Objectives: To compare pain, systemic lidocaine toxicity and complications between periprostatic with intraprostatic local anaesthesia for transrectal prostate biopsy. Methods: This study was carried out in the Department of Urology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka Medical College (DMCH) and Comfort Nursing Home, Dhaka during the period of January 2009 to October 2009, For this purpose, a total number of 60 consecutive patients having increased prostate specific antigen (PSA >4.0ng/ml), abnormal DRE/transrectal ultrasound were admitted in the above mentioned hospitals were enrolled in this study for surgical management. Results: The age ranged from 50 to 90 years and the maximum number was found in the age group of 61-70 years in both groups. The mean(±SD) age was 68.5±7.5 years and 70.3±8.2 years in group I and group II respectively. The mean(±SD) PSA was 17.0±12.8ng/ ml with their PSA ranged from 5.9- 62.8ng/ml in group I and in group II was 17.2±17.3ng/ml with their PSA ranged from 4.6 – 55.1ng/ml, which was not significant (p>0.05) between two groups. Normal digital rectal was found 14(46.7%) and 16(53.3%) in group I and group II respectively. Carcinoma was found 13(43.3%) and 14(46.7%) in group I and group II respectively and rest of them were benign in group I and group II respectively. The mean(±SD) pain degree during biopsy was 2.6±1.1 and 2.0±1.2 in group I and group II respectively according to allocated pain score. Pain degree after 30 minutes of biopsy, most of the patients had no pain in both groups. Pain during anesthesia it was found that 4(13.3%) and 13(43.3%) of the patients had no pain in group I and group II respectively. The mean(±SD) pain degree during anesthesia was 2.7±1.2 and 2.1±1.2 in group I and group II respectively. Conclusion: It is a simple and safe method that is less painful and it should be considered in all patients undergoing transrectal ultrasound guided prostate biopsy. The decreased discomfort of this procedure may enable more core biopsies to be taken in patients at high risk for prostate cancer or in those with an enlarged prostate Bangladesh Journal of Urology, Vol. 15, No. 2, July 2012 p.33-39

Background: Prostate cancer is the most common cancer in men. The most common prostate cancer test is the prostate-specific antigen (PSA) test. This is a simple blood test that measures the presence of prostate-specific antigen circulating in bloodstream. This test is usually the first step in any prostate cancer diagnosis. Objective: To detect the occurrence of prostate cancer at different level of serum PSA level between 2.5ng/ml and 4ng/ml. Method: This hospital based cross sectional analytical study was conducted between the periods of January 2012 to April 2013. A total of 30 patients with features of lower urinary tract symptoms with enlarged prostate attending to the Department of Urology, National Institute of Kidney Diseases & Urology (NIKDU), Sher-E-Bangla Nagar, Dhaka were purposively selected as study population by taking the permission of ethical committee. Patients more than 50 years old with lower urinary tract symptoms at S. PSA level 2.5 - 4 ng/ml and enlarged prostate in DRE were selected as study population. Patients with bleeding disorder, anorectal pathology, active UTI or prostatitis or urethral stricture were excluded from this study. DRE was done to see the size, consistency and nodularity of prostate. Those who had enlarged prostate found on DRE, they were sent for biopsy multi parametric MRI (MPMRI) & Prostate Imaging Reporting and Data system (PIRAD) score may be applied. Result: The mean age of the patients was 66.87±10.13 years with a range of 52-90 years. Among 30 patients 10 (33.3%) were in the age group of 51-60 years, 10 (33.3%) were in the age group of 61 - 70 years, 5 (16.7%) were in the age group of 71 - 80 years and 5 (16.7%) were in the age group >80 years. Among 30 patients 4 (13.3%) had malignant lesion and 26 (86.7%) had benign lesion. Mean serum PSA level among the patients with histopathological findings benign and malignant were 3.34±0.51 and 3.47±0.43 ng/ml respectively. Out of 4 patients with malignant lesion, 1(25.0%) had serum PSA level within 2.50-2.99 ng/ml, another 1(25.0%) had 3.00-3.49 ng/ml and 2(50.0%) had serum PSA level within 3.50-4.00 ng/ml. There is no statistically significant difference observed in serum PSA level among the patients with histopathological findings benign and malignant (P>0.05). Conclusion: For early diagnosis of prostate cancer cut-off value of serum PSA of 2.5 ng/ ml may be used as an indication for prostate biopsy. Bangladesh Journal of Urology, Vol. 19, No. 2, July 2016 p.85-89

