Background: Due to advancement of endourology, percutaneous nephrolithotomy (PCNL) is a common procedure for removal of renal stones. Intravascular absorption of normal saline during the PCNL may result in fluid overload, electrolyte imbalance and cardiovascular instability. Objective: To evaluate the changes in cardiovascular status and serum electrolyte levels in patients undergoing percutaneous nephrolithotomy. Method: Sixty adults underwent percutaneous nephrolithotomy were studied. Among them male female ratio was 13:7 and age ranging from 20-50 years. Heart rate, blood pressure and serum electrolytes were monitored before irrigation, during irrigation and post operatively. Stone size, duration of irrigation, volumes of irrigation fluid used and amount of absorption of irrigation fluid were recorded. Result: The mean heart rate, systolic and diastolic blood pressure levels were significantly higher (p<0.05) during PCNL compared to base line values. Serum sodium, potassium levels were decreased during the operation compared to the baseline levels (p < 0.005) but mean chloride concentration increased gradually compared to baseline but it was significantly higher at 120th min of irrigation and postoperatively (p<0.05). There was no significant change of serum bicarbonate concentration compared to base line value (p>0.05). The volume of irrigation fluid varied from 10000 ml to 24000 ml with mean volume 17045(±3383) ml. Total duration of irrigation varied from 30 min to 120 min. Total absorbed irrigant varied from 200-1000 ml with mean volume absorbed 526.27(±215) ml. Conclusion: In conclusion, these changes in cardiovascular status and serum electrolyte levels during percutaneous nephrolithotomy (PCNL) may be due to the invasive nature of the intervention to the kidney and the continuous irrigation of this vital organ. Bangladesh Journal of Urology, Vol. 22, No. 1, January 2019 p.3-7
Background: TURP is the gold standard for the endoscopic treatment of BPH. Nonetheless, it remains associated with significant morbidity, especially in terms of hemorrhage leading to possible blood transfusion and delayed hospital discharge. TUVP is associated with reported improvements in subjective and objective measures but a high rate of postoperative irritative symptoms and lack of tissue for histologic examination. The concept behind TURP and TUVP sandwich procedure is to overcome the drawbacks of the two procedures. Objective: To compare the outcome of bipolar transurethral resection of prostate (TURP) and bipolar transurethral resection and electrovaporization of prostate (TURP-TUVP) sandwich procedure in patient with benign prostatic hyperplasia. Methods: This quasi experimental study was conducted in the Department of Urology, National Institute of Kidney Diseases and Urology (NIKDU), Dhaka, Bangladesh from July 2017 to June 2019 over a period of 2 years. Sixty patients with BOO caused by benign prostatic hyperplasia scheduled for transurethral resection of prostate were included in this study. Patients were selected first by purposive sampling and were grouped into A and B with randomization. Group A patients underwent bipolar TURP while group B patients underwent sandwich method. Perioperative findings as well as IPSS Qmax and PVR after 3 months of operation were compared. Results: Operative time was significantly longer in TURP-TUVP group than in TURP group (P value 0.036).Post operative hospital stay was significantly longer in TURP group (P value <0.001). Catheterization time was significantly higher in TURP group (P value <0.001).Intra-operative irrigation was significantly higher in TURP-TUVP group (P value 0.001). Post operative irrigation time was significantly longer in TURP group (P value <0.001). Hemoglobin decrease was significantly higher in TURP group (P value <0.001). Similarly, sodium decrease was higher in TURP group than that of TURP-TUVP group but not statistically significant (P value 0.81).Clot retention was 2 (6.7%) in TURP group. Short-term follow up at 3 month showed no significant difference in IPSS in TURP and TURP-TUVP groups (P value 0.349), significantly higher Qmax in TURP-TUVP group (P value 0.022) and significantly higher PVR in TURP group (P value0.005) Conclusion:. TURP-TUVP procedure has higher operative time and intraoperative irrigation, but has significantly lower catheterization time, postoperative irrigation time, hemoglobin change and hospital stay. Bangladesh J. Urol. 2021; 24(2): 161-165
Objective: To assess the articles published on current treatments for Peyronie’s disease (PD) and it’s new development and to assist clinicians to select the effective management of PD by increasing understanding and awareness of the outcomes associated with current medical and surgical treatment options. Methods: A Hinari literature search was conducted to identify relevant, peer-reviewed, clinical and review articles published related to current treatment options and it’s new developments of Peyronie’s Disease. Search terms for this non-systematic review included ‘Peyronie’s disease’, ‘current treatment, outcomes’, new development. ‘Erectile dysfunction or ED’, search terms were searched separately and in combination. Case studies and editorials were excluded, primary manuscripts and reviews were included, and references of articles of interest were reviewed and key references were obtained. Result: Currently, there are several investigational minimally invasive and non-surgical treatment options for PD; however, surgical treatment remains the standard of care for patients with stable disease and disabling deformity or drug-resistant erectile dysfunction. Each of the different surgical procedures that are used for treatment of PD, including tunical shortening, tunical lengthening (plaque incisions or partial excision and grafting), and use of inflatable penile prostheses, carries its own advantages and disadvantages in terms of potential complications and postoperative satisfaction. No single, standard, surgical treatment for this disorder has prevailed and multiple variations of each type of procedure exist. Obtaining data on current treatment and its modifications to these procedures, and new surgical techniques and materials may serve to further guide Conclusion: The real etiology of Peyronie’s disease and the mechanisms of formation of the plaque still remain obscure. Although conservative management is obtaining a progressively larger consensus among the experts, surgical correction still remains the mainstay treatment for this condition. Treatment should be tailored to each patient after a detailed evaluation of disease severity and sexual function. Bangladesh Journal of Urology, Vol. 17, No. 2, July 2014 p.87-96
Objective: To compare the outcomes of tubularized incised plate urethroplasty and modified tubularized incised plate urethroplasty in the primary management of distal hypospadias Materials and Methods: Total 70 patients of age group 2 to 10 years with distal hypospadias were selected for this study from January 2008 to December 2010. They were divided into Group-A (n=35) treated by the tubularized incised plate urethroplasty and Group-B (n=35) treated by the modified tubularized incised plate urethroplasty.The modification was performed by using inner preputial skin on the incised plate before tubularization. All patients were followed up immediately and at 4th, 8th and 12th weeks after operation. Results: The satisfactory cosmetic and functional outcomes were observed in 29 patients (82.85%) of Group-A and all families of Group-B were happy with aesthetic and functional outcomes. Urethrocutaneous fistula developed in 5 patients (14.70%) patients of Group- A and 1 (2.94%) patient in Group-B. Three patients (8.82%) in group-A and one patient (2.94%) in group-B were found to develop meatal stenosis. One patient (2.94%) developed stricture urethra in group A but no patient in group-B developed urethral stricture. Overall complications occurred in 10 patients (29.41%) in Group-A and 2 patients (5.88%) in Group-B. Conclusions: This study demonstrates that modified tubularized incised plate urethroplasty had excellent cosmetic and functional outcomes and fewer complications than that of tubularized incised plate urethroplasty in the primary management of distal hypospadias. Bangladesh Journal of Urology, Vol. 17, No. 2, July 2014 p.75-81
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