quantitative study conducted in the UAE in efforts to test the level of awareness regarding general knowledge on testicular cancer and self- examination practices among residents revealed that nearly 50% either never or rarely self-examined. This study suggested that the general public in the region currently possesses little information regarding the symptoms, risk groups and self-examination practices Monthly testicular self-examination is a good tool to pick up changes in testicle early and thus detecting cancer in the initial stage. Programs for improving the level of awareness regarding the disease and importance of testicular self-examination is highly recommended.


Dr. Shameer Hameed

MBBS, MS (General Surgery), DIP. LAP, MCh (Urology) FECSM (Sexual Medicine)

Specialist Urologist writes in Khaleej times and now available in our blog.


testicular cancer
testicular cancer

Diseases of the Prostate Gland

What is prostate gland and where is it located?

Prostate gland is a male reproductive organ which secretes prostate fluid in semen. Muscles of the prostate help to propel seminal fluid into the urethra during ejaculation. It is situated just below the bladder, allowing passage of first part of urine tube through it to the outside. It is protected by the pelvic bone all around and is accessible for examination to the doctor through the rectum.

What are the common medical problems affecting the prostate?

Two most common and important medical conditions involving the prostate gland are non-cancerous enlargement of the prostatecausing obstruction to urine flow and cancer of the prostate gland.
Prostate enlargement happens to almost all men as they get older. As the gland grows, it can press on the urethra and cause urination and bladder problems. An enlarged prostate is often called benign prostatic hyperplasia (BPH).
This is a disease of aging men and normally seen above 50 years of age. Not all prostate enlargement needs to be treated; the best outcome of treatment occurs in patients who have definite obstruction to urine flow. Medical treatment for prostate is quite effective although it needs to be taken long term and a fifth of patients on medical treatment can have side-effects.Prostate-Gland Surgical treatment of prostate enlargement is one of the most commonly performed operations in urology and is quite effective. Of course, as in any operation, there are side effects; but incidence of major side-effects in good hands are negligible. Moreover, this is an endoscopic operation without making any cuts in the body and has very short hospital stay, the added advantage being avoidance of side-effects due to medications.

Cancer of the prostate is a widespread problem in the aging population world-wide. The number of new cases of prostate cancer was 119.8 per 100,000 men per year in the united states with number of deaths at 20.1 per 100,000 men per year. There are three well-established risk factors for prostate cancer: increasing age, ethnic origin, and genetic predisposition.A hospital based survey carried out in 2003 in the UAE reported low incidence of prostate cancer,with annual incidence of prostate cancer estimated at 4.5/100,000 male population. Majority of patients (77.7%) presenting with advanced disease. This clearly indicates that in population based study in the UAE, one would expect higher incidence of prostate cancer. Screening for prostate cancer would surely lead to diagnosis of prostate cancer in early stages, and therefore, readily amenable for curative treatment. Screening for prostate cancer is known to reduce deaths due to prostate cancer, and should be strongly pursued. A 2015 study by Health Authority Abu Dhabi revealed that Prostate cancer is 4th most prevalent cancer in adult men in UAE. Screening PSA and digital rectal examination by the urologist in men above 50 years of age, or younger if risk factors are present, is recommended. Persons with raised PSA and/or abnormal prostate on palpation should undergo multiparametric MRI and systematic/targeted biopsy of the prostate. Prostate cancer can then be risk-categorized into low, intermediate and high-risk categories. Unlike other cancers, prostate cancer is relatively slow growing disease and readily treatable with surgery, radiation therapy, hormonal therapy and chemotherapy agents. In certain low risk prostate cancers, treatment is not indicated immediately, and patients are put on active surveillance. Organ confined prostate cancers of intermediate and high-risk category should be treated with surgery or external beam radiotherapy with curative intent. Adjuvant or neo-adjuvant treatment may be necessary based upon results of various other test results such as final biopsy.

Surgical removal of the prostate can be accomplished through open or key-hole surgery. Advantage of key-hole surgery is clearly apparent with shorter hospitalization and early discharge from the hospital with indwelling catheter for 2 weeks.

Once prostate cancer has spread beyond the confines of the prostate and regional lymph glands, control and not cure would be the goal of management. Even so, prostate cancer is highly responsive to hormonal treatment, although duration of remission is variable. When castration resistant prostate cancer has spread to various partsof the body, survival can further be improved in this group of patients, by use of new androgen receptor signalling inhibitor and chemotherapy.

In summary, early diagnosis is the key to survival benefits in prostate cancer. As far as proper balance can be maintained between benefits versus unnecessary overtreatment by adhering to guidelines and protocols, medical fraternity will go a long way in improving men’s health in this group of patients. As Eleanor Roosevelt put it – Yesterday is history, Tomorrow is mystery, Today is a gift –So, get screened for prostate cancer.

