Frequently asked questions

Laser hair removal is one of the most popular methods for permanent or long-term removal of unwanted hair. Here are some reasons why people choose laser hair removal:
1. Permanent or long-term results: The laser targets and destroys hair follicles, preventing future hair growth. While multiple sessions may be required to achieve permanent results, the treatment is effective in the long run.
2. Precision: The laser targets the hair with precision, affecting only the hair area and leaving the surrounding skin unaffected.
3. Quick process: Laser hair removal is usually faster than other hair removal methods, such as waxing or shaving.
4. Reduced pain: Laser hair removal is generally less painful than methods like waxing, although pain tolerance varies from person to person. Modern lasers have built-in cooling systems to reduce the sensation of pain.
5. Safe for the skin: When performed by trained professionals, laser hair removal is generally safe for most skin types and hair colors.
6. Reduced risk of folliculitis: Unlike shaving or waxing, which can cause inflammation in the hair follicles (folliculitis), laser treatment is less likely to lead to this issue.
7. Reduction in hair volume: Laser hair removal is also effective for individuals with thick hair, as it can reduce the number of hairs and make the skin smoother.
Furthermore, Alexandrite laser is also very popular due to its ability to treat larger areas of skin more quickly with pulsed light emission, making it more efficient in less time and with fewer risks. It emits light at a wavelength of 755 nanometers (nm), which is effectively absorbed by melanin, the pigment found in hair and skin. The laser's energy is converted into heat, destroying the hair follicle without affecting the surrounding skin. If you are considering laser hair removal, it is important to consult with a professional to determine if it is the right method for you, as precautions must be taken to avoid potential risks, such as burns or allergic reactions.
For more information, please refer to:
New Clarity II LPA Alex Laser 755nm (HYBRID version) (Both ICD+Cryo) by Lutronic

Urinary incontinence is characterized by the involuntary loss of urine continuously or intermittently. The usual age of onset is after the age of forty.
As a consequence of this is observed:
a) Social self-isolation - effect on the psyche.
b) financial burden
c) skin lesions
25% of men and 45% of women of the third age are today affected by incontinence, one of the most widespread diseases around the world, with serious consequences in the daily life of the person suffering from the problem.
Unfortunately, in our country it remains a taboo condition, as the majority of sufferers do not visit the doctor (only 4% of cases they report the problem to their doctor) due to shame or ignorance of the important treatment prospects. With the new methods, pharmaceutical or surgical, incontinence can become a bad memory for those who make the decision to visit their doctor. As you mention, childbirth injuries for women and prostate problems for men are the main causes of incontinence, which mainly concerns the elderly, since in productive ages it does not exceed 8%.

Elements of female anatomy and physiology:
The pelvic floor consists of the muscles of:
a) pelvic diaphragm and the muscles of the internal layer.
b) of the urogenital septum and the middle layer
c) outer layer and the same perineum.

Of exceptional importance is the function of the anus elevator. With a specific mechanism during its contraction, it narrows the space of its legs and compresses the urethra, the vagina and the intestine so that the pelvic floor is pulled from above while at the same time dragging the urethra above the pubic adhesions.
The female urethra is 4cm long and is divided into a pelvic and perineal spine. In the external sphincter of the urethra is developed the middle third point at which the urodynamic examination is performed due to the maximum intraurethral pressure.

Urinary incontinence in women.
According to the INTERNATIONAL CONTINENCE SOCIETY we distinguish:
1. Urinary incontinence from effort
2. Urinary incontinence from persuasion
a) kinetic type
b) aesthetic type
3. Urinary incontinence from bladder automation or reflex incontinence
4. Urinary incontinence from overflow
5. Non-urethral incontinence or urinary incontinence without urethral insufficiency.

And its frequency:
60% from effort
10% from persuasion
20% effort and persuasion together (Mixed)
10% all other forms.

Urinary incontinence from effort (Stress Incontinence)
It concerns 60% of cases and is a secretion of urine in cases of effort due to insufficiency of the sphincter mechanism. Depending on the severity, we distinguish three grades:
1st degree: incontinence when coughing, straining, sneezing, lifting weights.
2nd degree: incontinence while standing, standing, walking.
3rd degree: incontinence while lying down.

