Background: Posterior Urethral Valves (PUV) are one of the most common urological problems having wide clinical implications and the prognosis depends upon the extent of the renal injury inflicted by the time of initiation of intervention and hence earlier the treatment, better the long-term outcome Objectives: To evaluate the outcome of endoscopic fulguration of posterior urethral valves (PUV) in children. Method: A cross-sectional analytical study was carried out on 50 male children with posterior urethral valves (PUV) from January 2011 to December 2012 in Dhaka Medical College Hospital, who were treated with endoscopic fulguration and came for routine follow-up. Results: In this series, median age of patients was 2 years ranging from 1 to 12 years. Approximately half of the patients (46.0%) were 2 years. Sixty four percent presented with poor urinary stream, 38.0% presented with straining during micturition. The most common physical finding was palpable bladder 60.0%, UTI was present in 52.0% cases. Proteinuria was found in 46.0% cases, raised serum creatinine was found in 36.0% cases. Electrolyte imbalance was found in 12.0% of cases. Ultrasonogram of KUB showed severe hydronephrosis in 14.0% cases. Voiding cystourethrogram diagnosed PUV in 92.0% of cases. The follow-up period was 24 months. At the end of final follow-up 3 patients remained incontinent. Urinary tract infections were absent in 52.0% cases. Hydronephrosis disappeared in 30.0% cases. Chronic renal failure developed in 6.0% of cases. End stage renal disease was found zero during the follow-up period. Conclusion: Follow-up period of longer duration needed to determine the ultimate outcome of these patients because some of the patients develop ESRD in the long run and ultimately renal transplant is the treatment. Treatment should be performed in higher centers where all the facilities are available. Bangladesh Journal of Urology, Vol. 22, No. 1, January 2019 p.8-14
Background: Kidney cancer is uniformly lethal once the tumor extends beyond Fascia Gerota. But if diagnosed early surgery provides excellent results with regard to local disease control and prospect for long term disease free survival. Objective : To assess the frequency of kidney cancer among the submitted kidney tissue for histopathological examination. Method: This analytical retrospective observational study of 550 histopathological reports of nephrectomy specimen was done in different hospitals and institute in Dhaka city. Histopathology reports from January 2007 to December 2009 were collected and all data are compiled and analysed using SPSS version 16 and appropriate statistical tests were done to make inference. Results : During the study period, among the 550 histopathological specimen of kidney tissue, RCC was found to be most common type 201(36.5%), TCC renal pelvis was 41(7.5 %), Wilms tumor 54(9.8%) and sarcoma 5 (0.9%) and rest were benign. Among the 201 cases RCC only in 130 cases tumor grade was mentioned, with grade II most common type. Peak age group of kidney cancer was found to be 4th decade and no cancer was found between 10 to 30 years of age. Wilms tumor became most common child hood renal malignancy with mean age 7 years. Conclusion: The results of the study shows kidney cancer, the most lethal of the urologic cancer is not a common cancer in our country .The most affected age group is 5th decade younger than western countries. RCC is the most common type found and males are affected almost twice than female. National cancer registry should be opened and proper entry should be ensured. Bangladesh Journal of Urology, Vol. 21, No. 2, July 2018 p.83-87
Background: Stones in the urinary tract is a common medical problem in the general population. At present, the great expansion in minimally invasive techniques has led to the decrease in open surgery. Extracorporeal shock wave lithotripsy (ESWL) has been introduced as an alternative approach which disintegrates stones in the kidney and upper urinary tract through the use of shock waves. Nevertheless, as there are limitations with the success rate in ESWL, other minimally invasive modalities for kidney stones such as percutaneous nephrolithotomy (PCNL) is also widely applied. There is a trend of using ESWL for treatment of renal stones smaller than 1 cm and PCNL in those with stones greater than 2 cm. Nevertheless, no consensus regarding treatment of renal stones between 1 to 2 cm stones. The objective of this prospective study was to compare the results of ESWL and PCNL for treatment of 1 to 2 cm renal stones. Method : This is a quasi experimental study. This study was conducted to compare the efficacy and safety of percutaneous nephrolithotomy (PCNL) and extracorporeal shock wave lithotripsy (ESWL) in treating 10 to 20 mm sized renal stone among the Bangladeshi population. This prospective study conducted between the periods of September, 2011 to August, 2012 in the department of urology, Bangabandhu Sheikh Mujib medical university (BSMMU) Hospital. All the patients attending the urology outpatient clinic with 10 to 20mm renal calculi were the study population. A total of 70 