Dr Flo, my cousin injured his ankle during a football match. It first swelled and then a wound formed. The wound has grown so big, that the bone is now visible. It also smells. We have tried to treat him but there has been no change. What should we do next? Elisha
A wound that does not heal in three months is called a chronic wound. If the bone is visible, then there is a likelihood that infection has spread to the bone, which makes it even more difficult to treat and the infection can spread to the rest of the body.
There are a number of factors that can cause a wound not to heal, such as presence of dead skin, poor blood supply, diabetes and poor diet, especially lack of protein.
Your cousin needs to be seen by a surgeon urgently so that the wound can be cleaned thoroughly. The level of infection also needs to be assessed and proper wound care prescribed. If there are other illnesses impairing wound healing, they also need to be addressed.
He may require hospital admission for the cleaning of the wound, which is sometimes done in theatre, and for treatment of the infection. The bone that is exposed will need to be covered with a skin graft once the wound heals.
Dr Flo, I am a 20-year-old young man and I have an issue with my left testis. I went to hospital and the doctor recommended an ultrasound which showed I have moderate testicular hydrocele. He prescribed painkillers and said that if it grows larger, I would have to undergo an operation to remove the fluid. The pain is no longer sharp and consistent, but I’m wondering if I need further help. I really don’t want to go through with the operation unless it is absolutely necessary. Kindly advise me. Nelson
A hydrocele is a collection of fluid around the testicle. During development in the womb, the testicles develop in the abdomen and then move to the scrotum through a short passage. The testicle is surrounded by a sac of fluid. The passage and the sac should seal off before birth and the fluid reabsorbed into the body.
There are two types of hydroceles: if the passage seals off but the fluid is not absorbed by the body, it is called a non-communicating hydrocele. This one does not grow in size and usually resolves within six months to a year. If the passage does not close and the fluid is not absorbed, you get a communicating hydrocele. The passage is open so fluid can pass to and from the abdomen. It’s also easier to get a hernia, where parts of the intestine can protrude through this passage.
Hydroceles are more common in babies, but can also occur in older men if the passage reopens or if it hadn’t closed and fluid enters the scrotum. It can also occur due to injury, inflammation, infection or other testicular illnesses, which should be screened and treated when diagnosed.
Hydroceles are usually not dangerous, other than causing swelling, discomfort, and occasionally, pain. If it is non-communicating, it will usually resolve on its own.
If it causes a lot of discomfort or if it is communicating, then surgery is done to prevent development of a hernia. The surgery is called hydrocelectomy.
There is no medication to treat a hydrocele. An option for needle aspiration followed by injection with a sclerosing agent exists, but it is not advisable as it may be painful, and there is risk of infection, and most of the time, the fluid accumulates again.
Dr Flo, I stopped having a strong erection abruptly one and a half years ago. Last month I decided to see a doctor, who diagnosed me with bacterial infection and prescribed a month’s dose of Addyzoa capsules. Three weeks later and the situation is not improving. Please help me. Japheth
Having a problem with achieving an erection once in a while is not a cause for concern.
However, when it persists, it may be due to either a physical and/or a psychological issue. You may have a physical problem that is affecting the quality of your erections e.g. reduced testosterone levels, advanced age, heart disease, high cholesterol levels, blocked blood vessels (atherosclerosis), diabetes mellitus, hypertension, nerve problems, some hypertension medicine, sleep disorders, obesity, alcoholism, smoking or other drug us, injuries to the spinal cord or pelvic region, or Peyronie’s disease (formation of scar tissue in the penis). It may also be due to psychological issues like stress, anxiety, depression, relationship issues, etc.
Addyzoa is a herbal preparation with minerals that is given to improve sperm count and quality, not for erectile dysfunction. I would advise you to see an urologist (like a gynaecologist for men), so that he can help you figure out the source of the problem and a solution for it. In the meantime, maintain a healthy diet, exercise regularly, get adequate sleep (seven to eight hours a day), avoid alcohol and cigarettes, and find a way to manage the stress. You may also benefit from pelvic floor exercises: contract the pelvic muscles as though you are stopping the flow of urine. You can practise this to identify the specific muscles by stopping the urine mid-flow when urinating. Contract these muscles for about 10 seconds, 10 times in one set, six to 10 sets in a day.
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