OBESITYANDTHEURINARY
TRACT
OBESITYANDTHEURINARYTRACT
• Kidneys:
• Stones
• Glomerulosclerosis
• Bladder
• Incontinence
• Urinarytractinfections
• Genitalia
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Skinbreakdown
Phimosis
Disappears
Infertility
Hypogonadism
Prolapse
ED
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DICK
• 50yearoldMale
• Presentswithrightloinpain
• USS:
• “difficultduetopatientsbody
habitus,multiplesmallstones
rightkidney”
• Classicforrenalstones
• “Similartolastlotofpain”
• Otherwise“well”
• BMI>35
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OBESITYANDSTONEDISEASE
• DICKWANTSTOKNOW..
• WHYDOC?
• WhyamIgettingallthese
stones?
• WHATCANIDO?
• CanIchangemydiet?
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OBESITYANDSTONEDISEASE
• WHY???
• IncreasedBMI=Increasedriskofstone
• Excessintakeoflithogenic substances
• Refinedsugars
• Lowfluidintake
• Oxalatesrichfoods
• Purinerichfoods
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OBESITYANDSTONEDISEASE
• WHY???
• IncreaseriskofUTI=Increaseriskofinfectionrelatedstones
• ReducedurinepH=Increasenumberofuricacidstones
• Treatments=Increaseoxalatebasedstones
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OBESITYANDSTONEDISEASE
• WHATCANIDO?
• LOSEWEIGHT
• Majorityoftheincreaseriskreturnstonormal
• ALTERDIET
• Decreaseyouroxalateintake
• Decreaseyourpurineintake
• Balanceoutyourcalciumintake
• INCREASEFLUIDINTAKE
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OBESITYANDSTONEDISEASE
• WHATDOESTHATACTUALLY
MEAN?
• Tryandgetpatientstoincrease
theirfluidintakeofWATERso
thentheirurineisclearlooking
• Alterationsinthedietto
PREVENTfurtherstones
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OBESITYANDSTONEDISEASE
DECREASEPURINERICHFOODSFOR
URICACIDSTONES
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DECREASEOXALATERICHFOODSFOR
CALCIUMOXALATESTONES
OBESITYANDSTONEDISEASE
• TREATTHECURRENTSTONES:
• SendforUrologyreferral
• AllinterventionsarestillavailableforObesepatientsdepending
on
• 1.Anaesthetic risk
• 2.SkintoStonedistancefortheequipment
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ANDALSO…IMREALLYWORRIEDABOUT…
• MYPENISITHASDISAPPEARED
• 31%=OBESE
• 35%=OVERWEIGHT
• ADULTBURIEDPENISISAN
INCREASINGPROBLEM…
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OBESITYANDTHEDISAPPEARINGPENIS
WHYISTHISAPROBLEM??
HYGIENE
SKINBREAKDOWN
PHIMOSIS
INCONTINENCE
“MISDIRECTEDFLOW”
RETENTION
SEXUALDYSFUNCTION
ERECTILEDYSFUNCTION
POSSIBLEPRECURSORTOSCCASSITTINGINMOISTENVIRONMENTCAUSING
MALADPATIVESKINCHANGES
• PSYCHOLOGICALHEALTH
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OBESITYANDTHEDISAPPEARINGPENIS
• SOWHYDOESTHISHAPPEN…
• WITHINCREASEDWEIGHT
• EXCESSIVEMOISTURE
• PROMOTIONOFBACTERIALOVERGROWTH
• TISSUEMACERATION
• INFECTION
• LEADINGTOCHRONICCYCLEOFINFLAMMATION,SCARRING,
ANDWORSENINGOFTHESKINANDFURTHERSHORTING
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OBESITYANDTHEDISAPPEARINGPENIS
• WHATCANIDODOC?
• WEIGHTLOSSAND
EXERCISE!!
• NOMEDICALTHERAPIES
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OBESITYANDTHEDISAPPEARINGPENIS
• SURGERIES:
• MULTIPLEDIFFICULTOPERATIONSAVAILABLE
• LIPOSUCTION,SKINGRAFTING,TRANSPOSITIONS…..
• RESULTSWITHUROLOGICALRECONSTRUCTIONSURGEONLIKE
MYSELFAREGOODWORLDWIDE
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OBESITYANDTHEURINARYTRACT
• Unfortunately:
• Increasingepidemic
• Increasingnumberofpatientseffected
• Importanttotryandalterdietandfluidforpreventionaseasier
thantreatment
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DR.ANNALAWRENCE
UROLOGIST
0220489661
[email protected]
[email protected]