Problems
Incontinence appears suddenly, usually causing surprise, but also terror to the sufferer, who does not know exactly what is happening to him. When he realizes what he is suffering from, he usually chooses to hide his problem, rather than face it and get rid of it. In addition to psychological problems, chronic incontinence can also create health problems, such as urinary tract infections and cystitis, which now necessarily lead the patient to the doctor.

The potential solutions.
Depending on the form of the problem, the doctor recommends pharmaceutical or interventional treatment. The new pharmaceutical treatments are particularly effective, as they are not accompanied by significant side effects. For example, the substance tolterodine acts selectively on the bladder and therefore does not cause side effects related to other body systems, such as dry mouth. Even greater progress has been made in the field of interventional therapies. The doctor today has to choose between a series of new revolutionary methods, depending on the case and the patient's problem.
Such methods are:
• Electrostimulation. A special device irritates the nerve endings, with the result that the behavior of the bladder is significantly improved.
• Periurethral injections. (Dexell SUI) New, greatly improved materials are inserted around the urethra and enhance its function.
• The artificial sphincter (Remeex). Highly effective adjustable mechanical device that is surgically implanted and applies pressure to the urethra.
• The slings or tapes, (Remeex). A recently perfected method that offers great efficiency. The bands are put around the urethra, press on it and close it.

Interventional techniques are not only highly effective, but also cheap, in relation to what they offer to the sufferer, as "there is no better feeling than getting rid of a problem that has tormented you for years and made your life difficult".

What is overflow incontinence?
It is any involuntary loss of urine associated with overdistension of the bladder. This may be due to either the bladder not being able to contract effectively or the urethra being narrowed for some reason. The result of the above is the retention of urine in the bladder. The bladder collects urine until it is overfilled. The increased intravesical pressure then causes involuntary, spontaneous leakage of urine. Because urine often escapes in the form of drops, this incontinence is also described as droplet incontinence.

The most likely causes of overfilling incontinence are: A) Weak detrusor or dysfunction of the detrusor and sphincter of the bladder.
B) Particularly in men, an enlarged prostate gland.

What is certain, however, is that incontinence must be treated because it can lead to infection, leakage, and reflux of urine into the ureters.

Characteristic symptoms of this form of incontinence are:
1. Difficulty starting to urinate or having a continuous flow.
2. Loss of urine in the form of drops after urination or in between
3. Making a special effort to urinate.
4. Frequent visits to the toilet during the day and night.

Multiple Sclerosis: What you need to know.

What is multiple sclerosis?
Multiple sclerosis (MS), or multiple sclerosis, is a disease of the brain and spinal cord. The age at which the diagnosis is made is between 20 and 50 years. In CSF the sheath that covers the nerves, the myelin, is destroyed and the nerve is damaged. The role of myelin is very important for the protection and proper functioning of the nerve. It allows the rapid transmission of nerve messages. When myelin and nerve fibers are damaged, the messages that start from the brain to move, for example, a body part, are not transmitted properly, resulting in a mobility problem. The same thing happens the other way around when messages related to sensation are carried from a part of the body to the brain.
The result is that body movements become slow or uncoordinated. The aesthetic messages to the brain are also altered.
After a first bout of the disease, recovery and a return to normal function can occur. But a plaque is created, a kind of scar within the central nervous system, which can permanently affect motor and sensory function. The disease can recur with new myelin lesions that can affect any part of the central nervous system. With this development, many plaques and scars can be created in the brain and spinal cord.

Each patient can present their own unique picture depending on exactly where their myelin will be affected.

Common symptoms of CSF are:
• Weakness or mobility problems
• Numbness
• Urinary or faecal incontinence • Lack of coordination of movements • Loss of balance
• Vision problems
• Cognitive problems
• Mood changes
• Tiredness • Speech difficulties
CSF is not fatal or contagious. But a small percentage of patients presents a severe form of the disease which can reduce the life expectancy.
Diagnosis
Diagnosing CSF is not an easy task and in some cases it is very difficult. there is no laboratory test that alone can prove that a patient has or does not have CSF. Certain additional tests such as MRI, cerebrospinal fluid analysis, and evoked potentials can provide information that strongly supports the presence of this disease. The diagnosis will be made by a neurologist or other doctor when there are unmistakable signs of MS in many parts of the central nervous system.