Chronic Kidney Disease (CKD)

Chronic kidney disease (CKD) is a condition characterized by a gradual loss of kidney function over time. The term chronic is used to refer to a condition which is permanent and irreversible. In addition, it progressively worsens even with treatment. This will eventually, over a period of time lead to need for dialysis or renal transplantation.
This is associated with complications such as high blood pressure, weak bones, low blood dialysis-access-management-the-miller-procedure-for-steal-syndromeDialysis-Treatment    hemoglobin and cardiac and nerve and brain damages.
Causes of Chronic Kidney Disease
The two main causes of chronic kidney disease are Diabetes mellitus and High blood pressure. These two diseases together are responsible for up to two-thirds of the cases.
High blood pressure, if uncontrolled, or poorly controlled, can be a leading cause of heart attacks, strokes and chronic kidney disease. Also, chronic kidney disease can cause high blood pressure.
Several other conditions can cause chronic kidney disease.
• Glomerulonephritis:A group of diseases that cause inflammation and damage to the kidney’s filtering units. These are unique diseases which generally affect the kidneys primarily and as a result of kidney damage can cause damage to other organs of the body. These disorders are the third most common type of kidney disease.
• Polycystic kidney disease An Inherited diseases, which causes large cysts to form in the kidneys and damage the surrounding tissue.
• Malformations and developmental abnormalities that occur during intrauterine development.
• Systemic lupus erythematosos and other diseases that affect the body’s immune system.
• Obstructions to urine flowcaused by problems like kidney stones, tumors or an enlarged prostate gland in men.
• Repeated urinary infections.
Most people may not have any symptoms until their kidney disease is advanced. However, the following symptoms occur as the disease progresses.
Tiredness and feeling less energetic in day to day activities; have trouble concentrating have a poor appetite and have difficulty in sleeping. These are non-specific symptoms and occur very slowly and are difficult to recognize in the beginning.
In addition patient may also have certain specific symptoms like swelling in the feet, and puffiness of the face especially around the eyes more so in the morning. Decrease in urination sometimes associated with the need to urinate more often at night occurs.
In severe cases and advanced renal failure patients have breathing difficulty, headache, convulsions, visual disturbances, and loss of consciousness. This warrants emergency treatment.
Detection of chronic kidney disease: Important tests of kidney function.
The earlier kidney disease is detected, the better the chance of slowing or stopping its progression.
Blood Urea Nitrogen: This is a chemical which accumulates in the body during day to day activities. It is normally excreted by the kidney and it accumulates in the blood in patients in whom the kidney function is reduced.
Serum Creatinine: this is also a waste material which accumulates in the body and if not cleared by the kidneys its blood levels raise. A raised blood urea and creatinine levels generally indicate kidney failure; however the values need to be interpreted taking in to account several other variables. Generally both blood urea and serum creatinine levels are to be considered.
If these tests are abnormal then several other chemicals in the body need to be measured to decide on the severity of the disease and to guide the treatment.
It is important to note that these tests indicate the severity of the disease and cannot confirm whether the disease is reversible or permanent.To decide if the damage is permanent or reversible renal scan is necessary
Ultra sound scan or CT scan of the kidneys will give information regarding the size of the kidneys and presence or absence of obstruction
In patients with Chronic kidney disease the kidney size is usually reduced to less than 9cms which is the normal size. In addition the appearance of the kidneys in the scan also is abnormal.
Kidney Biopsy:
In some patients if the kidney size is normal taking a small bit of kidney tissue though a needle and studying the microscopic structure may be necessary
Additional tests may be necessary to detect the complications or response to treatment measures.
Salient points:
Early detection can help prevent the progression of kidney disease to kidney failure.
Heart disease is the major cause of death for all people with Chronic kidney disease.
Hypertension can causechronic kidney disease and chronic kidney disease can cause hypertension
Persistent proteinuria (protein in the urine) means Chronic kidney disease is present and may in some cases lead to kidney failure.
High risk groups include those with diabetes, hypertension and family history of kidney failure.
Two simple tests can detect Chronic kidney disease: blood pressure, urine albumin and serum creatinine.
Treatment options

