Background: Fracture of the penis is a urological emergency which occurs as a result of abrupt trauma to an erect penis. Immediate surgical repair is the standard of care and is superior to non- operative management due to excellent long term outcomes. Objective: The aim of this study was to investigate surgical and functional outcomes in patients who underwent penile fracture repair. Methods: A cross sectional descriptive study was conducted during the period of July 2017-June 2018 to find out the pattern of surgical management of fracture penis among the patients admitted in the urology department of Dhaka Medical College Hospital. A total 50 patients of fracture patients were selected purposively. Outcome of surgical management was investigated by using semi structured and International Index of erectile function questionnaire. Results: The study reveals that the mean age of the patients were 34.26±9.96 (range: 18–65), predominantly married (70%). The mean follow-up period was 12 weeks. Patients ‘history and clinical examination were highly sensitive and accurate in predicting a tunical tear. 15 patients (30%) received surgical treatment within six hours from the hospital admission, while 31 patients and 4 others seek surgical intervention within 6-24 hours and more than 24 hours respectively. It was revealed that the presenting symptoms were pain (72%), penile swelling (100%), eggplant deformity (100%), and hematuria (22%) with associated urethral injury in 22% of patients. Post- operative complications found were infection (14%), penile nodule (26%), chordee (14%), painful erection (16%) and erectile dysfunction (34%). There is a significant relationship between having painful erection and erectile function of the patients at the time of interview [X²=23.44, df=4, p=0.000], The relationship between the time elapsed from hospital admission to surgery and erectile function at the time of interview was not significant [X²=10.39, df=8, p=0.239]. The relationship ..
Background: Prostate cancer is common in urological practice. Diagnosis of prostate cancer depends on biopsy of the prostate. For the last two decade TRUS guided 6 core (sextant) biopsy is being considered as standard for prostate biopsy. Various studies in different countries showed the drawback of sextant biopsy. The debate remains alive on number of biopsy core which is appropriate for obtaining representative tissue. Moreover, more number of needle biopsy may be associated with more complication. Methods: In this hospital based Quasi experimental study, a total of 50 patients were allocated into two groups by purposive sampling technique where 6 core prostate biopsy in one group and 12 core biopsy in another group. Baseline demographic and clinical data were recorded. Post procedural morbidity & histopathological findings were recorded. All the collected data were compiled. Further Statistical analyses of the results were obtained by using Microsoft Xcel, 2010 and web based computer software - Graph Pad Software, 2017. A probability value (p) of less than 0.05 was considered to indicate statistical significance. Results: The baseline characteristics like age, S.PSA, prostate volume & DRE findings were similar in two groups. Cancer detection rate was not significantly different between the 6 core biopsy group and 12 core biopsy group (48% Vs 60%, p=0.395). Dysuria with difficulty in micturition and hematuria after biopsy significantly more in 12 core biopsy group (24% Vs 44% and 32% Vs 60% respectively). Other post procedural complications like fever, perrectal bleeding was found statistically not significant between two groups Conclusion: Trans rectal ultrasound guided 6 core biopsy is equally effective as Trans rectal ultrasound guided 12 core biopsy for detection of prostate cancer.
Background: The management of VVF involves a multi-modal technique. Surgical repair remains the treatment of choice for VVF. The repair could be undertaken through the transabdominal or transvaginal route. Although the vaginal route was the commonest route employed in the repair of VVF, it is clearly associated with post-operative incontinence, high recurrence and low success rate. Objectives: To compare the outcomes of surgical repair of vesicovaginal fistula between transabdominal and transvaginal Route. Methods: This prospective comparative study intended to compare the outcomes between surgical repair of vesicovaginal fistula- between transabdominal and transvaginal route. A total of 50 cases of VVF patient planned for surgical repair of VVF in Dhaka Medical College Hospital from April 2017 to September 2018, included in this study according to the inclusion and exclusion criteria. Cases were randomly allocated to group A (Transabdominal repair of VVF) and group B (Transvaginal repair of VVF). Each group consisted of 25 patients. The outcome variables were success rate of operation, post-operative complication, post-operative pain, post-operative hospital stay and recurrence. Data were analyzed and compared by statistical tests. Results: No significant differences were found regarding age (p=0.3921), etiology (p=1.000), fistula number (p=0.4174), haematuria (p=0.667), vaginal bleeding (p=1.000), wound infection (p=0.4174) and hospital stay (p=0.4828) between two groups. Post-operative incontinence (p<0.0448) was less in group A than group B cases. Success rate is higher in group A in comparison to group B (p<0.0223). Conclusions: Trans-abdominal route is better than trans-vaginal route in VVF repair. It significantly reduces post-operative incontinence and recurrence of VVF. Success rate is also high in trans-abdominal route than trans-vaginal route. So, VVF repair by trans-abdominal route is safe and effective.
Background: Stricture urethra is a frequent urological problem and substitution urethroplasty is the standard treatment for longer (>2 cm) urerthral strictures, multiple urethral strictures and recurrent strictures. Currently, buccal mucosa graft (BMG) is the preferred donor site for substitution urethroplasty which is associated with donor site morbidities. The mucosa covering the lateral and undersurface of the tongue is identical to the rest of the lining of oral cavity and seems to be associated with less risk of donor site complications. The aim of the study was to compare the surgical outcome and donor site morbidity of buccal versus lingual mucosa graft in anterior urethroplasty. Methods: A prospective experimental study was done in the department of Urology Dhaka Medical College Hospital during the period of April 2017 to September 2018. Total 54 Patients were included by purposive sampling for the study as per inclusion and exclusion Criteria. Patients were than allocated into two groups. Group A consisted of 27 patients where Lingual mucosa graft (LMG) urethroplasty done and group B also consisted of 27 patients where Buccal mucosa graft (BMG) urethroplasty done. Results: In the present study, the baseline characteristics of the patients in group A and Group B were almost similar having no statistically significant difference. The overall surgical outcome between two groups was in group A 92% and in group B 88%. The inter-group difference was not statistically significant. Donor site complications more frequently occurred in Group B. Pain in oral cavity at 3rd week in Group A was in 1(4%) patient and in group B was in 9(36%) patients, at 6th month follow up, eating and drinking problem (Group A 4% versus group B 32%), peri-numbness (Group A 4% versus Group B 28%), oral tightness (Group A 0% versus Group B 32%), salivary disturbance (Group A 0% versus Group B 28%) were significant statistically (p<0.05). Conclusion: We conclude that that lingual mucosa ....
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