Contents Volume 1 Section 1: Milestone of Urology 1. History of Urology MA Salam Prehistoric Urology in Different Parts of World 4; Middle Ages to the Eighteenth Century 6; Nineteenth Century 7; Great Mind and Philosophers in Urology 22 3 Section 2: Presentation of Urological Disease 2. Presentation of Urological Disease MA Salam, Mohammad Shafiqur Rahman Art of History Taking (Careful Listening to the Patient is an Art) 33; Smoking and Urological Disease 41; Drug Allergies 41; Physical Examination of Urological Patients 42 33 Section 3: Investigations of Urological Disease 3. Laboratory Test for Urological Work-up 47 4. Application of X-ray in Urology 57 5. Intravenous Urography and Contrast Study of Lower Urinary Tract 64 6. Principles of the Ultrasound and its Applications in Urology 68 7. Computed Tomography 85 MA Salam, MA Wahab Urinalysis 47; Laboratory Tests 51; Hormonal Studies in Urine 55 AKM Zamanul Islam Bhuiyan Radiology Techniques 57; Radiation Exposure Hazard 57; Contrast Media 58; Anaphylactic Reactions 59; Nephrotoxicity 59; Cardiovascular Toxicity 59; Radiological Investigations for Urological Patients 59 AKM Anwarul Islam, Zahirul Islam Miah Procedure 64; Basic Techniques and Principle of Intravenous Urography 64; Contraindications of Intravenous Urography 65; Indications of Intravenous Urography 65; Advantages of Intravenous Urography 65; Limitations of Intravenous Urography 65; The Future of the Intravenous Urography 65; Antegrade Urography and Retrograde Urography 66; Voiding Cystourethrogram or Micturating Cystourethrogram 66; Cavernosography and Cavernosometry 67 MA Salam Physics of Medical Ultrasound 68; Ultrasound Imaging Methods 68; Intraoperative Use of Ultrasound 72; Renal Ultrasound 72; Bladder Ultrasound 76; Ultrasound Imaging of Prostate Prelude 78; Determination of Prostate Volume with Ultrasound 78; Benign Prostatic Hypertrophy 78; Prostate Cancer 78; Prostatic Infection 79; Techniques of Ultrasound Study of Prostate 79; Perineal Approach 79; Biopsy of Prostate 80; Seminal Vesicle Cyst 80; Ultrasound Scan of Urethra 80; Scrotal Ultrasonography 81; Doppler Principles 82 Jahangir Kabir History of CT Scan 85; Principle of Techniques of CT Scan 85; Principles of Three-dimensional Image Reconstruction 87; Recent Advances in CT 87; Common Problems in Interpreting CT Scan 87; Limitations of CT Scan 87; Criteria for CT 87; CT Renal Arteriography 89; Digital Subtraction Angiography 89; CT Urography 89 xx Principles and Practice of Urology 8. Magnetic Resonance Imaging 9. Nuclear Medicine in Genitourinary Tract Abdul Mannan Khan Physics of MRI 92; Recent Advances of Mri 92; Basic Principles of Mri 93; Clinical Applications of Mri 94; Advantages of Mri 97; Contraindications of Mri 97; Magnetic Resonance Urography 97; Advantages and Disadvantages of Mri 98 SA Khan, Shankar Kumar Biswas Radioisotope Measurement of Glomerular Filtration Rate 101; Radionuclide Techniques Available for Studying the Function of the Renal Tract 102 10. Abdominal Positron Emission Tomography or Computed Tomography Ali Akbor Radioisotopes 108; Cyclotron Centers 109; Indications of Pet/CT 110; Transitional Cell Carcinoma 110; Renal Cell Carcinoma 110; Testicular Malignancies 110 92 101 108 Section 4: Emergency Urology 11. Acute Ureteric Colic 115 12. Acute Urinary Retention 126 13. Renal Trauma 130 14. Ureteral Injury 137 15. Lower Genitourinary Tract Trauma 142 16. Urinary Bladder Injury 145 MA Wahab, MA Salam Presentation 115; Diagnosis 115; Differential Diagnoses of Flank Pain 118; Management 121 SAM Golam Kibria, AKM Anwarul Islam Etiology 126; History 127; Physical