Background: The standard management of urethral strictures involving the anterior urethra is dorsal onlay buccal mucosa augmentation urethroplasty. This requires circumferential mobilisation of the urethra, which might cause ischemia of the urethra in addition to chordee. In this research, we managed the anterior urethral stricture, applying a dorsolateral onlay urethroplasty.Methodology: This prospective study was conducted in the Department of Urology, BIRDEM General Hospital& some private hospitals from July 2009 to June 2015, the outcomes of a total cases of 103 of one sided anterior dorsolateral onlay OMG Urethroplastywere assess and compared. Patients with anterior and recurrent urethral stricture more than 1 cm were included as study population. Urethrogram and Uroflowmetry were the mainstay of assessment. Success was defined as a maximum flow rate of>20 ml/sec., normal RGU, and/or urethroscopy. Poor outcomes were defined as the presence of obstructive urinary tract symptoms, Qmax <15 ml/sec., stricture diagnosed on retrograde urethrogram/ urethroscopy, and the need for any postoperative urethral intervention.Result: Of the 103 patients, 97 had (94.2%) successful outcome and 6 (5.8%) were failure. Four failed cases underwent optical internal urethrotomy and two patients had persistent narrowing and they were managed by BMG Urethroplasty. Follow up period was 12 months on an average. In conclusion, it can be said thatthe preservation of one sided vascular supply to the urethra and its entire muscular and neurogenic support represent significantly towards perfecting the surgical technique of urethral reconstruction using a minimally invasive approach.Conclusion: In this study, we found it to be a technically feasible, easily adoptable and finally successful procedure.Anwer Khan Modern Medical College Journal Vol. 7, No. 2: Jul 2016, P 16-19
Background: Despite increasing use of testosterone in the management erectile dysfunction, debate remains regarding the selection of candidate for the hormonal treatment. The aim of this study is to find out the role of testosterone in erectile dysfunction (ED), the incidence of testosterone deficiency in the patient of ED and therapeutic response of testosterone in ED in common practice.Material & Methods: This cross-sectional study had conducted among the patients with age above 30 years, complaining of erectile dysfunction treated with testosterone by self-medication or clinical practitioners. Total 103 cases interviewed, who attended the private chamber of Urologists and the Urology OPD, BIRDEM General Hospital between periods of April 2014 to September 2015.Result: Of 103 cases, testosterone level was normal in 78.6% cases. All were treated with testosterone. Among the participants 47.57% were between 30-40 years and 9.09% were of the age between 60-70 years. Twenty-two patients having testosterone deficit were treated with testosterone supplement and marked improvement was observed (88.1%). In this study 49 patients having normal testosterone level received testosterone along with sildenafil or tadalafil, of these 47 cases (95%) had moderate to marked improvement. On the other hand 32 patients having normal testosterone level received testosterone monotherapy but there was no improvement in 87.5% cases.Conclusion: The result of the study suggests that testosterone replacement therapy is beneficial in patient of ED due to hypogonadism. However, testosterone monotherapy in erectile dysfunction with normal testosterone level should be considered injudicious.Anwer Khan Modern Medical College Journal Vol. 8, No. 1: Jan 2017, P 45-49
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