This is usually possible when there is a history of at least two or more episodes of neurological problems and more than one symptom.
For example there may be weakness in one arm and the other leg or weakness in one limb and numbness in the other or weakness in one limb along with urinary incontinence.

What causes multiple sclerosis?
We don't know what causes MS. Myelin destruction appears to be due to an immune disorder. The body's immune system, i.e. the system that with special cells and antibodies is responsible for the defense against foreign pathogens, due to some pathological mechanism turns against the body's own myelin and destroys it.
This autoimmune mechanism may be caused by an abnormal reaction of the immune system after a childhood infection with a virus or other microorganism
The disease is not hereditary. Despite this fact there seems to be a genetic predisposition because a small increase in the frequency of the disease in close relatives has been observed.

What is the progression of patients suffering from multiple sclerosis? The progression depends on how often the patient has episodes of destruction of their myelin and how much their brain and spinal cord have been affected. The most common form is that in which patients have episodes of relapse and remission of their disease. In relapses their symptoms become much worse. In remissions they improve and their symptoms can completely or partially subside.
75% of cases of patients with CSF begin their disease in this way.
About 15% of patients have a progressive disease from the beginning. Their symptoms do not go away and may get worse. This form is called the primary progressive form.
About 6-10% of patients have progressive progression with acute attacks, which is called progressive relapsing CSF and is a relatively rare form.
Finally, 50% of patients who start with the form that presents relapses and remissions, develop after 10 years, secondary progressive CSF. They may continue to have attacks and have partial improvement but their symptoms and disabilities gradually worsen.

It is important to emphasize that all these forms can stabilize or worsen at any time.
About two-thirds of patients with CSF will retain their mobility during their lifetime. But many of them will need walking aids (such as a cane) and some will choose a wheelchair or other similar means to save their strength.

What are the treatments for multiple sclerosis? The treatments used against the attacks of the disease are corticosteroids and ACTH. In relapses, these drugs can reduce the duration of symptoms.
Other drugs and therapeutic methods are also used against muscle spasms, against pain and incontinence.
Good nutrition and adequate body rest help significantly. Physical exercise helps in mild to moderate forms of the disease.

There are currently other drugs that seem to be able to modify the progression of the disease.
These drugs can reduce the frequency of relapses, delay the onset of disability, and reduce the degenerative effect of CSF as evidenced by MRI. Medicines such as interferon (Rebif or Betaferon or Avonex) or glatiramer acetate (Copaxone) are recommended for patients who have frequent attacks of the disease, about two each year, especially if they are severe and if patients do not fully recover from the attacks.

Rehabilitation treatments of patients, physiotherapy, urine collection and psychological support of patients are also of great importance and should not be neglected.

Hysterosalpingography (or HSG) is a medical procedure used to evaluate the anatomy and function of the uterus and fallopian tubes in women. During the procedure, a catheter is used to insert contrast fluid into the uterus to ensure that the fluid passes freely into the fallopian tubes. The catheter is placed in the cervix, and through it, is ensured the proper flow of the fluid. The procedure of hysterosalpingography is typically performed when there is suspicion of fertility problems, such as blocked tubes or other anatomical abnormalities that may affect conception. Moreover, it can be useful, not only for difficulties in conceiving a baby, but also for diagnosing and understanding the cause of any other gynecological issue. The procedure is relatively quick and is usually done in an outpatient setting. Women may experience some pain or discomfort during the examination, but this is usually mild and temporary. This procedure can help identify blocked fallopian tubes, such as adhesions or blockages that prevent the free movement of eggs, anatomical abnormalities, including severe or minor structural issues in the uterus like polyps or fibrosis, as well as infections or adhesions, problems caused by infections or inflammation of the reproductive system.

