Background: Posterior Urethral Valves (PUV) are one of the most common urological problems having wide clinical implications and the prognosis depends upon the extent of the renal injury inflicted by the time of initiation of intervention and hence earlier the treatment, better the long-term outcome Objectives: To evaluate the outcome of endoscopic fulguration of posterior urethral valves (PUV) in children. Method: A cross-sectional analytical study was carried out on 50 male children with posterior urethral valves (PUV) from January 2011 to December 2012 in Dhaka Medical College Hospital, who were treated with endoscopic fulguration and came for routine follow-up. Results: In this series, median age of patients was 2 years ranging from 1 to 12 years. Approximately half of the patients (46.0%) were 2 years. Sixty four percent presented with poor urinary stream, 38.0% presented with straining during micturition. The most common physical finding was palpable bladder 60.0%, UTI was present in 52.0% cases. Proteinuria was found in 46.0% cases, raised serum creatinine was found in 36.0% cases. Electrolyte imbalance was found in 12.0% of cases. Ultrasonogram of KUB showed severe hydronephrosis in 14.0% cases. Voiding cystourethrogram diagnosed PUV in 92.0% of cases. The follow-up period was 24 months. At the end of final follow-up 3 patients remained incontinent. Urinary tract infections were absent in 52.0% cases. Hydronephrosis disappeared in 30.0% cases. Chronic renal failure developed in 6.0% of cases. End stage renal disease was found zero during the follow-up period. Conclusion: Follow-up period of longer duration needed to determine the ultimate outcome of these patients because some of the patients develop ESRD in the long run and ultimately renal transplant is the treatment. Treatment should be performed in higher centers where all the facilities are available. Bangladesh Journal of Urology, Vol. 22, No. 1, January 2019 p.8-14

Penile strangulation caused by foreign bodies mostly occurs in adolescents and adult male. A man may place metal object for erotic or autoerotic purposes, for masturbation or increasing penile erection, and due to psychological disturbances which lead to penile strangulation. Penile strangulation results in reduced blood flow distal to the injury, leading to edema, ischemia, and sometimes gangrene. These injuries are divided into five grades and their treatment options are divided into four groups. Here an innovative surgical technique, which can be adopted in Grade II and Ill injury has been described. Journal of Surgical Sciences (2013) Vol. 17 (2) : 96-98

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

Objectives: To compare the outcomes of early primary endoscopic realignment and suprapubic cystostomy with the outcomes of delayed reconstruction in the management of posterior urethral injury. Methods: This is a quasi-experimental prospective study Conducted in the Urology department Dhaka medical college and hospital from January 2009 to December 2010. Atotal of 60 consecutive patients were selected for this study and inclusion criteria, male patients and age 18years and above. Posterior urethral injury resulting in distraction defect and urethral injury with pelvic fracture. Group-A, 28 patients underwent early primary endoscopic realignment after initial suprapubic urinary diversion and Group-B, 32 patients underwent primary suprapubic urinary diversion and delayed urethral reconstruction after 3 months of injury. Results: After procedure 21(75%) out of 28 patients in Group-A developed stricture 12(42.9%) had simple and short segment stricture and 7(32.1%) had simple and long segment stricture, while in Group-B 12(37.5%) patients developed simple and short segment stricture. All of the patients in Group-A had minimum blood loss during operation. While, majority (81.3%) of patients in Group-B had a history of maximum blood loss. None of the patients in Group-A developed incontinence throughout the observations period (from removal of catheter to 9 months), while 15.6% of the patients in Group-B had incontinence at removal of catheter after anastomotic urethroplasty and at 3 month. The incontinence further increased to 18.8% at 6 and 9 months. Complaints of impotence were significantly less in Group-A than that in Group-B throughout the period of observation (14.3% vs. 37.5%, p = 0.042; 14.3% vs. 37.5%, p = 0.042 and 14.3% vs. 37.5%, p = 0.042). At removal of urethral catheter, stricture formation was observed and statistically there was no difference in Group-A and Group-B (14.3% vs. 21.9% in Group-B, p = 0.448). At month 3, stricture formation was significantly higher in Group-A than that in Group-B (42.9% vs. 15.6%, p = 0.020). At month 6, about 18% of patients in Group-A had stricture, but none of patients in Group-B was found so (p = 0.018). Conclusions: Early primary endoscopic realignment of traumatic posterior urethral disruption is a simple, less traumatic, safe, and rapid technique. It provides a low morbidity and less postoperative complications. Though recurrent stricture formation is higher but the strictures are simple and short and amenable to be corrected endoscopically. It may be considered as initial therapy in the management of posterior urethral distraction defect over suprapubic cystostomy with delayed reconstruction. Bangladesh Journal of Urology, Vol. 16, No. 1, Jan 2014 p.29-35

Background: Several different modalities are available for ureteral stone fragmentation. From them pneumatic and holmium: yttrium-aluminum-garnet (Ho: YAG) lithotripsy have supportive outcomes. Aims: To see the outcome of lower ureteric stone fragmentation by laser in comparison with pneumatic lithotripsy. Methods: The prospective clinical study was conducted during the period from July 2012 to June 2014 in Dhaka Medical College Hospital. From the patient admitted in Dhaka medical college hospital a total of 60 patient were selected using purposive sampling methods. Selected patients were numbered chronologically and odd number group as group A (laser lithotripsy) and even number group B (pneumatic lithtripsy). Cystoscopy followed by ureterescopy with the help of guide wire was done and stone fragmentation done by either laser lithotripsy (done in general operation theatre in Dhaka Medical College Hospital) or pneumatic lithotripsy (done in Urology operation theatre in Dhaka Medical College Hospital). Collected data were processed and analyzed using computer software SPSS (statistical package for social science), version-18. Un-pair t-test, chisquare test and Fishers Exact probability test were used to analyze the data. The findings of the study showed age and sex are almost identically distributed in both groups. Results: The mean age of group A and group- B were 35.63±11.66 and 38.90±11.21 years respectively. A male predominance was observed in both groups with 70% male in group- A and 53.3% in group-B. Stone size was also observed identically in both groups. 43% of stone are larger than 10mm in group- A and 47% stone are larger than 10mm. None of other baseline variable found very between groups. Immediate stone clearance was much higher in group-A (96.7%) then that in group- B (80%). Although both the groups demonstrated 100% clearance after 1 month. Immediate complications were higher in group B then those of group- A. Ureteral perforation in group B was found 6.7% as opposed to none in group-A. Fever in group A (6.7%) was observed to be more than 3 times higher than in group- B (23.3%). Comparison of complications after 1 and 3 months shows some differences (higher in group-B) but that is not significant. Ureteral stricture developed in 3 patients in group- B compared to nil in group- A. More than 90% of patients of group-A were released from the hospital within 3 days after operation, in contrast about 40% in group-B left the hospital within 3 days. Conclusion: So, laser lithotripsy is better option for the management of lower ureteric stone by using semi rigid ureteroscope, in term of stone migration, rate of stone fragmentation and clearance, operation time, hospital stay and complication. Bangladesh Journal of Urology, Vol. 23, No. 2, July 2020 p.169-175