BACKGROUND & OBJECTIVE: Benign prostatic hyperplasia (BPH) is a prevalent cause of voiding problems in older males and is most commonly associated with acute urological complications, most important of which is acute urinary retention (AUR). α1- antagonists are the treatment of choice for the management of patients with BPH. Our objective was to evaluate the efficacy of tamsulosin for the treatment of patients with AUR due to BPH in terms of trial without catheter (TWOC). METHODOLOGY: This randomized control trial was conducted in a Urology Section, Department of Surgery, SIUT Karachi, from 21-12-2016 to 20-06-2017. Our study included 136 patients who presented AUR due to BPH as per selection criteria. Patients were randomized into two groups. Group A patients received tamsulosin (0.4 mg), and group B patients received placebo drug immediately after insertion of Foley catheter. The success of TWOC was evaluated after 3 days of medical treatment. Statistical analysis was carried out using SPSS v20.0. RESULTS: The mean age of the study patients was 59.45 + 8.05 years. The mean duration of BPH disease was 15.39 + 6.84 months. There were 33 (48.5%) patients in the tamsulosin group in which TWOC was successful and only 22 (32.4%) patients in placebo group in which TWOC was successful (p-value 0.04). There was no effect of age and duration of BPH disease on the outcome of this study. CONCLUSION: Tamsulosin is effective for the treatment of patients with AUR due to BPH.

Objective: To determine the frequency of post-operative complications of transurethral resection of prostate (TURP), in benign prostatic hyperplasia (BPH) patients, using the Modified Clavien Classification System (MCCS). Study Design: Descriptive study. Setting: Urology Department, Sindh Institute of Urology and Transplantation, Karachi. Period: 26th May, 2019 to 25th Nov, 2019. Material & Methods: A total number of 162 patients with benign prostatic hyperplasia planned for TURP were included in this study and Post-operative complications data was collected, and classified according to the Modified Clavien Classification System (MCCS). Patient’s demographics and other parameters like prostate volume, operative time, mean prostatic tissue resected and hospital stay was collected. Results: Mean age was 63.32±8.36 years. Mean prostate volume was 56.99±13.25 grams. Mean operative time was 26.55±9.46 mins. Mean prostate tissue resected was 16.75±12.09 grams. Mean hospital stay was 1.27±0.60 mins. Grade I complication was occurred in 06 (3.70%) patients, grade II in 03 (1.85%) patients, grade III in 00 patients, grade IV in 01 (0.62%) patients and grade V in no patient. While there were no complications in remaining 152 (93.83%) patients. Conclusion: Clavien–Dindo classification system can be easily applied by urologists to grade the post-operative transurethral resection of prostate (TURP) complications. We observed that TURP is a very safe procedure for surgical management of benign prostatic hyperplasia, and is having low morbidity and mortality.

Objective: To compare stone clearance rate in patients with distal ureteric stones, undergoing URS with safety guide wire and without safety guide wire. Study Design: Randomized Clinical Trial study. Setting: Department of Urology, Pir Abdul Qadir Shah Institute of Medical sciences. Period: January, 2020 to December 2020. Material & Methods: The study patients fulfilling the inclusion criteria were divided into two groups using the lottery method. Group A: Patients underwent URS with insertion of safety guidewire (SGW). Group B: These patients underwent URS without safety guidewire (SGW). Patients in both groups were compared for stone clearance. Results: Mean age in Group A was 37.79±12.44 years and in Group B were 33.31±11.48 years. Group wise distribution of gender showed 79 (73.83%) male and 28 (26.17%) females in Group A and 70(65.42%) male and 37 female (34.57%) in Group B. In comparison of both groups, 65.42% stone clearance was noted in Group A while 78.50% stone clearance was found in Group B and p-value found to be significant (P=0.033). Conclusion: Our study concluded that stone clearance in patients with distal ureteral stones undergoing URS without SGW is higher in comparison to URS with SGW, without any added advantage.

The natural history of benign enlargement of the prostate is variable and ranges from mild symptoms to chronic retention and renal failure. In this study, the outcomes of patients with urinary retention alone were compared with those of chronic retention and renal failure caused by an enlarged prostate. The first group had 79, while the second group had 20 patients included. The mean maximum flow rate after transurethral resection of the prostate (TURP) in the two groups was 16.9 ± 7.9 vs. 14.6 ± 4.1 ml/sec (p value > 0.05), and the mean post-void volume was 15.1 ± 27.6 vs. 21.7 ± 35.7 ml (p value > 0.05), respectively. However, the residual symptoms after surgery were higher in the chronic retention group. It was concluded that patients, with chronic retention experience and higher postoperative residual storage symptoms, after transurethral resection of the prostate, are able to void without a catheter and their renal functions were stabilised.

Objective: To evaluate surgical outcomes and renal functions after cystectomy + MAINZ Pouch II and epispadias repair as a staged procedure in adult patients with exstrophy epispadias complex (EEC).