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: Bladder cancer is the second most common cancer of the genitourinary tract. Mitomycin C has been commonly used in a perioperative fashion delivered intravesically immediately after TURBT Objective: To compare the results of post TURBT immediate single dose and multidose regimen of Mitomycin C therapy in the management of superficial transitional cell carcinoma of the urinary bladder. Method: The present prospective and comparative interventional study was conducted in the Department of Urology, National Institute of Kidney Diseases and Urology, Sher-E-Bangla Nagar, Dhaka from January 2015 to December 2016. Patients of superficial bladder cancer (tumor size ≤3 cm, number ≤3, grade I, II) were randomly included in the 2 groups. The sample size was seventy four (74). Thirty (30) patients were in each group and fourteen (14) were excluded from the study. In MMC single dose group (Group A), single dose of MMC 40mg/ 40ml was started immediately within 24 hours of TURBT. In MMC multi-dose group (Group B) 1st instillation of chemotherapy was started immediately within 24 hours of TURBT and additional instillation (5 instillations) were given as OPD basis and was continued weekly for 5 weeks. Follow-up was done on 3rd, 6th, 12th month of initial TURBT. Results: In this study mean age was 61.8±13.7 years in group A and 62.7±13.6 years in group B. Male was found 25 (83.3%) in group A and 26 (86.7%) in group B. Female was found 5 (16.7%) in group A and 4 (13.3%) in group B. Mean size of the tumor was found 2.13±0.78 cm in group A and 2.05±0.84 cm in group B. Mean number of tumor was found 1.8±0.8 in group A and 1.9±0.7 in group B. Tumor grade I was found 23 (76.7%) in group A and 25 (83.3%) in group B. Tumor status Ta of superficial bladder was found 25 (83.3%) in group A and 26 (86.7%) group B. Tumor status T1 of superficial bladder was found 5(16.7%) in group A and 4 (13.3%) group B. Five (16.7%) patients was found recurred in group A and 4 (13.3%) in group B at 6th month follow up. At 12th month follow up, 6 (20.0%) patients was found recurred in group A and 5 (16.7%) in group B. Side effect was found in 2 (6.7%) patients in group B and not found in group A. Conclusion: MMC single dose was similar to MMC multi-dose regimen with insignificant difference among the two. Bangladesh Journal of Urology, Vol. 23, No. 1, January 2020 p.62-66

Back ground: The incidence of renal calculi is rising and more patients are presenting with small renal calculi. The treatment options for renal calculi (d”2 cm) are ESWL, percutaneous nephrolithotomy (PCNL) and retrograde intrarenal surgery (RIRS). The development of minimal invasive surgery for the treatment of renal calculus has led to an increase in success rates and, at the same time, has decreased the morbidity associated with these treatments. Objective: The study aimed to evaluate outcome of retrograde intrarenal surgery (RIRS) and percutaneous nephrolithotomy in the treatment of upper calyceal stone of d”2 cm in diameter. Methods: 60 Patients with radiopaque upper calyceal stone (d”2 cm) were admitted and underwent RIRS (Group A) & PCNL (Group B) in Urology department as per inclusion and exclusion criteria by purposive sampling (30 patients in each group). Complete clinical evaluation including history, physical examination, relevant examinations & laboratory investigations were performed. Result: Mean age was 37.23±11.59 years (range 18-62years) in group A and 40.10±11.49 (range 18-65 years) in group B. Mean operative time was significantly lower in group A (90.13 +/- 18.79 min) than group B (107.36 +/- 16.4 min) (p <0.05). Mean volume of irrigation fluid used during surgery, mean drop in the postoperative hemoglobin concentration, hospital stay, mean VAS score at 8 hours & 24 hours after operation were significantly lower in RIRS group than PCNL group (p< 0.05). We achieved a stone clearance of 90.00% in the RIRS group and 96.67% in the PCNL group. The difference in stone clearance in two groups was not statistically significant (p=0.30). Conclusion: The study concluded Retrograde intrarenal surgery (RIRS) in the treatment of upper calyceal stone of d”2cm in diameter is a feasible, effective and safe treatment option. Given the added morbidity in PCNL, RIRS should be considered standard therapy in these patients. Bangladesh J. Urol. 2021; 24(1): 99-104

Background : Urolithiasis is one of the oldest disease known to human beings and has been documented in ancient Greek. Urolithiasis continues to pose a significant health hazard, causing progressive renal impairment, if left untreated. The etiology of renal insufficiency in patients with nephrolithiasis is multifactorial and includes renal obstruction, urinary infection, frequent surgical interventions, and coexisting medical diseases. The purpose of this study is to assess the change in renal function following removal of kidney stones by Percutaneous Nephrolithotomy (PCNL) in patients with associated impaired renal function. Materials and methods : 50 Patients with renal stone disease with associated impaired renal function who were admitted and underwent PCNL in Urology department were selected as per inclusion and exclusion criteria by purposive sampling. Complete clinical evaluation including history, physical examination, relevant examinations & laboratory investigations were performed. All the patients were treated by PCNL monotherapy with Double J stenting. Mean age was 46.63±11.95 years (Age range: 24-72 years). There were 36 males (72%) & 14 females (28%) & male to female ratio was 2.57:1. Results : In this study, a significant fall in mean serum creatinine (0.5 mg%) was demonstrated following the stone removal. The creatinine value remained unchanged in 12% and improved in 84% patients. In contrast to the improvement of renal function as evident by a decline in the mean serum creatinine values, the mean Glomerular Filtration Rate (GFR) registered a small fall of 1.78 ml/min (Statistically not significant). we have observed that total 12 (24%) patients out of 50 cases experienced different sorts of complications. Conclusion: This study showed that PCNL approach to urolithiasis in patients with impaired renal function significantly improves renal functional status manifested according to the preoperative and postoperative difference of serum creatinine and 99mTc DTPA performance. JCMCTA 2019 ; 30 (2) : 70-74

Objectives: To evaluate urinary symptoms and quality of life in patient with BPH before and after TURP. To determine the impact of TURP on the urinary symptoms (IPSS) and peak urinary flow rate. Methods: This study is prospective study carried out between 2010 and 2011 in the department of Urology, National Institute of Kidney Diseases & Urology. Total 102 cases were selected purposively according to selection criteria. Each patient was observed and followed up at 8 weeks (1st visit), 16 weeks (2nd visit) 24 weeks (3rd visit) after transurethral resection of prostate (TURP). IPSS score, QOL score also recorded and uroflowmetry was done to see the peak urinary flow rate (Qmax) of urine and voiding time. USG was done to see post voidal residual urine volume and DRE also done in selected cases. Data was complied and statistical analysis were done using computer based software, Statistical Package for Social Science (SPSS), using paired ‘t’ test. A P value <0.05 was taken as significance. Results: Before TURP, IPSS range 17-25 and mean 21.61+2.43, after TURP, range 0-7 and mean 4.27+1.71). Hence a significant improvement of IPSS was found from 2 months to 6 months follow up after TURP. The change was tested using “paired student ‘t’ test”. Before TURP Qmax range 7-12.2 and mean was 9.96+1.69, which became range 18-25 and mean was 22.61+2.28 after TURP and therefore change of mean Qmax was 12.64+2.69. The change was tested using “paired student ‘t’ test”. The change was found significant (P<0.001). Conclusion: Transurethral resection of prostate resolves obstructive symptoms, rapid improvement of urinary flow rate Bangladesh Journal of Urology, Vol. 16, No. 1, Jan 2013 p.11-15