Objective: To determine the short term outcome of anastomotic urethroplasty. Material and Methods: From January 2013 to June 2015, 25 male patients underwent anastomotic urethroplasty at our center and were analyzed prospectively. Mean age was 28.1 years (range 13-50), average stricture length was 2.5 cm (range 1.5-2.5). Patients with post-prostatectomy stricture, stricture more than 2.5 cm in length or patients of stricture with neurogenic bladder and patients with any perineal disease were excluded from the study. Retrograde urethrogram and voiding cysto-urethrogram was done in every patient to assess stricture length and location. Stricture excision and end-to-end anastomosis of urethra with spatulation was performed in every patient. Minimum followup period was 6 months and maximum 30 months. All patients had obliterative stricture. Results: The mean operative time was 105 min (range 90-120). Four patients (16%) developed complications postoperatively. Wound infection occurred in 01 (04%) patient. Stricture recurrence found in 02 (08%) patients and erectile dysfunction in 01 (04%) patients. Twenty one patients (84%) had excellent outcome, Two (08%) needed optical internal urethrotomy and of them one (04%) failed to respond. Conclusion: Anastomotic urethroplasty has a high success rate of 92%. It is technically straightforward with minimal morbidity. Long term follow-up is strongly recommended for ultimate success. Bangladesh Journal of Urology, Vol. 19, No. 1, Jan 2016 p.38-42
Objective: To find out the optimum evaluation tools for male infertility. Methods: Hinari database were searched for articles related to male infertility for review to find out how a male infertile patient can be evaluated optimally.EUA guidelines on Male Infertility and AUA best practice statement on Optimal Evaluation of the Infertile Male updated on 2010 were also considered for review. Results: Initially thirty five articles were obtained and finally twenty eight articles were considered for review. Some cross references were considered to be cited in the reference section. We have mentioned in this review the evaluation tools those are necessary for male factor infertility at the optimum. Conclusion : As male infertility problem are increasing so optimum evaluation should be carried out to diagnose every possible underlying cause. Bangladesh Journal of Urology, Vol. 19, No. 1, Jan 2016 p.43-48
Background: Evaluation of the safety and efficacy of day case laparoscopic cholecystectomy in a teaching hospital may influence the rationale of this practice to gain widespread acceptance. Methods: Day case laparoscopic cholecystectomy was offered to patients during a two and a half year period (Jan 2010 - July 2012) in Minimally Invasive Surgery unit in BSMMU who met the following established inclusion criteria: ASA (American Society of Anesthesiology) physical status classification classes I and II; age: 18 - 70 years; body mass index (BMI) < 30 kg/m2; patient acceptance and cooperation (informed consent). Acute cholecystitis was considered as an exclusion criterion. Follow-up was done by clinical examination on an outpatient basis one week and 3 months after operation. Evaluation was done about success rates, postoperative outcome (complications, readmissions, morbidity and mortality) and patient's overall satisfaction. Results: 40 consecutive patients, predominantly female (62.5%) and ASA II (75%) with a mean age 44 ± 13.3 years underwent cholycystectomy. 85% patients had symptomatic gallstone disease. Mean operating time was 45±15.1 minutes and no conversion was needed. 25% cases experienced post operative nausea and vomiting and all patients were discharged in the following morning. 20% developed minor complications that resolved spontaneously. 1 case was readmitted and overall patient satisfaction rate was 90%. Conclusions: This study suggested that day case laparoscopic cholecystectomy is clinically effective and can be performed safely in a teaching hospital by competent surgeon. Journal of Surgical Sciences (2014) Vol. 18 (1) : 15-19
Background: Understanding SSI and providing feedback to the surgical team has been shown to reduce the incidence of surgical site infection and the cost incurred due to it. Objective: To assess the risk factors of surgical site infection (SSI) in elective gastrointestinal surgery. Methods: prospective data were collected on 1122 surgical patients admitted in the surgery department in BSMMU from January 201 0 to July 201 2. All preoperative risk factors were evaluated .Patients operated were followed in the post operative period and if any wound infection noted, swab from the site of infection was sent for culture and sensitivity and antibiotics were given accordingly. Results: The incidence of SSI was 1 83(1 6.31 %).Out of this 1 83 cases 65.6% had BMI <25. Anaemia was present in 45.90% cases, bronchopulomnary disease was present in 1 1 .5% cases and DM & jaundice was present in 8.1 9% and 28.9% cases accordingly. 69(37.7%) cases were habitual smoker.SSI rate progressively increased with rate of contamination and maximum infection occurred in lower GIT surgery which was 144(1 7.84%). SSI developed more, in 1 02 (55.74 %) cases when duration of peration was more th ;1 1 1;1.2 hours. In 73.8% cases of SSI drain tube was used. Statistically significant risk factors for SS were found to be smoking habit, BMI <25, preoperative anaemia and duration of operation more than two hours. Conclusion: Specific optimization of the patients' preoperative condition is essential to reduce the risk of SSI following elective gastrointestinal surgery. Surveillance should be conducted and maintained in all hospitals to promote better surgical outcomes. Cessation of smoking, optimization of nutritional status, correction of anaemia and reduction of operation time should be associated with a lower incidence of SSI. Journal of Surgical Sciences (2012) Vol. 16 (2) : 71-75
Introduction: Genitourinary tuberculosis (GUTB) is the leading cause of morbidity and mortality worldwide especially in developing countries. Surgery is an essential management modality in genitourinary tuberculosis when indicated. Objective: This study aims to document the role of surgery for genitourinary tuberculosis according to the organ involved. Materials and Methods: Retrospective review of 33 GUTB cases was done that underwent surgery at department of urology, Bangabandhu Sheikh Mujib Medical University from January 2008 to December 2014. Patient’s baseline characteristics, mode of presentation, organ involvement, investigation, surgical intervention and follow up were studied. Results: Among enrolled patients, mean age at presentation was 31.5 years and 64% (21, 33) were male. The most common presentation was irritative voiding symptoms. Kidney was the most common organ involved in 39% (13, 33) cases, and next common site was bladder in 30% (10, 33) cases. Preoperative bacteriologic diagnosis was confirmed only in 21% (7, 33) cases. A total of 41 surgical procedures were performed as some patients needed more than one procedure. These included 13 endoscopic, 6 temporary diversion, 19 ablative procedures and 3 reconstructive procedures. Post surgical follow up of all the patients were given after 3, 6 and 12 months. Then the patients were followed with RFT and ultrasonography 6 monthly for 3 years and then annually. The intravenous urography and diethylenetriamine pentaacetic acid scan were performed when indicated. Conclusion: Multidrug chemotherapy with judicious surgery when indicated is the ideal treatment. Surgery plays an important role in symptomatic relief and helps to lead a normal life. The results of reconstructive surgery are good and should be done when possible. Rigorous and long term follow up is necessary in patients undergoing reconstructive surgery. Bangladesh Journal of Urology, Vol. 19, No. 2, July 2016 p.69-73
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