Rapporteur’s Report
176th Seminar of the Global Millets Foundation & Sustainable Development Forum
Date: 9 November
Venue: Mel Mana Gardens, Kerala, India
Session Chairman: Dr Mathew Abraham – Executive Chairman, Sustainable Development Forum (SDF) & Global Millets Foundation (GMF)
Rapporteur: Dr Shivaprasad, MD
Speaker: Dr Shal Kakkatil, HOD – Urology, MOSC Medical College, Kolenchery
Topic: Common Urinary Problems, Prostate Disorders, Kidney Diseases, and Preventive Urological Health

1. Introduction
The 176th seminar opened with an in-depth presentation by Dr Shal Kakkatil, who stressed the indispensable role of timely medical consultation in preventing and managing urinary and renal diseases. He issued a clear caution against self-medication, highlighting the risks of kidney damage, drug resistance, and complications arising from unsupervised drug use.
He advised that patients should first consult their family physician for initial evaluation and thereafter seek a urologist or nephrologist if necessary. Most urinary disorders arise after middle age due to hormonal shifts, anatomical changes, decreased immunity, and chronic illnesses such as diabetes and hypertension.
The presentation revolved around two major themes:
1. Kidney Failure and Transplantation
2. Cadaveric Organ Donation Programmes
These themes provided a comprehensive view of both preventive measures and advanced treatment options.

2. Health Awareness and Preventive Approach
Quoting the World Health Organization (WHO), Dr Shal reiterated that health is a state of complete physical, mental, and social well-being. He reminded participants that the body offers early warning signs—pain, fatigue, discomfort—which should never be dismissed.
Lifestyle Recommendations
• Begin the day with light exercise or a morning walk.
• Maintain regular meal timings; avoid late or irregular meals.
• Engage in reading or mental activities to maintain cognitive vitality.
• Stay well hydrated; limit caffeine and reduce salt intake.
• Undergo routine health check-ups to identify problems early.

3. Common Urinary Problems
3.1 Urinary Tract Infection (UTI)
Among the most common urological issues, UTIs present with burning during urination, lower abdominal pain, urgency, and frequency. Women are more vulnerable due to anatomical factors; in men, UTIs often develop due to prostate enlargement or stones.
Timely diagnosis and completion of the full antibiotic course are essential to prevent recurrence and kidney involvement.

4. Prostate Disorders
4.1 Benign Prostatic Hyperplasia (BPH)
A common condition after 50 years, BPH results from hormonal changes. Symptoms include weak urinary stream, frequent urination, and incomplete bladder emptying. Dr Shal clarified that BPH is non-cancerous.
Management includes:
• Medication to relax or reduce prostate size
• Surgical options for persistent symptoms
4.2 Surgical Advances
• TURP remains the gold standard for treating BPH, offering reliable, long-term results.
• Newer minimally invasive procedures include:
o Prostatic Artery Embolisation
o Urolift Procedure
4.3 Prostate Cancer
A significant concern among elderly men, often silent in early stages. Diagnostic tools include:
• Digital Rectal Examination (DRE)
• PSA test, MRI, and prostate biopsy
Alarm symptoms include back pain or unexplained weight loss. Treatment options range from robotic, laparoscopic, or open prostatectomy to radiation and hormonal therapy.

5. Male Urological Issues
5.1 Prostatitis
Common in younger men, it presents with pelvic pain and urinary discomfort. Treatment includes antibiotics, hydration, and lifestyle modification.
5.2 Erectile Dysfunction (ED)
Linked to vascular disease, stress, or hormonal imbalance, ED may serve as an early warning sign of cardiac disease. Cardiological evaluation is therefore essential. Treatment ranges from oral medication and injections to implants.
5.3 Urethral Stricture
A narrowing of the urethra due to trauma or infection, causing reduced urinary flow. The definitive treatment is urethroplasty.

6. Female Urological Conditions
Post-menopausal changes can lead to urethral narrowing or urinary incontinence.
• Urethral Stricture: treated with topical oestrogen or surgery
• Stress Incontinence: improves with pelvic floor exercises
• Urge Incontinence: managed with biofeedback and lifestyle modification
Severe cases may require surgical intervention.

7. Kidney Disorders
7.1 Kidney Cancer
Often discovered incidentally via imaging.
• Small tumours → partial nephrectomy
• Large tumours → total nephrectomy
7.2 Bladder Cancer
More aggressive, often linked to smoking and chemical exposure. The main symptom is painless haematuria. Treatment includes surgery, chemotherapy, and radiotherapy.

8. Kidney Stones
Stones develop due to dehydration, dietary factors, or infection. Asymptomatic stones can be dangerous, causing silent obstruction.
Diagnosis: Ultrasound is the safest method.
Management:
• <6 mm → Usually passes spontaneously
• ≥6 mm → ESWL, laser removal, or PCNL
Infection accompanying stones must be addressed promptly.

9. Preventive Health Screening
Recommended tests include:
• Urine Albumin & Microscopy
• PSA (men)
• Serum Creatinine
• Kidney and bladder ultrasound
• Rectal examination

10. Kidney Physiology and Function
Each kidney receives 20% of cardiac output. Their vital roles include:
• Electrolyte regulation (sodium, potassium)
• Activation of vitamin D
• Production of erythropoietin for haemoglobin
Impairment leads to bone weakness, anaemia, and systemic complications.

11. Kidney Failure and Its Causes
Major causes:
• Prolonged painkiller use (Ibuprofen, Voveran)
• Certain antibiotics
• Obstruction from stones or prostate enlargement
• Acute rises in serum creatinine
Acute kidney failure is often reversible; chronic failure may require dialysis or transplantation.

12. Dialysis and Kidney Transplantation
Haemodialysis: External purification of blood; used in adults.
Peritoneal Dialysis: Frequently used in children.
Transplants:
• Live Donor (relative or spouse)
• Cadaveric Donor via national organ-sharing networks
Public awareness and early registration are essential to increase donor participation.

13. Lifestyle and Dietary Advice
Excessive tamarind (Irumban Puli–Bilimbi fruit -) consumption increases oxalate levels, contributing to kidney stone formation.
General advice:
• Avoid unnecessary painkillers
• Regularly monitor blood pressure and blood sugar

14. Conclusion
Dr Shal concluded by reiterating that awareness, preventive measures, and timely medical consultation form the cornerstone of urological and renal health. Early detection, disciplined lifestyle habits, and responsible health management can prevent irreversible complications, including kidney failure and prostate cancer.
The session successfully motivated participants to adopt healthier lifestyles and to disseminate awareness on preventive urology within their communities.