Mr Gulamhusein offers private management of adrenal conditions jointly with endocrine doctors and is one of very few surgeons with the expertise in open and robotic surgery to manage them.
What is the adrenal gland?
There are two adrenal glands, one above each kidney which sit in either flank. They are triangular shaped and approximately 5cm long and 2cm wide. They produce a variety of hormones which work as ‘chemical messengers’ in the blood stream forming part of the endocrine system.
What is the function of adrenal glands?
There are numerous hormones produced, the three main ones are:
Cortisol: this is a ‘natural steroid’ involved in the response to illness and helps regulate metabolism.
Aldosterone: this helps to maintain the body’s water and salt balance. This is important in regulating blood pressure.
Adrenaline: this is important in the management of stress situations, the ‘flight or fight’ response.
Problems related to the adrenal glands
Signs and symptoms are typically due to either under or over production of the adrenal hormones. These can therefore be related to blood pressure, metabolism, the immune system or features of stress. Many symptoms are similar to other illnesses making identification difficult.
Adrenal tumours
Adrenal tumours are typically found incidentally, and the majority are benign (non-cancerous). Adrenal cancer is rare but may present with the same symptoms.
Common conditions include:
Conn’s syndrome: caused by overproduction of aldosterone, commonly due to a small benign tumour of the adrenal gland that can lead to high blood pressure, typically resistant to blood pressure medication.
Cushing’s syndrome: due to excess cortisol, which can give rise to obesity, diabetes, high blood pressure, osteoporosis and irregular periods in women.
Addison’s disease: secondary to hormone underproduction leading to low blood pressure, fatigue, weight loss, nausea, abdominal pain and low blood sugars. This can be life threatening.
Phaeochromocytoma: tumours characterised by over production of adrenaline, which causes very high blood pressure, headaches, sweating and a fast heart rate.
Investigations
The mainstay of tests involves the measurement of hormones in blood tests. Some can also be checked for in urine samples. Further investigations might include CT (computed tomography) scans or an MRI (magnetic resonance imaging).
Treatment
Management is often multifaceted with drug therapy as well as surgery. You will be seen by a medical doctor called an endocrinologist and an adrenal surgeon. New patients are typically discussed in a multi-disciplinary meeting encompassing all the relevant medical professionals.
Medication is used to either supplement or suppress the hormones or manage effects of the hormones. Surgery offers an excellent option where there is a tumour found, either benign or cancerous.
Surgery
This can be either key-hole or an open operation to remove the adrenal gland or tumour. Most are amenable to a minimally invasive approach using a surgical robot.
Depending on the indication this allows for a short hospital stay and sometimes a same day discharge. A full recovery is generally expected in a few weeks and often means no further medication is required.
Find out more at urologyclinics.co.uk / Contact Urology Clinics Manchester e: info@urologyclinics.co.uk
