I was operated for prostatis seven years back, but since the last two years I’ m having difficulty in passing urine completely. The doctor found that there was a stricture, which was removed with an operation. I was prescribed “Contiflow” and “Uritone” for two months without much improvement. Then for three weeks I was put on catheter and after that I was advised to do self catherization, which I am still continuing. Now doctors say that I have a neurogenic bladder for which there is no treatment. Is there any treatment for this? Will Botox help?
Your neuropathic bladder can be corrected. You need to get a URODYNAMIC evaluation done and then consult your urologist. Botox is used for overactive bladder and not for your condition. Your bladder is probably hypotonic and you may need Tab Urotone 1 tablet three times a day.

Despite the unfortunate results of your first two pregnancies, there’s no reason your next one shouldn’t have a happier outcome. Yes, your doctor’s advice is correct – you should have a cervical cerclage (to tie a ligature around the mouth of the uterus) by the 15 or 16th week, after checking the fetus for any congenital abnormality. Initially, after the stitch is taken, you will have to be on a strict bed rest for at least 1 month. After that period you can go to the toilet and also have a quick bath. Then a repeat sonography should be done to check how the stitch is holding and depending on that, your activity level will be decided. Most women do well and have a 36- or 37-week pregnancy uneventfully.

I’m 28 years old and unmarried. There is white fungus in the skin folds of my penis, which I have to clean every day. I’ve become frustrated having to do this daily, because it increases if I don’t. What is the problem?
The white “fungus” that you refer to, is a normal secretion that accumulates under the foreskin, called smegma. If the foreskin is not retracted and the smegma not washed off during the bath every day, the secretion will accumulate and develop a stony consistency over a period of time. You need to wash off this smegma daily.

I am 73. I am an exercise freak accustomed to regular early morning walks coupled with mild aerobic exercise. Of late, while walking or standing for a long time I experience numbness in my toes, wobble, and lose my balance. An MRI revealed that there is “circumferential disc bulge and posterior disc protrusion at L-4 to L-5 levels, L5-S1 level with compression on S1 nerve root.” I was put on spinal chord rehab which has given only 50% relief. I am continuing the exercises, but not walking as much as I used to, with the result my weight is increasing. At this advanced age with coronary heart disease, is spinal surgery an option, or is it advisable to battle it out as I am doing now? Can I use an exercise bicycle to stay in shape without any damage to the spine?
You have a mechanical problem of spine degeneration with bone formation in the discs and joints. A spine surgery to decompress is acceptable even at your age, as this is a problem of ageing. The surgery will give you considerable pain relief. Still, you will need to exercise prudence to prevent the other discs from deteriorating. The exercycle is unfortunately unkind to the knees. For the present you’ll have to rely on a judicious diet to keep your weight down.
Do keep in mind that when you decide on the surgery, it should be undertaken by a Spine/Neurosurgeon and not a general/ orthopedic surgeon.

I have oily skin but in winter my skin gets dry by the time it is evening. Trying to ease the situation, I apply a moisturizer but I get acne as a result. What should I do?
Usage of heavy oil-based or heavy moisturizers is probably blocking your pores leading to more acne. You should use a mild face wash with salicylic acid (saslic foam wash or Salvosh). Salicylic acid works by softening keratin, a protein that forms part of the skin structure. This helps to loosen dry scaly skin making it easier to remove. It also prevents clogging of pores and helps in breakdown of blackheads and whiteheads. Do not use a toner in winter as it would further dry your skin. Apply a gel-based sunscreen. At bedtime, use a mild cleansing lotion such as Cetaphil cleansing lotion instead of soap or a face wash. Soaps alter the Ph balance of the skin making the skin drier. Apply a thin coat of oil-free moisturizing lotion or Emolene cream but do not massage. The massage itself would stimulate sebaceous glands to secrete more sebum or oil. If you still get acne, please consult a dermatologist.

I am very keen to breastfeed my baby. I am eight months pregnant. Is there anything I can do to increase the quantity of breast milk once the baby is born?
Breast milk production starts as soon as the baby is born. You can start breastfeeding the child immediately after delivery; in fact it is very much encouraged. Breast milk contains all the nutrients a baby needs for healthy growth and development during the first six months of life, as well as substances that help protect a baby from many illnesses. Breastfeeding provides health benefits for the mother, including an early return to her pre-pregnancy weight. And there are emotional benefits for mother and baby from the special bond that develops between them. Take a breastfeeding class before you give birth. ASK your hospital for a referral. Some lactation consultants (experts in breastfeeding) will meet you before your baby is born. The quantity of milk depends very much on the mother’s diet. Food absorbed by a nursing mother not only 1 fulfills her own nutritional needs, which are greater during the postnatal period, but also enables her to produce milk. Include fenugreek, milk, spinach, rice, pulses and green vegetables in your diet.

