Outcome of 500 cases of transurethral resection of Prostate (TURP) in District level teaching Hospital.

Type of Study: This is a prospective study in a district level teaching from 1sr march 2003 to December 2008. The sample size was n – 500. All Patients were evaluated with history, clinical examination and allied investigations. As per selection criteria we did TURP and each patient was followed up to six months. Purpose & Importance of TURP: It has been established that open prostatectomy has got higher morbidity than that of transurethral resection of prostate (TURP). The shorter hospital stay, early institution to working place, minimum blood loss, and acceptable financial involvement makes it excellent patient’s compliance. Method: The prospective studies include n – 500 cases of LUTS predominately obstructive voiding symptoms. After evaluation & fulfilling the selection criteria standard TURP were done in all cases. Result: The mean Q max improved in n – 476 cases (from 6.68 ml/ sec. to 17.47ml/second) in early post-operative period. Among others most of the cases improved within 06 months. Some of the cases (0.25%) needs secondary procedure for late complications like stricture urethra. Erectile dysfunction was not a major problem in our series. Death noticed in two cases in post operative ward due to cardiogenic shock. Conclusion: The outcome of the present study has been compared with other studies and it appears that TURP is an excellent minimally invasive procedure for the management of symptomatic BPH.

Personal series with clinical review of fracture penis.

Penile fracture is an uncommon Urological emergency. In flaccid state it allows significant degree of deformation without any injury to the vital structures but in erected state it is vulnerable to blunt injury. The tumescent corpora cavernosa may have got injured due to nonphysiological bending of penile shaft. The true incidence of penile fracture is not known even in western countries. It is either under reported or hidden for potential social embracement. We have reviewed all of our cases of penile fracture and has been conducted a retrospective study in the Department of Urology, Bangladesh Medical College, Dhaka. The study period was from October 2001 to January 2006. The sample size was 23. All patients have got classical history of penile fracture. The time between the onset of symptom and seeking of medical care ranges from 02 hours to 07 days. The diagnosis was made on the basis of history and clinical examination only. All the patients were underwent surgery. The potency was well preserved in all of our patients. The local tissue healing process is better among the patients, reported earlier. The overall result is excellent.

Intravesical adjuvant therapy using mitomycin C.

Bladder cancer is mostly superficial at first diagnosis. High incidence of recurrence is the major problem after initial management with transurethral resection (TUR) of bladder tumor. Adjuvant chemotherapy has been advocated to reduce the incidence of recurrence. A study was carried out to observe the efficacy of intravesical adjuvant therapy with single immediate versus delayed multi-dose regimen of Mitomycin C (MMC) in preventing recurrence of superficial bladder cancer. One hundred Patients having intermediate risk superficial bladder cancer were randomized into two equal groups. All patients were followed carefully. Total duration of follow-up was minimum 12 months, maximum 36 months, mean 29 months. No recurrence was seen on 3(rd), 6(th) and 9(th) month of intravesical therapy. As much as 94% and 96% of recurrence free rate was observed in immediate single and delayed multi-dose group respectively on 12(th) month; 86% and 84% on 18(th) month; 74% and 72% on 24(th) month; 70% and 68% on 36(th) month of follow-up cystoscopy respectively. Efficacy of post transurethral resection of bladder tumour (TURBT) MMC single immediate dose was found similar to that of MMC delayed multi-dose regimen in preventing the recurrence of intermediate risk superficial bladder transitional cell carcinoma (TCC) in the study. The difference between the two groups insignificant (p>0.05).