Examination 127; Management 127; Complications of Relieving Obstruction 128 Shivaji Basu Principle of Treatment of Acute Upper Genitourinary Tract Injury 130; Upper Tract Trauma (Renal Injuries and Ureteral Injuries) 130 MA Salam, AKM Khurshidul Alam Etiology of Ureteric Trauma 137; Clinical Diagnosis 137; Radiological Diagnosis 137; Classification of Ureteric Injury 138; Management of Ureteric Injury 138 MA Salam, Md Sayedul Islam Causes of Lower Genitourinary Tract Trauma 142; Pathophysiology of Lower Genitourinary Tract Trauma 142; History 142; Physical Examination 143; Prehospital Care 144; Principle of Management of Lower Urinary Tract Trauma 144 K Sasidharan Diagnosis of Bladder Injury 145; Cause and Pathophysiology of Bladder Injury 145; Classification of Bladder Injury 146; Computed Tomography Scan 148; Cystography 148; Excretory Urography 148; Management of Bladder Rupture 148; Penetrating Bladder Injury 148; Postoperative Care 148; Follow-up 149 17. Urethral Injury 150 18. Penile Injuries 156 Sanjay Kulkarni, MA Salam Applied Anatomy and Pathophysiology 150; Etiology 151; Mechanism of Injury 151; Clinical Assessment 152; Classification of Urethral Injury 152; Presentation 152; Work-up 152; Anterior Urethral Injuries 153; Posterior Urethral Injuries 153; Female Urethral Injuries 154; Complications of Urethral Injury 154; Outcome and Prognosis 154 MA Salam, SM Mahbub Alam Common Injuries of Penis 156; Strangulation of Penis by Metallic or Nonmetallic Ring 160 xxi Contents 19.Scrotal and Testicular Injury MA Salam, Mirza M Hasan Mechanism of Injury 162; Etiology 162; Presentation 162; Physical Examination 162; Imaging of Scrotal Injury 163; General Management of Scrotal Injury 163; Complications of Scrotal Injury 164; Indications for Scrotal Exploration 164; Follow-up 164; Complications of Testicular Injury 164 162 Section 5: Genitourinary Infection 20. Urinary Tract Infections 169 21. Urinary Tract Infection in Children 179 22.Urosepsis 187 23. Prostatitis or Chronic Pelvic Pain Syndrome 193 24. Epididymitis and Orchitis 197 25. Perioperative Antibacterial Prophylaxis in Urology 200 26. Recurrent Urinary Tract Infection 204 27. Sexually Transmitted Diseases 212 28. Genitourinary Tuberculosis 217 29. Interstitial Cystitis 221 Jahangir Kabir Pathogenesis of Urinary Tract Infection 169; Bacteriological Evidence of Infection 169; Pathophysiology 170; Prevalence of Urinary Tract Infection 171; Risk, Mortality and Morbidity 171; The Natural History of Urinary Tract Infection 171; Physical Examination 172; Differential Diagnoses 172; Work-up of Urinary Tract Infection 172; Treatment 174; Prevention of Urinary Tract Infection 177; Complications 177 Isteaq Ahmed Shameem Etiology 179; Pathogenesis and Risk Factors 179; Signs and Symptoms 179; Classification 179; Diagnosis 180; Schedule of Investigation 183; Treatment 183; Management 184 Rajeev Kumar Definition 187; Pathophysiology of Sepsis 188; Clinical Manifestation of Urosepsis 188; Treatment 189; Focus on the Management of the Septic Patient 190; Focus on Outcome from Sepsis 191 AKM Khurshidul Alam Diagnosis 193; Classification Systems 194; Treatment 195 Golam Mowla Chowdhury Incidence and Prevalence 197; Pathogenesis and Pathology 197; Diagnosis 197; Treatment 198 AKM Khurshidul Alam, MA Salam Aims and Objectives 200; Risk Factors 201; Principles of Antibiotic Prophylaxis 201; Regimens for Prophylaxis for Different Procedures 202 Mohammad Shafiqur Rahman Definitions 204; Risk Factors 204; Diagnosis 205; Antimicrobial Strategy for the Treatment of Urinary Tract Infection 205; Management of Specific Urological Infection 