Diseases & Conditions Blog

Fibroid tumors of the uterus are tumors of muscle and connective tissues. They constitute the most common type of pelvic tumor, occurring in about 20 per cent of women of 35 years of age or older. They are characteristic of sexual maturity. The vast majority of them occur in middle life, commonly in the third, fourth and fifth decades.

Fibroids may be as small as a garden pea or as large as a full term pregnancy, although huge sizes are rarely seen today because the growths are usually recognized and removed before attaining tremendous dimensions. Frequently the tumors are multiple and knobby, and cause the womb to be not unlike a lumpy potato, with nodules buried in its wall.

Symptoms

Often a fibroid tumor is discovered in a routine physical examination of a woman who has experienced no symptoms. The growths are painless, in absence of complications, and may be present for many years without causing distress. If enlargement is sufficient to exert pressures on nearby structures, various symptoms depending on size and location may occur difficult urination, constipation, vague feelings of “heaviness,” disturbances of menstruation.

If the fibroids are small and cause no pressure symptoms or menstrual abnormalities, they need not be treated actively, but there should be an examination every six months or so to keep watch on the situation. Otherwise, the usual treatment is surgical removal. Many factors affect the decision in the case of an individual patient, as evaluated by the doctor. In a procedure called myomectomy, the tumors are removed from their beds and the cavities closed. This operation may be preferred in young women who desire to become pregnant.

In women who are near or past the menopause, the entire uterus may be removed (hysterectomy) instead of excising individual tumors. Tumors of moderate size that cause no symptoms in women near the menopause may just be left alone and watched, since there is some tendency for fibroids to regress after the change of life. When surgery is considered too hazardous for a particular patient, treatment by radiation (x-ray) tends to shrink the tumors.

Ovarian Cysts

The ovary may be the site of various types of tumors, many of which are benign. Some are malignant. A cyst is a sac containing fluid or mucoid material. Several varieties may arise in the ovary. Small cysts sometimes disappear without treatment, but if they enlarge or become twisted they must be removed. A cyst that has a slender stem (pedicle) may twist tightly around the stem, causing intense abdominal pain that may arouse suspicion of appendicitis.

The ovary, as well as being a producer of eggs, produces sex hormones. The ovary secretes estrogen, necessary for feminine development, and progesterone, which is necessary for preparing the uterus for pregnancy. Some tumors of the ovary may cause excessive hormone production. It is not possible to determine the exact nature of an ovarian cyst until it has been removed surgically and examined under a microscope. Generally, cysts exceeding size of an average orange should be removed.

What is this Condition?

Male infertility – inability of a man to reproduce – is suspected whenever a couple fails to achieve pregnancy after about 1 year of regular unprotected intercourse. Male infertility accounts, in whole or in part, for 40% to 50% of infertility problems in North America.

What Causes it?

Numerous factors, including anatomic and hormonal abnormalities, can cause male infertility.

What are its Symptoms?

The obvious sign of male infertility is failure to impregnate a fertile woman. An infertile man may also have shrunken testicles, or an empty or swollen scrotum; inflamed seminal vesicles (pouches that secrete seminal fluid, which keeps sperm cells viable after ejaculation); abnormal masses on the spermatic cord and vas deferens (a tube that forms part of the spermatic cord); abnormal growths on the penis; hypospadias (a congenital defect in which the urinary opening is on the underside, rather than the tip, of the penis); or prostate enlargement.

How is it Diagnosed?

The doctor obtains a detailed history, which may reveal abnormal sexual development, delayed puberty, infertility in previous relationships, and a medical history of prolonged fever, mumps, impaired nutritional status, previous surgery, or injury to the genitalia. After a thorough history and physical exam, the most conclusive test for male infertility is semen analysis.

The doctor also may order other lab tests, such as studies of the organs that control hormone secretion and sperm formation, and measurement of testosterone levels in the blood. He or she may also perform a biopsy (removal and analysis of testicular tissue) and may order X-rays of the reproductive system.

How is it Treated?

If male infertility stems from an anatomic problem or infection, it’s treated by correcting the underlying problem. For instance, enlarged varicose veins in the scrotum must be surgically repaired or removed.

If infertility results from sexual dysfunction, treatment includes education, counseling or therapy (on sexual techniques, frequency of intercourse, and reproductive physiology), and proper nutrition with vitamin supplements. Men with decreased levels of follicle-stimulating hormone (which stimulates sperm formation) may respond to vitamin B therapy; those with decreased levels of luteinizing hormone (also active in sperm formation) may respond to therapy with chorionic gonadotropin (a hormonal substance that stimulates testicular function). Men with normal or elevated levels of luteinizing hormone require low doses of testosterone. Those with decreased testosterone levels, reduced semen motility, and a low sperm count may respond to chorionic gonadotropin.

Men with a low sperm count who have a normal history and physical exam, normal hormone study results, and no signs of disease need emotional support and counseling, adequate nutrition, vitamin. supplements, and hormone therapy with chorionic gonadotropin. and testosterone.

What can an Infertile Man do?