Before answering this question, dear readers, we should clear up in our minds an axiom: in all patients with traumatic or other damage to the Spinal Cord, their bladder is "neurogenic". This exact neurogenic cyst often does not empty at all, or partially empties, or worst of all, empties by developing large intravesical pressures. This last form is also the worst for a person with a neurogenic cyst, because precisely this pressure is transmitted by reflux to the kidneys with destructive results over time. In the past, we should mention that the most frequent cause of death of patients with a neurogenic cyst was kidney failure, which was precisely due to this destruction of the kidneys from the high pressures inside the cyst.
The most important way to deal with this condition is to empty the bladder at the right time, and without letting urine remain in it for a long time. This was also understood by the ancient Greeks who, of course, not having today's catheters, used improvised catheters made of thin reeds which they anointed with honey for a lubricating effect.

WHO NEEDS INTERMITTENT CATHETERS?
Intermittent catheterizations (ICs) are needed not only by patients with traumatic spinal cord injuries, but also by patients with neurogenic cysts due to multiple sclerosis, meningocele, diabetes mellitus, or stroke and other conditions. But we should emphasize that the neurogenic cyst of patients with traumatic spinal cord injury is the most "unruly" of the species, and it is no exaggeration to say that it requires more attention from the patient and from the attending Urologist.
This group of people (with a neurogenic cyst due to a traumatic spinal cord injury) is precisely the one that needs more intermittent catheterizations compared to patients with a neurogenic cyst from another cause.

HOW MANY CATHETRATIONS PER DAY?
Many patients ask us, when we tell them the number of catheterizations they need each day, why is there a difference in this number between them and their friends or colleagues who apparently suffer from the same disability? The answer is that even though two people may have the same apparent disability (eg paraplegia), in reality the spinal cord injuries are very different. This rule is also followed by the nervous system of the bladder of these patients (but we will deal with the explanation and classification of the phenomenon of the neurogenic bladder in one of our next articles).
The number of daily catheterizations necessary in a patient with a neurogenic bladder is strictly individualized and based on the results of urodynamic testing.
In a few words, the number that the urologist suggests to the patient should in no case be random or a routine number that is applied to a patient regardless of the problem he has but should be based on the urodynamic control.

WHO ARE NOT SUITABLE CANDIDATES FOR INTERMITTENT CATHETERS?
There are a number of people with neurogenic cysts who, despite needing intermittent catheterizations, are unable to perform them. These patients are divided into categories according to the cause that makes it difficult for them to perform D.K.
Specifically:
a) People with motor problems of the upper limbs, such as quadriplegic friends who naturally cannot perform fine movements with their hands, and who most of the time rely on a nurse assistant, or people from their environment to carry out of catheterizations. Here of course the problem lies with the people who do not have access to these facilities and the problem clearly has a social basis.
B) Obese people who, due to their body size, cannot properly direct the catheter
C) People who do not have the mental capacity to understand the logic of use and the technique of D..K.
D) Women who, due to their anatomy, their disability does not allow them to easily find the external opening of their urethra
E) People with urological problems such as urethral strictures, urethral injuries, or bladder neck strictures. This category definitely needs urological treatment before it is decided that the patient should undergo D.K.

In a patient who is correctly indicated for intermittent catheterizations, who is trained to perform them correctly, and who has regular follow-up, the likelihood of developing complications is very high. y little However, as with any treatment, there is a possibility that some complications may occur with intermittent catheterizations.

A) URINARY INFECTIONS
The finding of microbes in the urine of patients using intermittent catheterizations is a common phenomenon and should not cause much concern or be treated unless accompanied by some symptoms or signs. Whether or not we give treatment depends on whether the patient has retained the sensation of his bladder or not. If the damage to the nervous system allows total or partial sensitivity of the bladder, then the patient will have the classic symptoms of a urinary tract infection such as frequent urination, burning during urination, dysuria, etc. But when he has lost sensation, which is the norm, then the symptoms of a urinary tract infection can be many and varied, such as increased spasticity, hyperhidrosis or redness in the upper part of the trunk or face. Cloudiness, hematuria, or a strange odor may be observed in the urine. As to whether intermittent catheterizations cause infections, most studies show that the rate of infections decreases, but there are also some (few) that show that the rate increases, but admitting that they are less harmful to the kidneys. Patients with reflux of urine from the bladder to the kidney (vesicoureteral reflux) have a higher rate of infections, especially of the kidneys. The introduction of self-lubricating single-use Curan catheters dramatically reduced the rate of infections in these patients. The correct way to further reduce infections is the sufficient number of catheterizations during 24 hours, and the perfect emptying of the bladder after each catheterization. We must emphasize again that prophylactic administration of antibiotics, or treatment of asymptomatic microbiosis is not necessary. UTIs accompanied by clinical signs should be treated with antibiotic treatment lasting from 3 or 5 to 10 or 15 days. There are also exceptions to this rule but this is a matter for the urologist to know and judge.

