Ask the Doctor - February Scotland on Sunday column

Sunday 27th February - Weak Bladder

Mr Ammar Alhasso is a Consultant Urological Surgeon at Spire Murrayfield Hospital.

The lower urinary tract comprises of the bladder and urethra with the addition of the prostate in men. Its function is storage of urine and subsequent voiding when appropriate and convenient.

Urodynamic testing can help investigate and plan appropriate treatment by reproducing symptoms of stress urinary incontinence and/or urgency incontinence, increased frequency of urinating, poor flow or the need to get up at night to pee.

The test involves filling your bladder via a small tube (catheter) passed through the water pipe. You will be asked to cough and strain as the bladder fills and then asked to empty your bladder. X-ray pictures taken during the test provide extra information.

A range of treatment options, depending on test results, include: Botox injection for overactive bladders, prostate surgery in men, implantation of an artificial urinary sphincter for stress incontinence, a tensionfree vaginal tape (TVTO) or urethral bulking injections.

Sunday 20th February - Eardrum Hole

Mr Hasan Beg is a Consultant ENT Surgeon at Spire Edinburgh Hospital.

It is usually caused by infection in the middle ear. The infection is the result of bacteria from the nose and sinuses passing through the Eustachian tube, which connects the back of the nose to the ear.

This can happen if the resistance in the body becomes low due to a cold. This can mean the bacteria lying dormant in the respiratory passages become active and take advantage of low resistance and become hostile. Hay fever, nasal allergy and asthma are diseases which can predispose the sufferer to bacterial infection of the ear. The infection can lead to difficulty in hearing, pain, or a hissing sound in the ear.

If the infection is not checked in the beginning, pressure build-up in the middle ear can burst the drum and cause pus to flow out through the ear canal. This relieves the pain but leaves a hole. If the hole is large it may not heal on its own and may need a grafting operation.

Sunday 13th February - Bunions

Mr Robert Clayton is a Consultant Orthopaedic Surgeon at Spire Murrayfield Hospital.

A bunion is a bump on the side of the foot at the base of the big toe.

In the early stages, a podiatrist can often help by providing small splints and padding to protect the painful areas and hold the toe straight.

If the bunion becomes painful or the toes start to cross over each other then surgery can be considered.

With modern surgical techniques there is usually no need to wear a plaster after the operation and it is safe to start putting weight onto the foot straight away. With modern anaesthetic and surgical techniques the recovery from surgery is now much less painful.

It is usually safe to return to sedentary occupations within two to three weeks and more physical occupations after six weeks.

Sunday 6th February - Painless Lump

Mr Stuart Hamilton is a Consultant Plastic Surgeon at Spire Edinburgh Hospitals.

Any unusual or new lump should be reviewed by your GP in the first instance.  The majority of lumps are benign. National guidelines recommend that any patient with a soft-tissue mass anywhere on the body that is increasing in size, has a size greater than 5cm or feels deep within the body, whether or not it is painful, should be reviewed and referred to a dedicated regional diagnostic centre for assessment.  These centres are present in Edinburgh, Glasgow and Aberdeen.

Sarcomas can start in any tissue and account for approximately 1 per cent of all adult cancers and can affect people throughout their lifetime, including as a child. A multidisciplinary team approach, including surgeons and oncologists, is required for the treatment of these unusual cancers.