Background: Infertility is a global health issue affecting approximately 8-10% of couples and has multidimensional problem with social, economic and cultural implications, which can take threatening proportions in countries with strong demographic problems. Reproductive health in Bangladesh focused mainly on women health and ignoring the role of men, in spite of the important role that men are playing in reproduction and fertility which impact his family and environment. Objective: To find out the factors of infertility among the males in selected hospitals of Dhaka city. Methods: A convenience sample of 112 medical records for males diagnosed with infertility in Shaheed Suhrawardi Medical College Hospital, National Institute of Kidney Diseases and Urology, Sher-E-Bangla Nagar, Dhaka, Fertility center Mohammedpur Dhaka, Infertility care and Research Center Mohammedpur Dhaka were retrospectively reviewed for the cause of their infertility. Four months duration of study from May 2016 to August 2016. After completion of data collection, the collected data was checked and verified on regular basis for accuracy, consistency and completeness. Data was edited and coded. The results were presented into the form of tables and figures. Data was processed in computer by using the software SPSS, version 22 and statistical analysis was done. Results: Male factor alone was accounted for 52% of infertility among couples of these 90 had primary infertility and 22 had secondary infertility. The mean duration of infertility was 4.98±3.99 years and the mean age for male cases was 33.5±7.24 years The most common causes among infertile men were, idiopathic infertility 36.6%, varicocele 32.1%, obstruction of the seminal tract 18.8%, and hormonal problems 5.4%. Least common causes found were, medication 1.8%, spinal cord injury 1.8%, cryptorchidism 1.8%, and testicular failure 1.8%. Conclusion: More than half of the infertile couples were from an idiopathic cause. Study results confirm that understanding about male reproductive function and the environmental factors that affect it is insufficient. Provide education to infertile men by doctors in charge about potential risk factors that may affect fertility and not just provide treatment because simple changes in lifestyle can improve fertility. Bangladesh J. Urol. 2021; 24(1): 37-45
Background: Percutaneous nephrolithotomy (PCNL) has gradually evolved to be one of the main endourologic treatment options for managing renal stone. For successful enctry into pelvicalyceal system can be obtained by fluoroscopy, ultrasonography and sometimes computed tomography (CT-guided) after RGP, but many are done without RGP. In this study, our objective was to compare the clinical outcomes of renal calculi management by PCNL with and without retrograde pyelography. Method: This quasi experimental study conducted on 60 cases with opaque renal calculi in lower, middle and upper calyx and lower calyx with renal pelvis. They were grouped into 2 groups purposely, one with RGP (30 patients) while other without RGP (30 patients). Result: We found no statistically significant difference between RGP and non RGP group in terms of duration of surgery (71.68 ±12.95 minutes vs 78.84±15.56 minutes), duration of radiation exposure (3.55± 1.34 min vs 3.74± 0.52 minutes) & hospital stay (3.0± 0.8 vs 2.6 ±1.0 days). Around 93.33 percent of the patients in the RGP group (n=28) were stone free, whereas in the Non-RGP group, 90% percent of the patients (n=27) were stone free. Conclusion: We can avoid RGP during PCNL in selected cases for pelvicalyceal access in the sight of no significant differences in duration of surgery, duration of radiation exposure, Hospital stay & complications in PCNL either with or without RGP. Bangladesh J. Urol. 2021; 24(1): 87-89
Objective: To determine the amount of blood loss and need for blood transfusion in patients undergoing percutaneous nephrolithotomy (PCNL). Study Design: Observational study. Place and Duration of Study: National Institute of Kidney Diseases and Urology (NIKDU) and Popular Medical College Hospital, Dhaka from 2015 to 2019. Methodology: The percutaneous Nephrolithotomy data were retrospectively reviewed to identify patients with postoperative blood loss and need for blood transfusion. The amount of blood loss was estimated by the postoperative drop in hemoglobin factored by the quantity of blood transfusion. Various patients and procedure-related factors were assessed for association with total blood loss or blood transfusion requirement using stepwise univariate, forward multivariate regression analysis. Results: A total of 232 procedures were performed on 216 patients. Two hundred and thirty-two procedures were included in the study. There were 167 males and 65 females. The mean age was 41±14 years. The mean hemoglobin drop was 1.68 ± 1.3 gm/dL. The overall blood transfusion rate was 13.2%. Stepwise multivariate regression analysis showed that female gender (p = 0.003), stag-horn stone (p = 0.023), stone fragmentation with ultrasound (p = 0.054) and chronic renal failure (p = 0.001) were significantly predictive of the need for blood transfusion. Conclusion: Chronic renal failure, female gender, presence of staghorn calculi, and stone fragmentation using the ultrasonic device were predictive of blood transfusion in this cohort of patients. Bangladesh J. Urol. 2021; 24(2): 124-128
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