206; Recommendations on Recurrent Urinary Tract Infection 210; Conclusion and Future 210 Pranashish Saha, Kazi Rafiqul Abedin Factors Responsible for the Sexually Transmitted Diseases 212; Nongonococcal Urethritis 212; Gonorrhea 213; Syphilis 213; Chancroid 214; Lymphogranuloma Venereum 214; Granuloma Inguinale 214; Condyloma Acuminata or Venereal Warts 214; Genital Herpes Simplex 215; Acquired Immunodeficiency Syndrome 215; Prevention of Sexually Transmitted Diseases 215 NP Gupta, Md Sayedul Islam Incidence 217; Etiopathogenesis 217; Pathogenesis 218; Presentation 218; Diagnosis 218; Treatment 218; Follow-up of Genitourinary Tuberculosis 219; Management of Drug Resistant Tuberculosis 219 Shahidul Islam Sugom New Concepts 221; Interstitial Cystitis Symptoms 221; Diagnosis 221; Potassium Test (Persons Test) 222; Management 222 xxii Principles and Practice of Urology Section 6: General Urology 30.Advances of Radiation Oncology and its Applications to Urology 227 31. CyberKnife in Urology 236 32. Application of Gene Therapy in Urology 239 33. Lasers in Urology 243 34. Image-guided Percutaneous Treatment of Genitourinary Cancer 259 AFM Kamal Uddin, Afiquor Rahman Kidney Tumors 227; Role of Radiotherapy in Renal Cell Carcinoma 227; Carcinoma of Bladder 229; Carcinoma Prostate 231 Dev Narayan Dutta Important Features 236; Imaging Techniques of CyberKnife 236; Other Stereotactic Systems 238; Clinical Uses 238 AFM Kamal Uddin, MA Salam Gene Therapeutic Strategies 239; The Future of Gene Therapy 241 Prem Nath Dogra, Prabhjot Singh History 243; Basic Principle of Laser 243; Components of Laser System 244; Laser Tissue Interaction 245; Types of Lasers 246; Laser Applications in Urology 249; Lasers in Laparoscopy 255 MA Salam, Md Faisal Islam Indications 259; Patient Preparation/Anesthesia 260; Image Guidance 260; Image-guided Tumor Ablation Modalities 261; Complications of Percutaneous Ablation 263; Follow-up 264 35. Stem Cells Research and its Practical Applications 266 36. Telemedicine in Urology 270 37. Tissue Engineering in Urology 273 Laila Anjuman Banu, Mohsin Uddin Embryonic Stem Cell Lines 266; Adult Stem Cells 266; Amniotic Stem Cells 267; Induced Pluripotent Stem Cells 267; Practical Applications of Stem Cell Research 269 Ishtiak Al Mamoon, MA Salam History of Telemedicine 270; Types of Telemedicine 270 Mohsin Uddin, MA Salam Principles of Tissue Engineering 273; Application of Stem Cells 274; Urological Applications of Tissue Engineering 274; Generation of Histocompatible Tissues Using Nuclear Transplantation 275 38. Ideal Operating Theater Complex 277 39. High Frequency Electrosurgical Apparatus (Diathermy Equipment) 284 40. Ultrasonic Surgical Shears (Harmonic Scalpel) 292 MA Salam, Nitin S Kekre Statutory Regulations for Operating Theater Complex 277; Different Zones of Operation Theater Complex 277; Sub Areas 278; Types of Operating Theater Complex 279; Principles to be Taken into Consideration While Planning an Operating Theater (Physical/Architecture) 279; Usual Disadvantages of Existing OT in Old Hospitals 282; Operating Theater for the Urologist 283 Prem Raj Gyawali Technical Concept 284; Tissue Effect 284; Unipolar Diathermy 285; Bipolar Diathermy 286; Urological Applications 286; Mode of Action 287; Quality of High-frequency Current (Modulation) 288; Factors Influencing the Therapeutic Effect 288; Safety Considerations 288 Jahangir Kabir, MA Salam Mechanism of Tissue Coagulation 292; Use of the Ultrasonic Surgical Shears or Harmonic Scalpel 292 xxiii Contents 41.Tissue Fusion System (LigaSure) and Evident Microwave Ablation System 294 42. Principles of