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: The distribution pattern of ABO and Rh-D blood group in our country including the tribal people is not fully established as elaborated and large scale studies have not been carried out on it. Therefore this study was designed to observe the distribution pattern of ABO and Rh-D blood groups among the Garo tribes of Mymensingh and general people of Dhaka city. Objectives: To determine and to compare the distribution pattern of ABO and Rh-D blood groups among the Garo tribal people of Mymensingh and general people of Dhaka city and to compare this distribution between this two groups. Materials and Methods: This observational study was conducted in the Department of Physiology, Dhaka Medical College, Dhaka from July 2008 to June 2009. After proper ethical consideration total 900 Garo people of Mymensingh and 784 general people of Dhaka city were included in this study. The Garo localities and the general people of Dhaka city were selected by systematic random sampling. ABO and Rh-D blood groups were determined by the antigen antibody agglutination test of slide method. Chi square statistical analyses were done to compare the results of ABO blood group systems between the Garo people and general people of Dhaka city. Results: This study revealed that there are significant variations in the distribution of ABO and Rh-D blood groups between the Garo tribal people of Mymensingh and the general people of Dhaka city. In this study it was observed that blood group ‘A’ was apparently predominant in Garo population, while blood group ‘B’ was predominant in general population (p<0.001), blood group ‘AB’ and ‘O’ were almost similar in both groups. Rh typing of the participants reveals that majorities of both groups were Rh positive. Rh negative persons are rare in both populations, but it is extremely rare in the Garo population (0.9%). Conclusion: From the findings of the present study it can be concluded that distribution of ABO and Rh-D blood groups varies between the Garo tribal people and the general people of Dhaka city

Objective: To find out stone clearance rate of lower calyx and to determine important anatomic predictive factors responsible for the stone clearance of lower calyx following ESWL. Methods: This prospective quasi experimental study was conducted in the Department of Urology, Dhaka Medical College Hospital, Dhaka, from January 2006 to July 2007. Patients with single lower calyceal stone (Stone size d” 20mm), age between 12 to 75 years and were agreed to participate in the study were selected. Different lower calyceal predictive factors were measured from IVU with the help of radiologist before ESWL. Selected patients were treated with ESWL by siemens lithostar machine in the department of Urology, Dhaka Medical College Hospital. Patients were discharged on the same day with advice to follow up after 1 month. All patients were followed up with plain X- ray KUB region to see stone clearance. Purposive sampling methods were followed. Data were processed and analyzed using software SPSS (Statistical Package for Social Sciences). Results: Lower caliceal stones with favorable anatomy (infundibulo-pelvic angle e”700, infundibular length d” 30mm, infundibular diameter >4mm, and infundibular length to diameter ratio < 7) were stone free in cases and was statistically significant in stone clearance. But number of minor calices , caliceal pelvic height and stone morphology have shown no impact on stone clearance in this study. Conclusion: ESWL for lower caliceal stone should be recommended only those patients those have favorable anatomy for discharge of fragments. Bangladesh Journal of Urology, Vol. 15, No. 1, Jan 2012 p.6-10

Background: The standard sextant biopsy protocol misses about 15% of cancer when compared with results obtained from a more extensive biopsy procedure. The number of systematic biopsies has increased over the years, with 10–12 cores currently accepted as the minimum standard. Objectives: To compare the detection rate of carcinoma prostate through standard sextant biopsy and extended 10-core biopsy in Bangladeshi male subjects. Methods: This prospective experimental study was conducted in the Department of Urology of Dhaka Medical College Hospital, Dhaka from January 2007 to May 2008 including a total of 69 male patients aged over 56 years having normal digital rectal examination (DRE) findings with serum PSA level of 4 ng/mL or greater or having abnormal findings on DRE irrespective of serum PSA level. The subjects underwent transrectal ultrasound (TRUS) and biopsies were taken systematically. Biopsy results were interpreted according to different sextant biopsy protocols and also following extended 10-core biopsy protocol. Data collection sheet containing the selected points were filled up. Data were analysed using SPSS version 12. The test statistic used to analyse the data were descriptive statistics and McNemar’s test. The level of significance was set at 0.05 and p <0.005 was considered significant. Result: Out of the total 69 subjects, 29 (42%) were diagnosed to have prostate cancer following biopsy. In the standard mid lobar sextant protocol the cancer detection was lowest (79.3%) while it was highest (89.7%) when lateral zone biopsy was performed. The extended 10-core biopsy regimen had higher cancer detection rate than any of the standard sextant protocols and it was 96.6%. The difference in the cancer detection rates between the two schemes was statistically significant (p <0.001). Conclusion: The sextant biopsy is inadequate in detecting carcinoma prostate and extended 10-core biopsy protocol including the apex, midlobar mid gland, lateral mid gland and lateral base with more extensive sampling of the lateral aspects of the prostate is superior. Bangladesh J. Urol. 2021; 24(2): 214-219

Self-inflicted foreign bodies in the male urethra and urinary bladder are an emergency that urologists may rarely have to face. A case of an electrical wire inserted in the male urethra and coiled in the bladder is presented here. A 33-year-old male presented with the inability to void and bloody urethral discharge after having introduced a long electrical wire in his urethra for masturbation 6 hours earlier. He had made several unsuccessful attempts to remove it. We know that variety of these objects may be impressive and removal of the foreign body may be quite challenging requiring imagination and high-level surgical skills. In this case an electrical wire was used and the diagnostic as well as the therapeutic steps for its removal are presented here. Bangladesh Journal of Urology, Vol. 14, No. 2, July 2011 p.62-64