obesity and the urinary tract - goodfellow unit · obesity and the disappearing penis • why is...

OBESITYANDTHEURINARYTRACT


• Kidneys:• Stones• Glomerulosclerosis

• Bladder• Incontinence• Urinarytractinfections

• Genitalia• Skinbreakdown• Phimosis• Disappears• Infertility• Hypogonadism• Prolapse• ED

[email protected] EDI:urospecl

DICK

• 50yearoldMale• Presentswithrightloinpain

• Classicforrenalstones• “Similartolastlotofpain”

• Otherwise“well”• BMI>35


• USS:• “difficultduetopatientsbodyhabitus,multiplesmallstonesrightkidney”

OBESITYANDSTONEDISEASE

• DICKWANTSTOKNOW..

• WHYDOC?• WhyamIgettingallthesestones?

• WHATCANIDO?• CanIchangemydiet?



• WHY???• IncreasedBMI=Increasedriskofstone

• Excessintakeoflithogenic substances• Refinedsugars• Lowfluidintake• Oxalatesrichfoods• Purinerichfoods



• WHY???

• IncreaseriskofUTI=Increaseriskofinfectionrelatedstones

• ReducedurinepH=Increasenumberofuricacidstones

• Treatments=Increaseoxalatebasedstones



• WHATCANIDO?• LOSEWEIGHT• Majorityoftheincreaseriskreturnstonormal

• ALTERDIET• Decreaseyouroxalateintake• Decreaseyourpurineintake• Balanceoutyourcalciumintake• INCREASEFLUIDINTAKE



• WHATDOESTHATACTUALLYMEAN?

• TryandgetpatientstoincreasetheirfluidintakeofWATERsothentheirurineisclearlooking

• AlterationsinthediettoPREVENTfurtherstones



DECREASEPURINERICHFOODSFORURICACIDSTONES

DECREASEOXALATERICHFOODSFORCALCIUMOXALATESTONES



• TREATTHECURRENTSTONES:• SendforUrologyreferral

• AllinterventionsarestillavailableforObesepatientsdependingon• 1.Anaesthetic risk• 2.SkintoStonedistancefortheequipment


ANDALSO…IMREALLYWORRIEDABOUT…

• MYPENISITHASDISAPPEARED

• 31%=OBESE• 35%=OVERWEIGHT

• ADULTBURIEDPENISISANINCREASINGPROBLEM…


OBESITYANDTHEDISAPPEARINGPENIS

• WHYISTHISAPROBLEM??• HYGIENE• SKINBREAKDOWN• PHIMOSIS• INCONTINENCE• “MISDIRECTEDFLOW”• RETENTION• SEXUALDYSFUNCTION• ERECTILEDYSFUNCTION• POSSIBLEPRECURSORTOSCCASSITTINGINMOISTENVIRONMENTCAUSINGMALADPATIVESKINCHANGES

• PSYCHOLOGICALHEALTH



• SOWHYDOESTHISHAPPEN…• WITHINCREASEDWEIGHT• EXCESSIVEMOISTURE• PROMOTIONOFBACTERIALOVERGROWTH• TISSUEMACERATION• INFECTION

• LEADINGTOCHRONICCYCLEOFINFLAMMATION,SCARRING,ANDWORSENINGOFTHESKINANDFURTHERSHORTING



• WHATCANIDODOC?

• WEIGHTLOSSANDEXERCISE!!

• NOMEDICALTHERAPIES



• SURGERIES:

• MULTIPLEDIFFICULTOPERATIONSAVAILABLE• LIPOSUCTION,SKINGRAFTING,TRANSPOSITIONS…..

• RESULTSWITHUROLOGICALRECONSTRUCTIONSURGEONLIKEMYSELFAREGOODWORLDWIDE



• Unfortunately:

• Increasingepidemic• Increasingnumberofpatientseffected• Importanttotryandalterdietandfluidforpreventionaseasierthantreatment

• DR.ANNALAWRENCE• UROLOGIST• 0220489661• [email protected]• [email protected]

obesity and the urinary tract - goodfellow unit · obesity and the disappearing penis • why is...

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