Intravesical Chemotherapy and Immunotherapy 297 Pranjal R Modi The Evident™ Microwave Ablation System 295 Hemant B Tongaonkar Intravesical Chemotherapy 297; Intravesical Immunotherapy 297; Indications of Intravesical Chemotherapy 297; Contraindications 297; Prerequisite for Intravesical Therapy 297 Section 7: Pediatric Urology 43. Applied Anatomy of Genitourinary Tract 301 44. Developmental Anomalies of the Upper Urinary Tract 306 45. Polycystic Kidney Disease 309 46. Wilms’ Tumor 311 47. Congenital Ureteral Obstruction (Congenital Pelviureteric Junction and Vesicoureteral Junction Obstruction) 317 48. Abdominal Masses in Children 324 49. Bladder Exstrophy Complex 326 50. Diseases of Urachus 330 51. Prune Belly Syndrome 332 52. Vesicoureteric Reflux 334 53. Neuropathic Bladder in Children 342 Laila Anjuman Banu Development of Kidney 301; Kidney 302; Ureter and Renal Pelvis 304 Zahid Hossain Bhuiyan Clinical Embryology of the Upper Urinary Tract 306; Renal Agenesis 306; Multicystic Dysplastic Kidney 306 Mozzam Hossain Autosomal Recessive Polycystic Kidney Disease 309; Autosomal Dominant Polycystic Kidney Disease 309; Multilocular Renal Cyst 310; Solitary Renal Cyst 310 Shafiqul Haque, Matiur Rahman Etiology 311; Causes 311; Pathology 311; Work-up 312; Presentation 313; Staging of Wilms’ Tumor 313; Management Principles 313; Treatment by Type and Stage of Wilms’ Tumor 314; Prognostic Factors 316 Jahangir Kabir, MA Salam Ureteropelvic Junction Obstruction 317; Bilateral Ureteropelvic Junction Obstruction 321; Complications 322; Outcome and Prognosis 322; Future and Controversies 322; Follow-up 322 Isteaq Ahmed Shameem Imaging Techniques 324 Paddy Dewan Cloacal Exstrophy (10%) 326; Classical Bladder Exstrophy (60%) 326; Epispadias (30%) 326; Diagnosis of Bladder Exstrophy 328; Management of Bladder Exstrophy 328; Prognosis and Natural History 328 Ishteaq Ahmed Shameem Patent Urachus 330; Urachal Cyst 330 Matiur Rahman Major Characteristics 332; Associated Anomalies 332; Management 332; Work-up 333; Treatment 333 Paddy Dewan Incidence 334; Pathophysiology 334; Causes 335; Consequences 335; Incidence 335; Grading System 335; Diagnosis 336; Work-up 336; Management 337; Surgical Techniques 340; Follow-up 340 Paddy Dewan Definition 342; Classification 342; Urodynamic Studies 342; Management 343; Follow-up of Neurogenic Bladder Patients 344 xxiv Principles and Practice of Urology 54. Nocturnal Enuresis 346 55.Rhabdomyosarcoma 348 Pranashish Saha Definition 346; Diagnosis 346; Treatment 346 Shahadat Hossain Presentation of Rhabdomyosarcoma 348; Pathology 348; Pathologic Classification 348; Clinical Groups of Rhabdomyosarcoma 349; Management 349 56. Acute Scrotum in Children 57. Empty Scrotum or Undescended Testis 381 Emdadul Haque Diagnosis 381; Treatment 381 65. Repair of Hypospadias: Current Trend 375 Shafiqul Haque Mechanisms of Sexual Differentiation 375; Disorders of Sexual Differentiation 376; Work-up of Ambiguous Genitalia 376; Gender Assignment 378; Timing of Genital Reconstruction 378; Management 378 64.Micropenis 373 Ishteaq Ahmed Shameem Presentation of Paraphimosis 373; Manual Reduction 373; Follow-up 374; Complications 374 63. Ambiguous Genitalia 368 MA Salam, Shahidul Islam Sugom Diagnosis 368; Treatment 368; Methods of Circumcision 369 62.Paraphimosis 364 Paddy Dewan Classification of Posterior Urethral Valves 364; Presentation of Posterior Urethral Valve or Membrane 364; Work-up of Posterior Urethral Valves 365; Management of Posterior Urethral Valves 365; Antenatal Treatment 365; Postnatal Treatment 366; Vesicostomy 366; Follow-up 366 61.Phimosis 361 K Sasidharan