Objective:The objective of this study was to assess the efficacy of tamsulosin and finasteride monotherapies, and their combination in men with benign prostatic hyperplasia (BPH).Materials and Methods:This is a prospective single-blind randomized study of ninety men with BPH who were managed using drugs. The International Prostate Symptom Score (IPSS), peak urinary flow rate, and prostate volume were measured as parameters for assessment at the beginning, 3 months, and 6 months of the study.Results:The mean age of patients was 61.65 with a range of 44–81 years. There was a progressive and sustained improvement in the IPSS score in all patient groups with mean decrease at 3 months of 7.24 (42.59%), 7.60 (41.85%), and 7.24 (40.61%) and at 6 months of 8.14 (47.88%), 10.33 (56.88%), and 11.1 (62.25%) in the tamsulosin, finasteride, and combination groups, respectively. There was an increase in peak urinary flow rate in all groups with mean increase at 3 months of 0.98, 0.05, and 3.55 (ml/s) and at 6 months of 4.11, 0.87, and 3.74 (ml/s) in the tamsulosin, finasteride, and combination groups, respectively. There was a reduction in the prostate volume in the finasteride and combination groups at 6 months of 6.8 and 6.32 cm3, respectively, while the tamsulosin group recorded an increase.Conclusion:At the end of 6 months, tamsulosin monotherapy and combination therapy appear to be equally effective in the treatment of lower urinary tract symptoms BPH while finasteride monotherapy appears to be the least effective. Bothersome, side effects were more in patients taking finasteride alone or as combination therapy.
Fournier's gangrene is a rapidly progressive necrotizing infection of the external genitalia. We aim to share our clinical experience in the management of this disease. This was a retrospective study with data retrieved from the case note of patients seen with Fournier's gangrene between January 2013 and April 2019. A total of 23 cases were analysed, who were all men, with a mean age of 47 years. The mean duration before presentation was 8 days. Perianal lesion was the most common aetiological factor occurring in 39% and the most common isolated organism was E. coli. The mean number of debridement was 1.5 while 2 patients required colostomy. The mortality rate was 9% in this study. Despite improvement in clinical care, Fournier's gangrene remains a potentially fatal condition. Thus, aggressive resuscitation, debridement and judicious antibiotic therapy are required.
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