Background: Lower Urinary Tract Symptoms (LUTS) due to Benign Prostatic Hyperplasia (BPH) are common in elder men and a number of drugs alone or combined are clinically used for this disorder. This study was aimed to evaluate the efficacy and safety of Alfuzosin monotherapy versus combination of Alfuzosin and Finasteride in treatment of LUTS due to BPH. Materials and methods: This clinical trial was conducted in the outpatient Department of Urology Chittagong Medical College Hospital from May 2007 to October 2008. After assessing for the eligibility, consecutive consenting 60 patients with LUTS related to BPH were randomly assigned to either 10mg Alfuzosin (Group A) or combination of 10mg Alfuzosin and 5mg Finasteride (Group B) for 12 months. The response was assessed by measurements of International Prostate Symptoms Score (IPSS) Maximum urine flow rate (Qmax), Post Voidal Residual Volume (PVR) and prostate volume at baseline and 3 monthly thereafter. Safety was assessed by Adverse Drug Events (ADE) rate. Results: Both Groups showed comparable significant improvements in all parameters in terms of decreasing IPSS, PVR and increasing Qmax. Both treatments were well tolerated with respect to ADE and distribution of ADE was similar in two groups. Conclusion: In men with benign prostatic hyperplasia, Alfuzosin was effective therapy and the combination of Alfuzosin and Finasteride was no more effective than Alfuzosin alone. JCMCTA 2017 ; 28 (2) : 75-80

Background: To find out the renal morphological changes after Extracorporeal Shock Wave Lithotripsy (ESWL) both in short and long term. Materials and methods: This prospective study was carried out in the in the Department of Urology, Chittagong Medical College Hospital, Chittagong from January 2009 to January 2010. Patients with symptom, radio logically proved renal stone(s) measuring less than 2 cm in diameter and who are normotensive were enrolled in this study. Results: All 50 patients were divided into four age groups. The age ranged from 38 to 68 years and the maximum number was found in the age group of 51-60 years. The mean age was 50.9 years with Standard Deviation (SD)±11.2 years. Out of which 58.0% were male and rest 42.0% were female patients. All patients had normal morphological kidney ESWL but after ESWL 4(8.0%) had peri renal hematoma hydronephrosis / increased size of the kidney. The difference was not statistically significant (p>0.05) before and after ESWL. Sub capsular hematoma or peri renal hematoma, hydronephrosis of kidney and increased size of the kidney diagnosed by USG of KUB region and CT scan. All patients had normal kidney before ESWL but after ESWL 6(12.0%) had paren chymal scarring / decreased size of the kidney. The difference was statistically significant (p<0.05) before and after ESWL. Morphological changes of the kidney like parenchymal scarring and decreased size of the kidney diagnosed by USG of KUB region. All patients had normal kidney before ESWL but after ESWL 3(6.0%) had hydronephrosis, obstruction in peliviuretuic junction and ureter, stein strasse formation. The difference was not statistically significant (p>0.05) before and after ESWL. Conclusion: ESWL is a good option for the management of renal stone less than 2cm. ESWL is considered a safe and well-tolerated procedure. Serious complications are rare, but need to be considered in certain number of patients with complications at short and long term after ESWL. Transient renal morphological changes occurs within short time and at variable period after ESWL.Post ESWL complication’s like renal morphological changes are rare, which become normal with in variable period. JCMCTA 2017 ; 28 (2) : 94-98

Background : Diseases of the bladder, particularly, inflammation (Cystitis), constitutes an important source of clinical signs & symptoms. Tumours of the bladder are an important source of both morbidity and mortality. The aim of the study was to make a histopathological evaluation of various bladder lesions and to observe the frequency of different bladder lesions. Material and methods : The study was conducted in the Department of Pathology, Chittagong Maa-O-Shishu Hospital Medical College (CMOSHMC) from Jan 2012 to Dec 2016. Patients particulars and histopathological diagnosis were kept in records. Tissue was processed in paraffin section technique and stained with routine Hematoxilin and eosin stains. Results : One hundred and twenty eight (128) cystoscopic sample were studied. Out of 128 cases males were 103 and 25 were females with a male to female ratio of 4.21:1. In malignant lesions the male to female ratio was 3.82:1. Age distribution ranges from 13 to 85 years with an average age of 57 years. The maximum age group belonged to 51 to 60 years and 61 to 70 years. The spectrum of lesions included non neoplastic and neoplastic lesions. Non neoplastic lesions were eosinophilic cystitis, granulomatous cystitis, radiation induced cystitis, chronic follicular cystitis and cystitis gladularis etc. The neoplastic lesions were, transitional cell papilloma, Papillary Urothelial Neoplasm of Low Malignant Potential (PUNLMP) low and high grade Transitional Cell Carcinoma (TCC) and leiomyosarcoma. Low grade TCC was the predominant type. Conclusion : Cystoscopic biopsy followed by histopatholigical examination is essential to diagnose any organic bladder lesion for proper management. Smooth muscle should be included in biopsy whenever malignancy is suspected. JCMCTA 2017 ; 28 (1) : 42 - 44

Background: Prostate cancer awareness is increasing day by day, especially in the USA and western world. Before PSA period, up to 27% of prostate cancers were detected incidentally in the TURP chips done for BPH. The Incidental diagnosis of prostate cancer in patients treated for BPH by a transurethral prostate resection is seen in 1.4-16.7% of patients, but it’s incidence is decreasing due to the use of Serum PSA testing. Nevertheless, some patients are still diagnosed with incidental prostate cancer. However, incidentally detected carcinoma prostate has been reported to vary across the globe since various factors can influence the identification of this malignancy in TURP specimens. In this study, we concentrated on rates of incidentally detected prostate cancer in TURP chips done for BPH in our hospital. Materials and methods: This retrospective study of histopathological findings of TURP chips was conducted for patients undergoing TURP from 2010. The inclusion criteria were patients diagnosed with BPH, DRE showing no abnormal hard areas and age adjusted PSA value is normal. Patients with elevated PSA, abnormal DRE, documented urinary tract infection and proved Adenocarcinoma Prostate (CaP) were excluded from the study. The age of the patients, clinical diagnosis, occurrence of carcinoma of prostate in the TURP chips and Gleason’s scores were recorded. Results: A total of 263 patients who fulfilled the inclusion criteria were studied. The incidence of CaP in the study group was 5.3 % (14/263). 10 (71.4 %) patients were aged ³65 years or older had maximum incidence of CaP. Conclusions: The rate of incidentally detected adenocarcinoma prostate in patients undergoing TURP for clinically diagnosed BPH was found to be only 5.3 % in our study, which is low when compared with similar studies done elsewhere in the world. JCMCTA 2017 ; 28 (2) : 16-20