DR FLO: Is there anything wrong with my kidney?

Dr Flo, I had a urinary tract infection four years ago. It spread to my kidneys before I got treatment. After it was treated, I started getting kidney pain, so I sought medical attention, but I still feel pain sometimes. I got a scan last year, but nothing came up, and all medical screening I have done since then returns negative. Does the pain indicate a serious problem? It feels like a pinch. Githinji

Dear Githinji,

Most of the times, urinary tract infection will clear completely with treatment. This includes infections that have spread to the kidney. Rarely, the infection will persist, causing pain and recurrent symptoms like pain or burning sensation when passing urine, change in urine colour and/or smell, passing urine frequently and fever. If these symptoms are not present and repeat tests have been normal, it is unlikely that you still have an infection.

You can have pain at the area near the kidneys due to other issues like structural kidney problems, kidney stones, muscle pain, or problems in any of the surrounding organs like the gall bladder and liver (on the right), heart (on the left), intestines, or lungs. If it is a muscular problem, the pain will be affected or triggered by particular movements. The other causes of pain also have different accompanying symptoms.

It would be advisable to see a urologist for a proper evaluation. You may be sent for a CT urogram or other specialised kidney tests.

Dr Flo, my nipples are itchy, and I must scratch them. What can I do to stop this because my husband is complaining? Adwar

Dear Adwar,

Nipples can itch for several reasons: inflammatory skin conditions like eczema; irritation by the bra fabric or the bra being too tight; too much sweat, which can also lead to a fungal infection; hormonal changes during the menstrual cycle; breast changes during pregnancy; and breastfeeding. Rarely, itchy nipples can be caused by some forms of breast cancer.

Please see a doctor for a breast exam and a prescription for a cream to help control the itching, if the cause can be addressed. Itching that comes due to hormonal changes and breast enlargement usually subsides after the changes are over.

Clean your breasts well, especially around the nipples and on the underside when you sweat a lot, and wear a well-fitting supportive bra made of breathable material like cotton.

Dr Flo, I am a 25-year-old man and I have a problem with erections. For months now, I haven't woken up with a morning erection. My libido has taken a nosedive. Please help me. John

Dear John,

In a healthy man, there will be three to five erections during a full night's sleep, each lasting about 25 to 35 minutes. This happens during the rapid eye movement (REM) phase of sleep. At the time of waking up, the erection may still be present, depending on the most recent phase of sleep, or it may have resolved.

Having a problem with achieving an erection occasionally 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, nerve problems, heart disease, high cholesterol levels, blocked blood vessels (atherosclerosis), diabetes, hypertension, sleep disorders, obesity, alcoholism, smoking or other drug use, 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 or performance anxiety. Low libido means that there is a decrease in desire for sexual activity, which can cause difficulty achieving an erection.

It's advisable to see a urologist, 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 stress. You may also benefit from pelvic floor exercises to strengthen the muscles in the pelvic region.

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