ABSTRACT
Background: The repair of inguinal hernias has seen an evolution over the past few decades and more research on the same is still underway. Though laparoscopy has gained widespread acceptance in today’s era of surgery, there is still a debate between laparoscopic and open hernia mesh repair. Methods: A randomized prospective study was conducted at a tertiary care teaching hospital to compare laparoscopic hernioplasty and Lichtenstein’s open mesh repair. The study consisted of 70 subjects with unilateral or bilateral inguinal hernia and they were randomly allocated into either group. Various parameters like duration of surgery, intra and post-operative complications, post-operative pain, recurrence, stay in the hospital and resumption of daily activities were compared.Results: Out of the 70 patients, 35 underwent laparoscopic hernioplasty and 35 underwent open hernia repair. The mean operative time for laparoscopic hernioplasty (unilateral 63.44mins, bilateral 123.80mins) was greater than open hernioplasty (unilateral 47.35mins, bilateral 90.42 mins). Post-operative complications, like wound infection, seroma formation and urinary retention were noted more in the open hernioplasty group. The mean pain score for laparoscopic hernia repair was lower than open hernia repair on postoperative day 3 and 7. The average duration of hospital stay was 3.5 days in laparoscopy group and 6 days in open group. The mean duration for resumption of daily activities was 4.8 days following laparoscopic hernioplasty and 8.1 days following open hernioplasty.Conclusions: Laparoscopic hernioplasty is more beneficial than Lichtenstein’s open hernia mesh repair as it is safer, with faster recovery, lesser post-operative complications and reduced morbidity.
ABSTRACT
Background: Uroflowmetry is a simple non-invasive technique in evaluating patients presenting with Lower urinary tract symptoms (LUTS), to assess voiding patterns, maximum urinary flow (Qmax), average urinary flow (Qave) and voided urine volume. Uroflowmetry is considered mandatory prior to surgical intervention in diagnosis and assessment of men with LUTS. Correlating the International prostrate symptom score (IPSS) with that of uroflowmetry results will allow a better diagnosis and help in determining more appropriate modality of treatment. Therefore, the purpose of our study is to correlate IPSS and the findings of uroflowmetry in evaluation of Benign prostrate hypertrophy (BPH).Methods: This was a prospective study of 50 patients presenting with LUTS diagnosed with BPH. Patient’s symptoms were initially evaluated by administering a pre-treatment IPSS/Quality of Life Score (QoL) and uroflowmetry. All patients underwent Transurethral resection of the prostate (TURP). A post TURP IPSS/QoL score assessment and uroflowmetry was done. Pre-operative IPSS and uroflowmetry results were correlated using spearman’s correlation coefficient. Outcome of IPSS and uroflowmetry following TURP was assessed in terms of percentage improvement.Results: Statistically significant correlation (p<0.05) was seen between IPSS and uroflowmetry results. No correlation was found between prostate volume and IPSS. Significant improvement in symptom severity (IPSS score) and uroflowmetry results was observed in post TURP patients.Conclusion: IPSS is a valuable tool in the evaluation and grading of LUTS. Correlating both IPSS and uroflowmetry results will help in better diagnosis and management of patients. It can also be concluded that IPSS and uroflowmetry can be used for evaluation and monitoring patients following prostate surgery.