Diagnosis 361; Treatment of Varicocele 362 60. Posterior Urethral Valves or Membrane 359 MA Salam, Md Saiful Islam Diagnosis 359; Treatment 359 59. Varicocele in Children and Adolescents 355 Paddy Dewan Significance 355; Classification 355; Diagnosis 356; Investigations 356; Treatment 357; Advantages of Early Orchidopexy 357; Prognosis 358 58.Hydrocele 350 Shafiqul Haque Diagnosis 350; Treatment of Testicular Torsion 352; Prognosis 352; Perinatal Torsion 353; Epididymitis 353; Testicular Cancer 353 Paddy Dewan History 382; Pathophysiology of Hypospadias 382; Classification System of Hypospadias 383; Risk Factors for Hypospadias 383; Differential Diagnosis of Hypospadias 384; Objectives of Repair of Hypospadias 384; Diagnosis 384; Treatment of Hypospadias 384; Techniques for Posterior Hypospadias 387; Two-stage Hypospadias Repair 389; Bladder/Buccal Mucosa Technique 390; Operative Technical Points 392; Complications of Hypospadias Repairs 393; Hypospadias Patients with Multiple Failures 394; Long Term Follow-up 394 382 xxv Contents Section 8: Neurourology 66. Applied Anatomy of Bladder 399 67. Flaccid Type of Neuropathic Bladder 406 68.Incontinence 411 69.Myelomeningocele 418 70. An Overview of Neuropathic Bladder 421 71. Overactive Bladder 428 72. Spastic Type of Neuropathic Bladder 434 73. Spinal Cord Injury 440 Laila Anjuman Banu Gross Anatomy 399; Histology 399; Bladder Innervation 400; Sphincteric Mechanisms 400; Bladder Neck in Male 401; Bladder Neck in Female 401; The Physiology of Vesicourethral Segment 402; Uropharmacology 403 MA Salam, ATM Aman Ullah Etiology of Flaccid Type of Neuropathic Bladder 406; Pathophysiology 406; Clinical Presentation 407; Laboratory Study 407; Management of Flaccid Neuropathic Bladder 407; Supplies Required for Self-catheterization Technique 408 MA Salam Pathophysiology of Incontinence 411; Mechanism of Incontinence 412; Classification of Incontinence 412; History 414; Causes of Neuropathic Bladder/Urethral Dysfunction 415; General Management 416 Jahangir Kabir Causes 418; Symptoms 418; Classification 419; Work-up 419; Management 419; Prognosis 420; Possible Complications 420 AKM Anwarul Islam Functional Features of Bladder 421; Pathophysiology of Neuropathic Bladder 421; Classification of Neuropathic Bladder 422; Outline of Diagnosis of Neuropathic Bladder 422; Complications of Neuropathic Bladder 425; Principle of Treatment of Neuropathic Bladder 427; Prognosis 427 Farakh Khan Definition 428; Pathophysiology 428; Management 429 Jahangir Kabir Pathophysiology 434; Clinical Presentation 435; Investigations 436; Management 437 MA Salam Pathophysiology 440; History 440; Complete Spinal Cord Transection Syndromes 441; Physical Examination of Spinal Cord Injury Patients 442; Causes of Spinal Injury 442; Goals in the Management of Neuropathic Bladder in Spinal Injury 443; Urodynamic Classification of Spinal Injury 443; Prehospital Care and Transportation of Spinal Injury Patients 444; Emergency Department Care 444; The Therapeutic Goal for Neurogenic Shock 445; Complications 446; Prognosis 447; Lifelong Surveillance 447 74. Urodynamic Studies MA Salam Components of Urodynamics 449; Simple Urodynamics 450; Complex Urodynamics 455; Practical Points of Urodynamic Study 457 449 xxvi Principles and Practice of Urology Section 9: Female Urology 75. Stress Urinary Incontinence 471 76. Vesicovaginal Fistula 486 77. Ureteric Injury in Pelvic Surgery 493 78. Interstitial Cystitis 501 79. Urethral Caruncles 504 Ajit Vaje Definition 471; History 471; Mechanism of Stress Incontinence in Female 471; Mechanism of Stress Incontinence in Male 