These include the following:
Supportive treatment in the early stages:
Renal replacement therapy when the disease is advanced:
Supportive treatment:
This is started when the patient has kidney failure but the degree of failure is not severe and the patient can be managed with medications and diet.
The aim of therapy is to
1. Control the symptoms
2. To delay the progression of kidney failure
3. To prepare the patient for eventual dialysis support.
Control of Symptoms:
These include medication to control blood pressure, blood sugars in patients with diabetes, and some medications to alleviate the problems due to alterations in electrolytes, water content of the body and the bone minerals. With strict control of blood pressure the progression of kidney failure can be significantly slowed down.
Salt restriction:to control blood pressure and fluid accumulation in the body.
Fluid restriction: to control swelling and fluid accumulation
Low protein: Protein in the diet acts as an additional burden on the already malfunctioning kidneys. Moderate reduction in dietary protein intake is known to reduce the progression of the kidney failure.
Fruits; generally fruits are very rich in a mineral called potassium. This is normally excreted only through the kidneys. In conditions where kidneys are unable work normally potassium accumulates in the body. High blood potassium levels are harmful to the heart and require urgent treatment.
Dietary advice from an experienced dietician is very helpful.
Renal Replacement therapy:
There are two treatment options for kidney failure:
Dialysis (hemodialysis or peritoneal dialysis) and kidney transplantation
Briefly Dialysis means removing the waste products from the blood periodically with the help of an artificial kidney or the patient’s own abdominal membrane.
Transplantation involves placing a normal kidney surgically from a donor either living or cadaver.

Hemodialysis is a treatment that removes wastes and extra fluid from the blood.During hemodialysis, the blood is pumped through soft tubes to a dialysis machine where it goes through a special filter called a dialyzer (also called an artificial kidney). After the blood is filtered, it is returned to the bloodstream.-peritoneal-dialysis-catheter
Dialysis is necessary if the kidneys no longer remove enough wastes and fluid from your blood to keep the body healthy. This usually happens when there is only 10 to 15 percent of kidney function left. The patient usually has severe symptoms such as nausea, vomiting, swelling and fatigue. However, one can still have a high level of wastes in the blood that may be toxic to the body and yet have minimal symptoms. Your doctor is the best person to tell you when you should start dialysis.
Blood is removed from the body using needles placed in the veins or through tubes inserted in to major veins. This is called dialysis access
For the peripheral veins to give good amount of blood for cleaning a small surgery to connect the vein to the artery is required. This needs to be done several weeks before dialysis is anticipated.
Dialysis is generally required 3 times a week each time lasting for 4-5 hours. This can be done as an outpatient procedure and the patients usually can get back to work after the session is over. Blood tests are done monthly to assess the adequacy of dialysis.
Peritoneal dialysis:
In this process a small soft rubber tube is placed in the abdomen and once the wound heals sterile fluid can be instilled in to the abdominal cavity through this tube. The fluid is left in place for 3-4 hours and during this time it takes up the waste material from the blood and it can then be removed through the same tube. This is called one exchange. Usually 3-4 exchanges are required daily and the patient is trained to do the same at home. The quality of dialysis is assessed monthly by the Nephrologist.
Renal Transplantation:
This is the most physiological way of replacing the kidney function. It involves placing a new kidney in the patient’s body usually the lower abdomen. The kidney can be donated by a close relative or it can also be from a brain dead person. The donor and recipient pair undergo a series of tests to confirm mutual compatibility and matching. The recipient will require medications life long and close and frequent monitoring.

Don’t Procrastinate with Pelvic Pain

If you have recurring pain in your pelvis or bladder, you probably don’t think “interstitial cystitis.” It’s a long name for a condition that can be difficult to diagnose because it can have multiple, interrelated causes.

Interstitial cystitis, or “IC,” is a chronic health issue in which patients feel pain or pressure in the bladder area. An estimated 4 million people in the U.S. suffer from IC, approximately 80 percent of them female.

Pelvic Pain Women

Several different conditions – or combinations of conditions – can cause IC. That’s why it’s important to consult with your physician if you’re experiencing pelvic pain. A proper diagnosis may require time and you don’t want to suffer any longer than necessary.

To further complicate the diagnosis, symptoms range from mild to severe and vary from person to person. Any of the following could indicate IC:

  • Pain ranging from ‘nagging’ to ‘intense’ in the bladder and surrounding pelvic region
  • A sense of urgency and/or increased frequency of urination
  • Pain that worsens during menstruation
  • Painful sexual intercourse for women
  • Pain or discomfort in the scrotum or penis
Pelvic Pain Man

For many, IC feels like a bladder infection, though antibiotics make no impact because there’s no infection to treat. The exact cause of pain with IC is actually not clear, but several theories exist. These range from an allergic response to autoimmune reaction to an excessive inflammatory response to even the slightest stimulus which would not generally be perceived as painful in a patient who does not have IC.

IC can frustrate patients because besides a challenging diagnosis, not everyone responds the same way to the same treatment. In addition, IC treatments can take several weeks to several months to provide relief.

If you suffer from pelvic pain, begin with an open discussion with your physician. Whether or not you are diagnosed with IC, you can start to work toward solutions to your condition. Treatment options, such as pharmaceuticals, nerve stimulations or surgery can be evaluated and your doctor can help you decide on the appropriate approach for you.