Comparison of Barcat-Redman technique with Duckett technique in the management of distal hypospadias

To compare the efficacy, safety and complication of Barcat-Redman technique with conventional duckett technique in the management of distal hypospadias. Prospective study carried out at urology department, services hospital, Lahore from 15th April 1998 to 14th April 2000. All Patients with distal hypospadias presenting to the Urology Department Services Hospital. Pediatric Surgery, Services Hospital and Mayo Hospital Lahore were included in the study. These patients were divided into two groups on alternate basis where Group-A patients underwent Barcat-Redman technique and Group-B Patients underwent Duckett technique for the management of hypospadias. Success of both procedures as good, fair and failure were assessed at 3 months follow up. A total of 60 patients were enrolled, 30 patients underwent Barcat-Redman technique [Group-A] and 30 patients were underwent Duckett technique [Group-B]. Ages of the patients ranged from 5 to 25 years with a mean of 11 +/- 5.8 Years. All the patients presented with dystopia of external urethral meatus and chordee [ventral curvature]. The subcoronal type of hypospadias was seen in 43[71.7%] patients and distal penile urethral opening 17[28.3%]. All patients had distal type of hypospadias associated with chordee. Of the 30 patients in Group-A who underwent Barcat-Redman technique, 21[70%] had good results, 5[16.6%] had fair results and 4[13.6%] were failure. In 30 patients of Group-B that underwent Duckett technique, 19[63.4%] patients had good result, 6[20%] had fair results while, 5[16.6%] were failure. The overall morbidity rate was 36.6% while, hospital stay was 3 days and the difference was statistically insignificant [P=0.860]. It is concluded that probably there will never be an operation for hypospadias that will be uniformly and totally successful, but Barcat-Redman technique is superior to Duckett technique

Trans vesical prostatectomy; judging the symptoms severity and quality of life

To determine the effectiveness of prostectomy in reducing symptom severity and quality of life. A prospective study. Urology department civil hospital Dadu. 2005 to 2007. 100 men under going prostectomy were assessed using the American urological Association [AUA] symptom index score and quality of life. The adverse events like urinary incontinence, erectile dysfunction and retrograde ejaculation also detected. The outcome was assessed after 3 month of prostectomy. Prostectomy was effective in reducing symptoms. Initial mean IPSS was 25 and reduced to 7 with p value < 0.001. Quality of life also assessed which showed majority of cases were mostly satisfied. Adverse events like transient incontinence 10%, retrograde ejaculation in 65% and erectile dysfunction in 25% respectively. Prostectomy is effective in reducing symptom severity and improve quality of life which was detected by IPSS and quality of life questionnaire

Prostatic hyperplasia transurethral electro vaporization: our experience

To asses the efficacy, safety and complication of TUEVP on the basis of subjective and objective parameters and to establish an alternative procedure in our setup. The study was conducted at Urology Department Services Hospital Lahore over a period of four years [I996-2000]. A total 50 patients suffering from Bladder outflow symptoms due to BPH were selected for the study. The TUEVP done by standard technique. The mean age was 64.16 with standard deviation of 7.86 years. The mean operating time in TUEVP was 20.6. Mean volume of irrigating fluid during the procedure was 8.28. Few patients require blood transfusion could be shorter resection time and less bleeding during TUEVP. Mean preoperative serum sodium was 138.8 mEq/1. After TUEVP mean changes in serum sodium was 1.1 mEq/1. Post operative mean volume of irrigant used was 11.12 liters. In TUEVP no patients developed significant haemorrhage during first 24 hours. Mean estimated cost of operation was Rs.4160/. Early complication rate like clot retention occurs in 4% and fever occurs [4%] while haemorrhage, TURP syndrome, retention of urine and DVT not reported. Late post operative complication included secondary infection [4%], Epididymoorchitis [4%], U.T.I in [12%], Retrograde ejaculation [24%] and stricture urethra [4%] patients. The mean symptomatic improvement in IPSS Score was 12.76 after two weeks, 8.72 after three month. Peak flow rate increased 13.4 ml/s after two weeks and 14.44 ml/s after three months. TUEVP is the effective and safe procedure with fewer complication and better recovery in our setup but required clinical trials to different urological centers to established its long term efficacy and safety