subjects were enrolled for this study and they were equally divided into two groups so that each group had 35 subjects. The one group received PCNL whereas the other group received ESWL. Statistical analyses of the results were obtained by using window based computer software devised with Statistical Packages for Social Sciences (SPSS-15). Results: There is no statistically significant difference in regarding age, sex, stone side(lt. or rt.), the distribution of stone (upper, middle and lower calyx) and size between the groups (p>0.05). At 3 month follow up among the patients in ESWL group stone cleared and not cleared were 25(71.4%) and 10(28.6%) respectively and at 3 month follow up among the patients in PCNL group stone cleared and not cleared were 33(94.3%) and 2(5.7%)respectively. There is statistically significant difference in stone clearance rate at 3 month follow up between the groups (p<0.05). All patients in ESWL group developed post procedure haematuria 35(100.0%). Other post procedure complications among the ESWL group pain, fever and steinstrasse were 12(34.3%), 07(20.0%) and 03(08.6%) respectively. Common post procedure complications among the patients of PCNL group pain, haematuria and fever were 11(31.4%), 33(94.3%) and 13(37.1%) respectively. Other post procedure complications in PCNL group were vomiting (8.6%), urinary leakage (5.7%), wound infection (11.4%) and urinary cutaneous fistula (5.7%). There was no statistically significant difference post procedure pain, haematuria and fever between the groups (p>0.05), but statistically significant difference observed in steinstrasse and wound infection between the groups (p<0.05). Mean±SD of hospital stay among the patients of ESWL group and PCNL group was 1.37±0.65 and 4.34±1.43 days respectively. There is statistically significant difference in hospital stay between the groups (p<0.05). Conclusion: Though some specific complications which can be treated conservatively are more in PCNL group it may be concluded that the treatment with PCNL is better option than ESWL among the patients having renal calculi 10 to 20 mm. Bangladesh Journal of Urology, Vol. 21, No. 2, July 2018 p.98-104
Background: Prostate cancer is the development of cancer in the prostate, a gland in the male reproductive system. The cancer cells may spread from the prostate to other area of the body, particularly the bones and lymph nodes. It may initially cause no symptoms. A disease known as benign prostatic hyperplasiamay produce similar symptoms. Objective: To identify the frequency of prostate cancer in prostatic tissue submitted for histopathological examination in selected hospital of Dhaka City. Method: This analytical observational study consists of review of 3914 histopathological reports of prostatic specimen examined in 13 selected tertiary level hospitals in Dhaka city. This study was carried out from January 2007 to December 2009 (three years). All data were compiled, analyzed and appropriate statistical tests were done to make inference. Results: During the study period, among the 2914 histopathological specimen of prostatic tissue, 637(about 16%) cases were diagnosed as prostate cancer (including PIN), 3221 (about 82%) cases were benign prostatic hyperplasia, 53 (1 .35%) were chronic prostatitis and the remaining 3 cases were other rare disease e.g. lipid storage disease etc. Among the prostate cancer, most common was prostatic adenocarcinoma (about 95%); about 3% was Prostatic Intraepithelial Neoplasia (PIN), 1% squamous cell carcinoma arid I % are primary Transtiona1 cell carcinoma (TCC). Most of the patients diagnosed with prostate cancers are of advanced age - between 70 to 80 years (53.46%), and the second peak age is 60- 70 years (34.57 %). Of the prostate cancer cases 8.78% were well differentiated, 34.84% were moderately differentiated and 64.36% were poorly differentiated. The ratio between benign and malignant prostatic disease was about 5:1. Though all the prostatic diseases are common in elderly people, benign prostatic disease occurs more commonly: in younger patients than the prostate cancer. Conclusion: From this study it is evident that the burden of prostate cancer is still low in our context. But the disease seems to be increasing in recent years mainly due to increasing number of aged population. So in near future, the burden of the disease will be increasing throughout the world including our country. Prostate cancer is a slow growing tumor. It has a very sensitive tumor marker (PSA) also. Early diagnosis and proper management certainly improves the prognosis of the disease. There is a screening program for early diagnosis of the disease though it is relatively a costly program. Screening should be considered in persons who have a strong family history of prostate cancer. Every urologist, health policy makers should be aware of the burden of the disease and appropriate planning, necessary manpower & skill development, resource allocation should be made to combat the situation efficiently. Bangladesh Journal of Urology, Vol. 21, No. 2, July 2018 p.88-92
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