Urologists prescribe medicines or surgery for issues related to kidney, bladder and male genital organs. In this interview, Dr Ijaz Hussain, a consultant urologist at Shifa International Hospital Islamabad talks about a common urological issue that is kidney stones
SN: Which are the common urological diseases in Pakistan?sni
The most common disease in Pakistan are kidney stones in adults and genetic issues in infants.sni
SN: Are people aware about visiting urologist with such issues?sni
The dilemma is people commonly prefer going to hakeems, dais (midwives) or homeopaths for treatment especially in case of stones. This however, worsens the issue. People come to urologists when their stone size increases by the use of wrong medicines. The prescribed drugs act as diuretics and increase urine flow causing the body to dehydrate and therefore stone size starts to grow.sni
It is easy to treat a small stone but treatment of a bigger stone is always difficult. Such people claim that their medicine can help remove the stone. However, in reality, majority of the stones get eliminated with time, particularly the small ones. And they take credit for its removal.sni
SN: Is it true that homeopathic or desi treatment is more effective in curing these problems? sni
Everyone wishes for a treatment that is cost effective, easy and does not cause pain. And that is what homeopaths or hakeems claim and mislead people. They are unaware about the scientific mechanism of treatment. They do not have any scientific knowledge about the disease, its causes and ways of treatment. As far as home remedies are concerned, keep in mind that different stones require different treatments. So, never try a home remedy without knowing the stone type.sni
| People prefer going to hakeems, dais (midwives) or homeopaths for treatment especially in case of stones. This however, worsens the issue |
SN: Pain in the lower abdomen is only caused by kidney issues; is it so?sni
There are many other organs in the lower part that could cause pain. Therefore, it is necessary to get it diagnosed first. Do not start self-treatment. It can be harmful and never take any medicine to suppress your pain. Sometimes, if you ignore the kidney pain once, it will not alarm you again until the last stage when cure becomes impossible.sni
SN: Is contaminated water a reason for having kidney stones?sni
People generally think that kidney issues occur due to contaminated water. But it is not the direct cause. But contaminated water can cause loose motions and dehydrate the body eventually producing stones.sni
SN: What are the actual causes of kidney stones?sni
Pakistan is situated in the “stone belt” region where chances of stone formation are the highest in the world. It is due to the severity of weather conditions. Unfortunately, southern Punjab and northern Sindh have the highest number of cases as this disease has now become hereditary (whether they live in such places or not). Another reason is inadequate water intake.sni
| People generally think that kidney issues occur due to contaminated water. But it is not the direct cause |
SN: Fluid intake is a must for preventing kidney and urine related diseases. How much fluid is best for us?sni
It is difficult to tell the exact amount. However, it is important to drink three to five liters in winters and four to five liters in summers. Moreover, urine should always be diluted and light in color in any season since concentrated, dark urine signifies an issue.sni
SN: Can diabetes and high blood pressure cause kidney issues?sni
Diabetes can cause stone formation but high blood pressure cannot. However, both conditions are highly dangerous for kidneys. Unfortunately, Pakistan and India are among the top countries to have blood pressure and diabetes incidence in the world.sni
To prevent these diseases, avoid self-treatment and have regular checkups especially after a certain age or if you have a family history. Get your weight, pulse, blood pressure and sugar level checked whenever you see doctor for any reason. Moreover, be alarmed if you feel unusually hungry or thirsty, have weight loss or an incurable wound or injury.sni
SN: What causes kidneys not to flush properly?sni
Balance of two things is important: water and the particles that dissolve in water. Stones are produced when this balance gets disturbed. If you suffer from dehydration, number of filterable particles will increase in the kidneys. Similarly, if water intake is good but kidneys are excreting unusual amount of filterable particles then also the function gets disturbed. So, maintaining the balance is highly important.sni
| Diabetes can cause stone formation but high blood pressure cannot. However, both conditions are highly dangerous for kidneys |
SN: Many times in old age, kidneys fail along with many other issues. Why is this so?sni
Aging is one of the factors. Part of our kidney weakens each year which we call glomerular filtration rate (GFR). Co-morbidity is also common in old age which means a person can have more than one disease. Also, older people use more medicines or have enlarged prostrate which affects their kidneys.sni
SN: Which foods to avoid in kidney problem?sni
Kidney’s culprit is salt which is used excessively in Pakistan. It can increase blood pressure, weaken bones and promote kidney stone formation. So, reduce its intake.sni
SN: How can kidney problems be diagnosed?sni
An ultrasound is the basic test that can help in diagnosis. It can tell about the shape of kidneys, stone type, form, size and its location.sni
| There are around 35 to 50 percent chances for stone reformation. Stone removal does not guarantee that new stones will not appear |
SN: Can stones recur?sni
Yes, there are around 35 to 50 percent chances for stone reformation. Stone removal does not guarantee that new stones will not appear. It is necessary to identify the cause for treatment and eventually get rid of the problem.sni
SN: Are kidney and bladder stones different?sni
Bladder stones are of two kinds; stones that pass to the bladder from kidney and stones that are formed in the bladder. The latter are formed when there is an obstacle in the urinary tract. But in Pakistani children, protein deficiency can also be the cause of bladder stones.sni
SN: How can bladder stones be treated?sni
Sadly, majority doctors opt to operate it which is an unfair practice in this advanced era. Urologists can treat it without operation, with the help of endoscopy. Surgery should only be done when the stone size is extremely big. Therefore, always prefer consulting an urologist over a general surgeon or quack.sni