If you have a low sperm count, avoid activities that may impair nor­mal sperm development by raising scrotal temperature, such as wearing tight underwear and athletic supporters, taking hot tub baths, or habitually riding a bicycle. Be aware that a cool scrotal temperature is essential for adequate sperm development.

If possible, consider participating in support groups where you can share your feelings and concerns with other couples with the same problem.

What is this Condition?

A common venereal disease that affects both sexes, gonorrhea is an infection of the genitourinary tract (especially the urethra and cervix and, occasionally, the rectum, pharynx, and eyes. Untreated gonorrhea can spread through the blood to the joints, tendons, membrane, of the spinal cord and brain, and the interior membrane lining of the heart; in women, it can also lead to chronic pelvic inflammatory disease and sterility.

After adequate treatment, the prognosis for both men and women is excellent, although reinfection is common. Gonorrhea is especially prevalent among young people (between ages 19 and 25) and people with multiple sexual partners.

What Causes it?

Transmission of Neisseria gonorrhoeae, the organism that causes gonorrhea, almost always follows sexual contact with an infected person. Children born of infected mothers can contract neonatal gonococcal conjunctivitis as they pass through the birth canal. Children and adults with gonorrhea can get this type of conjunctivitis by touching their eyes with contaminated hands.

What are its Symptoms?

Although many infected men may have no symptoms, after 3 to 6 days, some develop symptoms of urethritis, including painful urination and a pus-filled urethral discharge, with redness and swelling at the infection site. Most infected women remain symptom-free, but some develop inflammation and a greenish yellow discharge from the cervix – the most common gonorrheal symptoms in women. Other signs and symptoms vary according to the infection site.

Signs of neonatal conjunctivitis include swollen eyelids, conjunctival infection in both eyes, and a heavy pus-filled discharge 2 to 3 days after birth. Adult conjunctivitis, most common in men, causes conjunctival redness and swelling in one eye. Untreated gonococcal conjunctivitis can progress to blindness.

How is it Diagnosed?

A culture from the infected body part usually establishes the diagnosis by isolating the organism. A lab test called a Gram stain supports the diagnosis and may be sufficient to confirm gonorrhea in men. A culture of scrapings from the eye confirms gonococcal conjunctivitis.

How is it Treated?

For adults and adolescents, the recommended treatment for uncomplicated gonorrhea caused by N gonorrhoeae is Rocephin by intramuscular injection. Treatment of concurrent chlamydial infection may require Vibramycin taken orally. A single dose of Race ph in followed by E-Mycin for 7 days is recommended for pregnant women and those allergic to penicillin. Other drugs may be used to treat complications.

Drug therapy should be continued for 24 to 48 hours after improvement begins; usually a full week of antibiotics is required, although the doctor may switch to different medications to finish treatment.

Routine instillation of 1 % silver nitrate or llotycin drops into the eyes of newborns has greatly reduced the incidence of gonococcal neonatal conjunctivitis.

What do Doctors call this Condition? -Soft chancre

What is this Condition?

Chancroid is a sexually transmitted disease marked by painful genital ulcers and swollen, possibly ulcerated, lymph nodes in the groin area.

This infection occurs worldwide but is most common in tropical countries. It affects men more often than women.

Chancroidal ulcers may heal by themselves and usually respond well to treatment if there are no secondary infections. A high rate of HIV infection has been reported among people with chancroid.

What Causes it?

Chancroid is caused by a bacterium and is transmitted through sexual contact. Poor hygiene may predispose men – especially those who are uncircumcised – to this disease.

What are its Symptoms?

After a 3- to 5-day incubation period, a small pimple erupts at the site of entry, usually the groin or inner thigh; in men, it may appear on the penis; in women, on the vulva, vagina, or cervix. Occasionally, it may erupt on the tongue, lip, breast, or navel. The pimple rapidly breaks out into an ulcer, becoming painful, soft, and foul-smelling; it bleeds easily and produces pus. It’s gray and shallow, with irregular edges, and measures up to 1 inch (2.5 centimeters) in diameter.

Within 2 to 3 weeks, lymph nodes in the groin area become swollen, creating pus-filled, inflamed nodes that may rupture into large ulcers or buboes. Headache and malaise occur in 50% of people with chancroid. During the healing stage, phimosis (narrowed orifice of the foreskin) may develop.

How is it Diagnosed?

Lab tests provide evidence of the disease but are not 100% reliable. A biopsy (removal and analysis of tissue) confirms the diagnosis but is reserved for resistant cases or cases in which cancer is suspected. Additional tests may be performed to rule out other sexually transmitted diseases that cause similar ulcers. Testing for HIV infection should be done at the time of diagnosis.

How is it Treated?

The treatment of choice includes the following drugs: Zithromax, E-mycin, or Rocephin. The safety of Zithromax for pregnant or breast-feeding women has not been established. Aspiration of fluid­filled nodes helps prevent spreading the infection.

What can a Person with Chancroid do?

Don’t apply lotions, creams, or oils on or near your genitalia or on other lesion sites. Avoid sexual contact until healing is complete (usually about 2 weeks after treatment begins). Wash your genitalia daily with soap and water. If you’re an uncircumcised man, you should retract the foreskin for thorough cleaning.