472; Classification 472; Work-up of Stress Urinary Incontinence 472; Treatment Options 476; Postoperative Care 483; Risks and Complications 483; Selection of Therapy for an Individual Patient 483 Ajit Vaje History of the Procedure 486; Incidence 486; Etiology 486; Pathophysiology 487; Risk Factors 487; Presentation 487; Work-up 487; Treatment 488; Complications 490 Khoorsheed Jahan Maula History of the Procedure 493; Incidence 493; Etiology 493; Classification 494; Pathophysiology 494; Diagnosis 495; Management 497 Afiquor Rahman New Concepts 501; Interstitial Cystitis Symptoms 501; Diagnosis 501; Management 502 Ajit Vaje, MA Salam Frequency 504; Pathophysiology 504; Presentation 504; Work-up 504; Treatment 504; Follow-up 505; Complications 505; Outcome and Prognosis 506; Future and Controversies 506 Section 10: Urinary Tract Obstruction 80. Urinary Tract Obstruction 509 81. Retroperitoneal Fibrosis 519 82.Ureterocele 528 83. Primary Obstructive Megaureter 533 84. Fetal Lower Urinary Tract Obstruction 537 Jahangir Kabir, MA Salam History 509; Etiology 509; Pathophysiology of Obstructive Nephropathy 509; Presentation 510; Work-up 511; Imaging Studies 512; Diagnostic Procedures 515; Treatment 515; Follow-up 517; Complications 517; Outcome and Prognosis 517 MA Wahab, KM Monwarul Karim Pathophysiology 519; Mortality/Morbidity 520; Presentation 520; Physical Examination 520; Causes of Retroperitoneal Fibrosis 520; Differential Diagnosis 521; Work-up 521; Histologic Findings 523; Treatment 523 Pranashish Saha Classification 528; Incidence of Ureterocele 528; Etiology 528; Presentation 528; Laboratory Studies 529; Imaging Studies 529; Principle of Treatment of the Ureterocele 531; Follow-up 532; Complications of Surgical Intervention 532; Outcome and Prognosis 532 AKM Anwarul Islam Prevalence 533; Pathophysiology 533; Presentation 533; Work-up 534; Histologic Findings 535; Treatment 535; Follow-up 536; Complications 536 Paddy Dewan Cause of Fetal Lower Urinary Tract Obstruction 537; Pathophysiology 537; Diagnosis and Prognostic Criteria 537; Management Options and Outcomes 538; Indications and Contraindications for Fetal Treatment 538; Follow-up 538 xxvii Contents Volume 2 Section 11: Urolithiasis 85. Urinary Tract Stone Disease Ravindra Bhalchandra Sabnis The Incidence of Urinary Tract Stone Disease 543; Pathophysiology of Urolithiasis 543; Causes of Urolithiasis 543; Types of Stones 545; Mortality/Morbidity Related to Urolithiasis 546; Clinical Review 546; Physical Examination 547; Differential Diagnosis 547; Work-up 547; Treatment 549; Follow-up 551; Complications of Stone Disease 551; Medical Treatment for Stone Disease 552; Prognosis 552 543 86. Acute Renal Colic 554 87. Extracorporeal Shockwave Lithotripsy 560 Md Fakhrul Islam Clinical Findings 554; Work-up 554; Management of Acute Renal or Ureteric Colic 557; Surgery for Recurrent Renal Colic 559 Isteaq Ahmed Shameem Technical Aspects 560; Evolution of Shockwave Lithotripters 561; Indications of Extracorporeal Shockwave Lithotripsy 562; Work-up 563; Factors Affecting the Outcome of Extracorporeal Shockwave Lithotripsy 563; Preoperative and Intraoperative Stenting 564; Techniques of Extracorporeal Shockwave Lithotripsy and Patient Care 564; Follow-Up 564; Complications 564; Future and Controversies 565 88. Intracorporeal Lithotripsy 566 89. Percutaneous Endourological Procedures 570 Agrawal Madhu Sudan Different Energy Sources Used in Intracorporeal Lithotripsy 566; Postoperative Care 567; Complications 568; Outcome and Prognosis 568; Intracorporeal Lithotripsy and its Future 568 Mahesh R Desai History 570; Relevant Anatomy 