Objectives: To compare pain, systemic lidocaine toxicity and complications between periprostatic with intraprostatic local anaesthesia for transrectal prostate biopsy. Methods: This study was carried out in the Department of Urology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka Medical College (DMCH) and Comfort Nursing Home, Dhaka during the period of January 2009 to October 2009, For this purpose, a total number of 60 consecutive patients having increased prostate specific antigen (PSA >4.0ng/ml), abnormal DRE/transrectal ultrasound were admitted in the above mentioned hospitals were enrolled in this study for surgical management. Results: The age ranged from 50 to 90 years and the maximum number was found in the age group of 61-70 years in both groups. The mean(±SD) age was 68.5±7.5 years and 70.3±8.2 years in group I and group II respectively. The mean(±SD) PSA was 17.0±12.8ng/ ml with their PSA ranged from 5.9- 62.8ng/ml in group I and in group II was 17.2±17.3ng/ml with their PSA ranged from 4.6 – 55.1ng/ml, which was not significant (p>0.05) between two groups. Normal digital rectal was found 14(46.7%) and 16(53.3%) in group I and group II respectively. Carcinoma was found 13(43.3%) and 14(46.7%) in group I and group II respectively and rest of them were benign in group I and group II respectively. The mean(±SD) pain degree during biopsy was 2.6±1.1 and 2.0±1.2 in group I and group II respectively according to allocated pain score. Pain degree after 30 minutes of biopsy, most of the patients had no pain in both groups. Pain during anesthesia it was found that 4(13.3%) and 13(43.3%) of the patients had no pain in group I and group II respectively. The mean(±SD) pain degree during anesthesia was 2.7±1.2 and 2.1±1.2 in group I and group II respectively. Conclusion: It is a simple and safe method that is less painful and it should be considered in all patients undergoing transrectal ultrasound guided prostate biopsy. The decreased discomfort of this procedure may enable more core biopsies to be taken in patients at high risk for prostate cancer or in those with an enlarged prostate Bangladesh Journal of Urology, Vol. 15, No. 2, July 2012 p.33-39

Carcinoma prostate is a common disease in urological aspect. Diagnosis of prostate cancer has evolved through the past century. In additions to estimations of serum PSA which has more predictive value than diagnostic value. In previous days diagnosis of prostatic cancer relied on three measures - DRE, needle biopsy and open biopsy. With development of medical science different biopsy techniques have evolved for prostatic biopsy. Each techniques has its own merits and demerits. This review article presented here discusses on ultrasonoguided transrectal prostatic biopsy following intraprostatic local anaesthesia. A thorough review literature search was done to resolve theses issues and finally a recommendation is drawn to develop a recommendated policy of biopsy for accurate diagnosis of prostatic cancer. Bangladesh Journal of Urology, Vol. 16, No. 2, July 2013 p.57-62

Objectives: To review the outcomes of modification of groin lymph nodes dissection on morbidity from surgical treatment of a patient with penile cancer and to find out accurate treatment plan according to stages of the primary lesion from current literatures. Methods: We searched the pubmed database for English Language published in the past for years using incidence, etiology, pathology, clinical presentation, staging and management of penile cancer. Result: From retrieved literatures better understanding of pathologic features allow for stratification of patients into low, intermediate, or high risk for lymph node involvement. Lymphatic mapping to this stratification improves selection of patients who might benefit from lymph node dissection after excision of the primary lesion. The recent use of a modified lymph node dissection has minimized morbidity. Current chemotherapy agents are ineffective in this disease. Conclusion: Patholoigc features of the primary lesion and the incorporation of lymphatic mapping have improved the selection of patients who might benefit from lymph node dissection. The use of a modified lymph node dissection in selection patients has decreased morbidity. Effective chemotherapy agents are needed in the management of advanced penile cancer. Bangladesh Journal of Urology, Vol. 15, No. 2, July 2012 p.48-55

Objective: To observe the improvement of the symptoms of pelvic pain, dysuria and haemospermia after treatment with magnetic infrared laser therapy in patients with chronic pelvic pain syndrome. Methods : This study was an observational study done on 30 male patients with pelvic pain and age range varied from 30 to 60 years. The study was conducted from 2009 to 2011 in a private medical center in Dhaka city . The MIL-therapy in use has a wave length of 904 nm and a frequency of 3000 Hz. The Laser beam reaches the prostate with a special optic probe. In this study the patients were examined per rectally by doing digital rectal examination with use of gloves and gel. At the beginning we used a “Laser Super Sonic” machine with endorectal probe according to Strada. The treatment schedule was one treatment every two days (treatment’s time of 5/10 minutes, wave length 1000 KHz)) for a total of 10 applications. After 10 applications patients were asked for follow-up and data were callected and analysed. Results : Out of 30 patients of chronic pelvic pain syndrome aged between 30-60 yrs with compains of pelvic pain, dysuria and haemospermia were under treatment with MIL therapy. 18 patients with pelvic pain, 13 patients with dysuria and 04 patients with haemospermia were cured after laser treatment . There were improvement of symptoms of pelvic pain in 11 patients, dysuria in 07 patients after laser therapy . But 01 patient found not improved . Among 30 cases 23 patients found normal sized prostate and 07 found enlarged prostate on digital rectal examination and on USG findings, 21 were found normal sized, 09 found enlarged sized prostate and 07 patients had increased PVR Conclusion : Patient sign and symptoms improved significantly after M/L therapy. Bangladesh Journal of Urology, Vol. 16, No. 1, Jan 2014 p.42-46

Objectives : To evaluate complications in Intra-prostatic local Anaesthesia and Periprostatic local Anaesthesia for TRUS Guided Prostate Biopsy. Methods: This study was carried out in the Department of Urology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka Medical College (DMCH) and Comfort Nursing Home, Dhaka during the period of January 2009 to October 2009, evaluate complications between periprostatic with intraprostatic local anaesthesia for transrectal prostate biopsy. For this purpose, a total number of 60 consecutive patients having increased prostate specific antigen (PSA >4.0ng/ml), abnormal DRE/transrectal ultrasound were admitted in the above mentioned hospitals were enrolled in this study for surgical management. Result : The age ranged from 50 to 90 years and the maximum number was found in the age group of 61-70 years in both groups. The mean(±SD) age was 68.5±7.5 years and 70.3±8.2 years in group I and group II respectively. No systemic lidocaine toxicity was observed in group II. But only dizziness were found in 2 cases (6.7%) and visual disturbance were found in 1 (3.3%) case respectively in group I. Urinary tract infection was found 2(6.7%) in group I and 1(3.3%) in group II patients. Hematuria was found 23(76.7%) in group I and 19(63.3%) in group II. Rectal bleeding was found 14(46.7%) in group I and 11(36.7%) in group II. The statistically not significant (p>0.05) between two groups in chi square and fisher exact test respectively. Conclusion : It is a simple and safe method that is less painful and it should be considered in all patients undergoing transrectal ultrasound guided prostate biopsy. Complications wer4e less in intra-prostatic local anaesthesia than periprostatic local anaesthesia for TRUS guided prostate Biopsy. Bangladesh Journal of Urology, Vol. 17, No. 2, July 2014 p.82-86