I have severe vaginal itching. I usually wear synthetic undergarments. Do you think this could be causing the itch? And what do I do to relieve the itching?
Stop wearing synthetic undergarments. Keep your genital area clean and dry. Use plain, unscented soap and always wear cotton panties. Also, cleanse by wiping or washing from front to back (vagina to anus) after urinating or having a bowel movement. It is also helpful to avoid scratching, which will only aggravate the problem. Avoid overexertion, heat and excessive sweating. You can use a calamine lotion to ease the itching. If there is a rash, you need to see a dermatologist. Using a moisturizing cream regularly will help you.

I will be getting married soon, but when I was courting my fiancée, I found that she was not getting aroused. In spite of my best efforts, I was not able to arouse her and she was not affected by my touch. Is it normal?
It seems that you are entering into an arranged marriage. If this is so, then what you are facing is a common problem. You are probably going too fast. The sexuality of a woman is predominantly heart-centered. She needs to feel emotionally close to you for her to get aroused. I would advise you to go slow with your caressing as she maybe feeling shy and awkward. Instead, you could win her heart by romancing her. Instead of being hasty physically, try to understand her hesitation. This will make her feel emotionally close to you. When this happens, she will be more than willing to share intimacy with you. If, after implementing my advice, you still feel that things are not warming up between the two of you, then a counseling session with a good sex counselor would be in order. This would take care of any myths or misconceptions that she may be carrying about physical intimacy. Also give her an opportunity to come up with her queries, if any.

I am 24 and my wife is 19. We are married for one year. How can I change my wife who always finds excuses to evade physical intimacy on the pretext of being busy?
It is important to understand why she needs to evade physical intimacy. Is it because she has been left unsatisfied or has had painful experiences of the sexual act with you? Is it because of fear of pregnancy? Is it because she disapproves of the kind of sexual behavior you demand? Is it because she considers the sexual act sinful or dirty? Is it because she has been a victim of sexual abuse? Is it because she has unresolved emotional issues with you and so cannot give in to intimacy without resolving them? Is she unwell? Is she overworked and too busy with the home and children? Is she involved with someone else? Does she have lesbian tendencies? All this needs to be explored with your wife. I suggest that both of you approach a relationship counselor to get to the bottom of the matter.

What exactly are ovulation kits? I have read that there is a choice between urine ovulation kits and saliva ovulation predictor tests. Which one is better? Or should I just give up on these kits and start charting Basal Body Temperature (BBT) and conduct cervical mucus examination? I know that ultrasonography (USG) is the best way to determine ovulation, but one cannot do it month-to-month. Can you throw more light on the ovulation kits available in the market?
You have already stated that the USG is the best way to determine ovulation; but you do not like the idea of doing it every month. But believe me; you have to go for a USG only 4 -5 times in a month. Ovulation kits available in the market are very expensive and not always accurate. Out of the kits described, the urine ovulation predictor kit is the best, which detects the LH surge. Usually, after 24 – 36 hours of the LH surge, an egg is released from the ovary and there is a high chance of pregnancy during this period. Basal Body Temperature (BBT) is the temperature of your body at rest. To take your BBT, you need a digital thermometer. Taking your temperature first thing in the morning, before you get out of bed, eat, drink or go to the bathroom will give you the most accurate temperature. Use a notebook or a BBT chart to record your temperature. During the first part of your menstrual cycle, the BBT will be lower. Right before ovulation, you will have a slight drop in temperature followed by a sharp rise in temperature. Also, for pregnancy to occur, the mucus should be slippery and copious.

I am a 26-year-old man working in the public sector. My teeth have been yellow in color since childhood. I have tried different toothpastes to no avail. Kindly suggest a way by which I can get a whiter set of 32.
Yellow or stained teeth from childhood are usually the result of using over chlorinated water or taking antibiotics like tetracycline in the early years. Regular toothpastes will not lighten your teeth, and the effect of whitening toothpastes is barely perceptible even on coffee stains. Get a professional whitening treatment at a dentist’s, which will last longer and offer better results.

My voice is heavy and not very clear. So whenever I speak with my friends, they can’t understand me and when I want to speak very quickly, my voice cracks up and my friends make fun on me. Please tell me what I have to do so that my voice becomes light and I can speak like a normal student and quickly?
You seem to be having multiple problems, if your voice is heavy, you need to be seen by a voice consultant who will do a voice analysis and get to the root of the problem. You also mention that your words are not clear to others, which indicates a pronunciation or diction problem, which can be treated only in consultation with a speech therapist. But don’t worry. Both these problems are curable.