Objectives: To determine the effectiveness of transurethral resection of bladder neck in the management of primary bladder neck obstruction (PBNO) in female Patients and Methods: This prospective study has been done with thirty female patients aged from 27 to 48 years who were presented with difficult micturition or urinary retention. These patients had unremarkable physical findings with normal perianal sensation, anal sphincter tone and lower extremity reflexes. Patients associated with cystocele, meatal stenosis, stricture urethra, urethral caruncle and urethral diverticula that may lead to mechanical bladder outflow obstruction were excluded from the study. Preoperative investigations include uroflowmetry, ultrasonography, serum creatinine, urethrocystoscopy with simultaneous “water flow test” was done. Seven patients presented with obstructed voiding symptom without renal impairment (serum creatinine, mean±SEM 1.24±0.04) and were initially treated with á-blocker (category A). Among the other 23 patients those had renal impairment 18 presented with near retention and these patients were on indwelling catheterization before operation (category B, serum creatinine, mean±SEM 2.72±0.13).Rest of the 5 patients presented with nausea, vomiting, and disorientation in addition to near retention and were put on haemodialysis along with indwelling catheterization to reach near normal creatinine level before operation(category C, serum creatinine, mean±SEM,9.34±0.96 ). PBNO causing voiding difficulty were diagnosed in all the cases and were undergone transurethral bladder neck resection (BNR). Three months after operations, their pre- and post-operative symptoms were analyzed, and serum creatinine levels, ultrasonographic findings (MCC, PVR), uroflowmetric study were compared. Results: Twenty-nine (96.33%) Patients become symptom free. Their average pre- and post-operative values of MCC (Maximum Cystometric Capacity), PVR (Post Voidal Residual urine), Qmax (Peak urinary flow during uroflowmetric study, Serum creatinine level were changed from 679.50 to 482.17ml, from 574.50 to 29.37ml, from 8.43 to 29.37ml/sec, from 3.48 to 1.13 mg/dl respectively. One patient (3.33%) did not continent ever postoperatively. One patient had become dry after using pad for stress incontinent for one month only. Serum creatinine level of category C patient did not reach to the normal level (post operative creatinine level Mean±SEM,2.8±0.15)within this three moths follow up period. Conclusions: Our short term follow-up suggests that judicious Transurethral BNR is effective in relieving voiding difficulty due to primary bladder neck obstruction in female. A thorough gynaecological, neurological and urological examination is essential along with uroflowmetric, ultrasonographic and cystoscopic study to reach a correct diagnosis and making a treatment plan. Bangladesh Journal of Urology, Vol. 16, No. 1, Jan 2014 p.23-28
Objective: To review the current understanding of testicular pain, possible etiology and the available treatment options. Materials and Methods: A literature search was made for abstract, original and review articles in the Medline, hand-searched relevant reference lists and conference proceedings and medical text book using the word “testicular pain” and orchialgia to find out possible etiology, understanding of testicular pain and treatment options. Results: After literature search, it has found that management of testicular pain sometimes a challenging work for an Urologist. Management differs for the original etiology and for testicular and extra testicular causes. Sometimes symptomatic treatment improve the quality of life but in few cases surgery is mandatory for relieve of pain. Conclusions: Management of chronic testicular pain depends on careful assessment of the causes. Relieve of symptoms is not always possible with analgesic only, in that case blockade of the spermatic cord will be helpful. Decision for surgery should not be undertaken quickly for there is no guarantee that there will always be resolution of pain For that reason patient should be counseled accordingly. Bangladesh Journal of Urology, Vol. 15, No. 1, Jan 2012 p.18-20
Objective: To determine the outcome of ureteroneocystostomy for vesicoureteric junction obstruction due to tubercular stricture. Patients and Method: Twelve patients age from 19 years to 47 years were underwant uretroneocystostomy with ifilateral D-J stanting for vecicoureteric junction obstruction (VUJO) with proximal hydroureteronephrosis tissue from the lower of the ureter shows granunation lesion complatable with tuberculosis. D-J stant were remove and patients were put into antitubercular chemotherapy Results: Patients were symptom free and follow up IVU at six months interval shows free passage of contrast at 10 minutes film. Conclusion: Vesicoureteric junction obstruction (VUJO) due to lower ureteric stricture by tuberculus lesion, though rare, should be searched, because if not treated properly may lead to damage of ipsilateral renal unit. Bangladesh Journal of Urology, Vol. 19, No. 1, Jan 2016 p.13-17
We report a case in which a 28-year-old infertile bilateral cryptorchoid man with decreased performance status presented to the department of urology with a mildly tender mass in right inguinal region. Both ultrasonography and Computerized axial tomography scan (CT Scan) suggested that the mass arose from right sided undescended testis and left sided testis was normal-sized intrabdominal. His serum á-fetoprotein and LDH were within normal range and only â-hCG was raised 3-fold. He was found azoospermic, his serum LH and FSH were increased but serum testosterone was reduced. The mass was removed by inguinal exploration and histopathology confirmed seminoma of testis. Orchidopexy was done on contralateral side one month after the first operation. A mass in the lower abdomen in a sexually active man with cryptorchoid testis strongly points towards the diagnosis of malignancy in the abdominal testis1. The clinician should aware of it and the urologist should do prompt removal of the tumor and orchidopexy in contralateral side in bilateral case irrespective of age. Bangladesh Journal of Urology, Vol. 17, No. 2, July 2014 p.101-105
Objective: To evaluate the effectiveness of single dose 5 % povidone iodine renal pelvic instillation sclerotherapy for the treatment for chyluria. Methods: In a prospective study from January 2009 and till June 2013, 47 patients presenting with milky urine (chyluria and hematochyluria) were included. Patients with other co-morbid illness like diabetes, urinary infection, renal stone disease, chronic pyelonehritis were excluded from the study. Apart from ether test, the presence of lymphocytes in urine and urine triglycerides levels were also done to confirm chyluria. Under local anesthesia, cystoscopic evaluation revealed right-sided efflux in 11 (23.4%), left-sided in 36 (76.6%), and no bilateral involvement was detected. 5F open-ended ureteric catheter was introduced in the ureteric orifice of affected side. Freshly prepared 10 ml of 5 % povidone iodine solution was instilled over a minute with the patient in Trendelenburg position. Results: Total of 47 patients were enrolled (26 males and 21 females; mean age 41 years, SD 8.4, range 29–71) with a mean follow-up of 12 months. Immediate clearance was seen in all patients and recurrence in 9 (19.15 %). Overall success rate 80.85%. Mean diseasefree duration was 12 months. Three patients had moderate to severe flank pain. Conclusion: Single dose 5 % povidone iodine sclerotherapy is a effective treatment for chyluria. As the patients discharged on the next day after procedure, it can be offered as a day care basis, so continuous ureteral and urethral catheterizations can be avoided. Bangladesh Journal of Urology, Vol. 18, No. 2, July 2015 p.74-78
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