Dear Doctor, is there any remedy for my bad tonsils?

Dear Doctor, I have had enlarged tonsils since I was 10 years old and I would like to know if there are treatments and medication available to reduce inflammation before surgery?

The tonsils may be removed because there are recurrent tonsillar infections, bleeding infected tonsils (haemorrhagic tonsillitis), there is difficulty breathing and/or swallowing, bad breath, having a peritonsillar abscess or suspicion of cancer. In addition, in children, they may be removed if there is speech impairment or abnormal dental and facial growth.

The treatment you take before surgery depends on the reason why surgery was recommended. If you have an infection, then you need to take antibiotics before surgery, and anti-inflammatory medication usually help with the pain. However, if there is no ongoing inflammation or infection, only enlargement, then there is no need for treatment. Medication will be given during and after the surgery as necessary.

Doctor, on some occasions during sex with my partner, we stop the session moments before I ejaculate. The semen comes out when I pee in the morning. Are there any health complications from semen retention in the system for a long period?

Semen retention, or intentionally avoiding ejaculation, is also known as sexual continence, seminal conservation or coitus reservatus. People practice it for a variety of personal reasons. In some instances, when there is a dry orgasm (without ejaculation), the semen may go back into the urinary bladder, which is called retrograde ejaculation, and the semen will later come out in urine. If the semen is retained in the reproductive system, then the body breaks it down and reabsorbs it.

There have been no definite negative (or positive) effects identified caused by semen retention, though there has been very little research on this topic. However, withholding ejaculations puts you at risk of epididymal hypertension (blue balls syndrome) – aching or pain in the testicles caused by blood congestion following sexual arousal without ejaculation. The solution is to reduce arousal or ejaculate. There are no long term negative effects associated with this.

Doctor, I recently got married into a family that practices the removal of the epiglottis — the flap of tissue that sits beneath the tongue at the back of the throat. I am told of the many people who have had it removed and experience no health problems. From your perspective, are there any dangers to removing it?

The epiglottis is a tissue flap located behind the tongue. It’s main purpose is to cover the windpipe when food is being swallowed to prevent any food particles from going into the airway.

In rare cases, the epiglottis can get inflamed and cause pain and blockage, as a result of infection, chemical injury, burns, physical injury, swallowing a foreign object or smoking cocaine. Inflammation of the epiglottis (epiglottitis) is a potentially life threatening emergency condition that is managed in hospital. The underlying condition is managed while supporting breathing. The epiglottis should only be removed under advise from an Ear, Nose and Throat (ENT) specialist, and this is done in cases of cancer or injury. In case of epiglottis collapse causing breathing obstruction, an epiglottis stiffening procedure can be done to preserve the function of the epiglottis while relieving the obstruction.

Some cultures promote removal of the epiglottis for various reasons e.g. to prevent respiratory infections, to cure cough, to prevent nausea and vomiting etc, which unfortunately is not the cure for any of these issues. Furthermore, this removal is usually not done in proper health institutions and is not advisable.

After removal of the epiglottis, the body can adapt to swallowing without it, though this may take some time for some people. The challenge is post-operative complications like infections or bleeding, especially when there is lack of proper health care.

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