Transurethral resection; a critical evaluation of the results

To establish the current usage and results of transurethral resection of prostate in patients of benign prostatic obstruction [BPO] who presented with severe irritative and obstructive prostatic symptoms. Saleem Medical Complex Hospital Quetta. Period: From April 1997 to December 2004. Transurethral resections for BPO were performed with 5% dextrose water in 500 consecutive patients. All these patients were followed for early and late complications and followed up to 6 months after TURP. Significant symptomatic improvement has been observed with minimal morbidity [14%]. None of the patient had significant hematuria and TURP syndrome. Mean operative time was 45.0 minutes. Mean interval to catheter removal was 26 hours. Only 15 patients [3%] revealed neoplastic changes in resected tissues. Incidence of secondary hemorrhage, stricture urethra, epididymo-orchitis, retrograde ejaculation and impotence were observed in 10 [2%], 20 [4%], 10 [2%], 5 [1%] and 20 [4%] patients respectively. Only 15 patients [3%] who developed post-operative retention and Re-TURP were performed in two patients for the residual prostatic tissue. None of the patient developed incontinence of urine. Pre operative and postoperative history of libido and sexual behavior was also assessed

Evaluation of hospital services by urological patient's home visit

To improve the quality of life of the patients by assessing the level of hospital services and benefits to the patients. 2]. To know the sufferings of the patients and their relatives. Mayo Hospital Lahore. May 16, 1995 - Sep 8, 1995. Case study. 52 patients were visited at their own homes in different localities of Lahore, after their treatment and discharge from the ward to discuss their experiences during their stay in the hospital in a relaxed and homely atmosphere. 60% of the patients belonged to very poor class earning less than Rs.3000/month, 80% were residing in smaller than 5 marla houses. 67% had their own houses and usually stuffed with their relatives. 60% were supporting their whole families. Only 46% of the patients had overall good impression about the services and facilities provided to them. 60% of the doctors and 40% of the nurses were responsive respectively. 60% of the patients had to stay in the hospital for up to 10 days and spend up to Rs. 6000.00 for their treatment. The main objection of the patients was the lack of communication from the staff. Improvement in hospital services will really effect positively the quality of life of the patients

Efficacy of extracorporeal shock wave lithotripsy in paediatric urolithiasis

To determine the efficacy of extracorporeal shock wave lithotripsy with reference to stone size and radiodensity in children. Design: Patients of either sex were treated with ESWL from April 1994 to January 1995. Setting: Department of Urology, Mayo Hospital, Lahore. Twenty five patients of age below twelve years presenting with renal, ureteric and bladder stone of size between '5-20 mm along their long axis were included. Main outcome measure: Efficacy. Single treatment session was sufficient in 40%, two in 28% and three in 8% patients. No stone clearance was observed in 20% patients after three sessions and 4% patients had to be operated after one session. There were 60% low density stones, 28% stones were equibone dense and 12% stones had radiodensity more than that of bone. Among low density stones 77.78% renal, 100% ureteric and 100% bladder stones were successfully fragmented with overall success rate of 86.6% [13/15]. Out of equibone density stones 14.28% renal, 14.28% ureteric and 42.86% bladder stones were successfully fragmented. So the success rate for equibone dense stone was 71.4% [5/7]. There were 3 [12%] stones with radiodensity greater than that of bone and had successful fragmentation rate of 33.33% [1/3]. Kidney stones 5-10mm in size were cleared in aII [100%] cases after one treatment session and those 11-15mm in size needed more shock waves on an average 1.8 treatment session. Stones 15-20 mm in size required 2-3 treatment session. Success rate for 5-10mm size ureteric stones was 100% but it was 0% for those of size 11-15mm. Bladder stones which measured 10-15 mm in size required one session while those measuring 15-20 mm were fragmented during1.16 treatment session. ESWL is an effective modality for treatment of urinary stones as monotherapy in selected patients

Role of prostaglandin synthesis inhibitors in the passage of ureteric calculus

Diclofenac sodium, one of the prostaglandin synthesis inhibitors was evaluated in terms of passage or movement of ureteric stones upto the size of 0.5 cm in a series of 80 patients. Forty-six [57.5%] patients passed the stone within a period of 4 weeks. This frequency of stone passage was significantly higher when compared with stone passage of similar size in other series [P< 0.001]. In 17 [56.6%,] out of 30 patients, stone moved from upper and middle ureter to the lower ureter which is also significant from therapeutic point of view. Complete pain relief was achieved in 67 [84%] patients. No side effects of the drug noted in this series. The sequence of events following ureteral obstruction by the stone, based on recent experimental and clinical studies is discussed and possible mechanism of action of diclofenac sodium was highlighted

Value of dipslides in the diagnosis of significant bacteriuria in Pakistan

The accuracy of the dipslide method for diagnosing significant bacteriuria was assessed. Dipslide culture method was compared with conventional pourplate method. One hundred Urine samples were collected from 2 groups of patients. The first group comprised of patients with symptoms of urinary tract infection. In the second group catheterized patients were included. Dipslide method showed 5.6% false positive and 5.6% false negative results. E. coli was the commonest organism isolated. It is recommended that this method should be routinely used in hospital and general practice

Ureterosigmoidostomy: a useful technique

Eight patients of bladder extrophy who had ureterosigmoidostomy have been retrospectively analysed. Six patients experienced no postoperative complications. There was no mortality. Open transcolonic mucosa to mucosa proves to be a useful technique of anastomosis. This type of urinary diversion is socially acceptable to Pakistani patients