Background: Nephrectomy is indicated in patients with an irreversibly damaged kidney. The nephrectomy can be performed through open or laparoscopic procedure. Although there is evidence that laparoscopy is the preferred choice, additional evidence is indicated. Objective: To compare the outcomes of nephrectomy through open and laparoscopic procedures. Methods: This prospective observational study was conducted in the Department of Urology, National Institute of Kidney Diseases and Urology, Sher-e-Bangla Nagar, Dhaka from July 2017 to December 2019 over a period of two and half years. In this study, 13 patients had laparoscopic nephrectomy and 17 patients had open nephrectomy. Operative time, length of hospital stay, loss of bleeding, transfusion requirement, peri and post-operative complications were recorded and compared. SPSS 12 was used for analysis. Categorical data were compared with Chi-square test and numerical data were compared with unpaired t test. Results: Maximum patients were more than 40 year old and mean age was 43.53 ± 5.55 years & 41.46 ± 6.31 years in open & laparoscopic nephrectomy group respectively. Male and female ratio was almost similar in both groups. Operative time for open nephrectomy was significantly lower than operative time for laparoscopic nephrectomy (147.9 ± 34.2 vs 184.6 ± 33.3 min; p=0.004). Mean length of post-operative hospital stay was significantly longer for patients receiving open surgery than for patients receiving laparoscopy (7.06 ± 3.67 days vs 3.92 ± 0.86 days; p = <0.001). There was no significant difference in mean postoperative time to oral intake for patients receiving open and laparoscopic nephrectomy (24.71 ± 2.91 hours and 24.00 ± 0.00 hours; p = 0.391). Per-operative complications occurred in 9 (52.9%) patients in the open nephrectomy group and in 3 (23.1%) patients in laparoscopic nephrectomy group. There was no significant group difference in complication rates (P = 0.098). Pain was reduced significantly in both groups. In each follow up, VAS was significantly lower in laparoscopic nephrectomy group than open nephrectomy group groups. Conclusion: The overall outcomes of the two procedures were similar. Pain was significantly less in laparoscopic nephrectomy. Bangladesh Journal of Urology, Vol. 23, No. 1, January 2020 p.52-55

Introduction: Radical Cystectomy (RC) is an effective surgical procedure for muscle invasive bladder cancer ( MIBC). 5 years disease free survival after RCs are PT2 - 81%, PT3a – 68%, PT3b – 47%, PT4a – 44% respectively, Stein et al, 2001[1]. In this study early surgical & oncological outcome have been assessed. Patients & methods: A total of 24(N) patients underwent radical cystectomy with urinary diversion between December 2013 to June 2016. Age ranges from 41-69 years. Indications were T2HG for twenty cases and T1HG for four cases. Among the T1 tumours, one had early recurrence, one had numerous tumours and two had multiple tumours with concomitant CIS. Urinary diversion methods were: Orthotopic Ileal neobladder-1, Ileal conduit-20, Cuteneous Ureterostomy -3 (2 due to unhealthy mesentry with gut, 1 single kidney with poor general condition), For uretero-Ileal anaestomosis we used Bricker method in all cases. Result: Mean OR time was 3:45 hours, blood loss average 350 ml, hospital stay after operation 9 days, enlarged pelvic lymph nodes were found in two cases. In follow up we found,stomal stenosis of cutaneous ureterostomy in 1 out of 3 cases, Ileal conduit prolapse with para-stomal hernia in 1 out of 20 cases, stenosis at uretero-Ileal anastomosis in 1 pt. .Distant recurrence occurred in two cases, one in Lt. Supraclavicular LN and another in sacrum near SI joint. No local recurrence was found in any case. Conclusion: Our experience on RC and all the three types of UD are safe and effective for patient and encouraging for us. Bangladesh Journal of Urology, Vol. 21, No. 2, July 2018 p.62-65

Introduction: Obstructive Uropathy which refers to the structural and functional change impeding the normal urine flow is one of the common cause of renal failure . It has diverse effect on normal renal function as well as there is also diversity on its etiology and outcome Material & methods: Total 108 patients who came to Nephrology OPD with various degree of renal dysfunction resulting from Obstruction of Urinary tract was included in the study. Result : Among the patients 65% were male and their mean age was 51±13.5 years . Common clinical features were loin pain (41%) ; vomiting (30%) ; edema (26%) ; Oligourea (46%) & LUTS (19%). Common etiologies of Obstruction was BEP (28.7%);Urolithiasis(24%); Cervical malignancies(11%); Congenital abnormalities (13%) & stricture urethra(12%). About 37% patients had to under go RRT. Conclusion : Specific strategies to target improvements in early diagnosis renal recovery and patients survival are needed in this patient group. Bangladesh Journal of Urology, Vol. 22, No. 2, July 2019 p.132-135