B) DETERIORATION OF KIDNEY FUNCTION
Intermittent catheterizations help maintain kidney function long-term. Here, the Urodynamic test has a fundamental place, which will diagnose us the type of neurological picture of the bladder, and from this it can be predicted which patients show an increased risk for deterioration of the kidneys. Cysts showing extensor muscle hyperreflexivity with or without sphincter-extensor dyssynergy, (in simple words spasticity), compared to those showing extensor muscle hyporeflexivity (in simple words, loose flaccid cysts) show increased chances, if the condition gets out of control, for kidney damage. Here, fellow readers must understand that rarely these lesions have a rapid deterioration and that kidney lesions are established very slowly and therefore do not give signs until the last stages.
Therefore, when a progressive deterioration of renal function is detected, the urologist must first investigate whether the scheme of intermittent catheterizations is appropriate for the patient's condition. Then, depending on the severity of the situation, he may resort to an accompanying pharmaceutical treatment, or in the most difficult cases to an enlarged cystoplasty.

C) URETHRAL TRAUMA
Catheterization of the urethra is certainly not a normal phenomenon, and the insertion of the catheter into its lumen may cause some irritation or damage. The spectrum of these lesions is wide and ranges from a simple inflammation to coagulation and perforation of the urethra. But in the vast majority the lesions are mild and are treated with antibiotic treatment, anti-inflammatory drugs, and placement of a permanent catheter for a few days.
All these complications have of course been reduced to a minimum, with the use of new technology self-lubricating low-friction catheters, such as Curan.

D) LITHIATION
Bladder lithiasis occurs in a small percentage of patients. This is usually due to the entry with the catheter of hair from the adolescent area into the bladder. Patients should be careful about this when they are catheterized. Bladder lithiasis is treated with endoscopic removal of the stone.

E) EPIDYMITIDA
Epididymitis logically only occurs in men (only they have an epididymis), and although this is also a form of UTI, we mention it separately to emphasize the importance for men undergoing intermittent catheterizations to have their testicles checked periodically them for unusual swellings.

CONCLUSION
The purpose of intermittent catheterizations is to ensure urinary continence, storage of of urine in the bladder under low pressure conditions between catheterizations, keeping the patient's kidneys in the best possible condition.

The best treatment is of no value if it is not applied...

Hollywood Spectra Q-Switched Nd: YAG Laser (1064nm-532nm), is a specialized laser machine that utilizes two different wavelengths and combines cutting-edge technology with multiple applications for aesthetic and dermatological treatments. Ιt is an ideal tool for clinics and physicians who wish to provide advanced solutions to their clients based on each patient's needs.
Uses and treatments: The device offers a variety of applications and is highly popular in aesthetic medicine. Its ability to use 4 different handpieces means there are various attachments and applications that allow physicians to focus on different areas of the skin with greater precision. Some examples of its uses include: tattoo removal, skin lightening, and reduction of hyperpigmentation, skin rejuvenation, treatment of telangiectasias (broken capillaries), acne treatment-general dermatological treatment and reduction of fine lines and wrinkles.
Possible Side Effects: Mild redness that subsides within a few hours, temporary dryness or irritation and in rare cases light peeling may occur.
Advantages: Non-invasive and painless procedure, no recovery time required, quick application (20-30 minutes approximately), suitable for all skin types.
It is ideal for individuals seeking a safe and effective method for skin rejuvenation and treating hyperpigmentation, with immediate and visible results. It is recommended that the procedure be performed by a specialized dermatologist or aesthetician.
For more information, please refer to:
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