570; Indications 570; Contraindications 575; Work-up 575; Treatment 576; Postoperative Care 577; Complications 577 Section 12: Benign Prostatic Disease 90. Benign Prostatic Hyperplasia KT Foo Pathophysiology 583; Presentation of Benign Prostatic Hyperplasia 584; International Prostate Symptom Score Index 584; Work-up 586; Imaging Studies 586; Histological Findings 587; Staging of Benign Prostatic Hyperplasia 588; Open Prostatectomy 590; Transurethral Resection of the Prostate 590; Transurethral Incision of Prostate 591; Transurethral Needle Ablation of the Prostate 593; Follow-up 595; Complications 595 583 Section 13: Lower Urinary Tract Symptoms in Men and Women 91. Lower Urinary Tract Symptoms KT Foo, MA Salam Epidemiology 599; Presentation 599; International Prostate Symptom Score Index 599; Assessment 599; Differential Diagnoses 601; Indications for Referral 601; Management of Lower Urinary Tract Symptoms 601; Risk Factors for Urinary Incontinence 602; Presentation 602; Differential Diagnoses 603; Investigations 603; Management 603; Complications 603; Prevention 603 599 xxviii Principles and Practice of Urology Section 14: Diseases of the Adrenal Gland 92. Adrenal Mass 605 93. Cushing’s Syndrome 615 94.Pheochromocytoma 619 Jagdeesh N Kulkarni Anatomy of Adrenal Glands 607; Physiology of Adrenal Glands 607; Work-up of Adrenal Masses 608; Adrenal Cysts 608; Aldosteronoma (Conn’s Syndrome) 609; Neuroblastoma 609; Myelolipoma 609; Pheochromocytomas 609; Medical Therapy 610; Postoperative Care 613; Follow-up 613; Complications 613; Prognosis of Adrenal Tumor 613 SAM Golam Kibria Pathophysiology 615; Etiology 615; Pathology 616; Clinical Presentation 616; Laboratory Work-up 616; Complications 617; Treatment 617; Prognosis 618 Hemant B Tongaonkar Pathophysiology 619; Mortality/Morbidity 619; History 620; Physical Examination 620; Work-up 621; Additional Tests after the Diagnosis of Pheochromocytoma 622; Histologic Findings 622; Staging 622; Treatment 623; Follow-up 623 Section 15: Practical Urology 95. Catheters for Urinary Tract 627 96. Male Urethral Catheterization 633 97. Female Urethral Catheterization 641 Fazal Naser, Md Waliul Islam Maruf Urethral Catheters 627 Moudud Hossain Alamgir, Shohrab Hossain History of Catheterization 633; Indications 634; Contraindications 634; Materials for Urethral Catheterization 634; Applied Anatomy 634; Catheters and Basic Designs 634; Urethral Catheterization in the Male Patient 635; Catheter Maintenance 636; Problems during Urethral Catheterization 636; Contraindications 637; Technique 638; Complications 639; Long-term Indwelling Catheters 639 AKM Khurshidul Alam Indications for Catheterization in Female Patients 641; Contraindications for Catheterization in Female Patients 641; Equipment 641; Practical Anatomy 642; Procedure 642; Complications 642; Difficult Catheterizations 642 98. Common Practical Problem for the Residents 644 99. Image Reproduction for Teaching, Documentation and Research 648 100. Principles of Intravesical Chemotherapy and Immunotherapy 650 Ahsan Kabir Practical Urological Problem 644; Tips for Post-transurethral Resection Bleeding 644; Management of Intractable Hematuria 644; Practical Urological Problem: Treatments for Intractable Hematuria 645; Practical Urological Problem: Transurethral Resection Syndrome 645; Practical Urological Problem: Deep Vein Thrombosis and Pulmonary Embolus 645; Pulmonary Embolus 646; Practical Urological Problem: Elective Surgery on Anticoagulated Patients 646; Blocked Catheter 646; Practical Urological Problem: Failure of Catheter Balloon to Deflate 647 ABM Golam Rabbani Videoendoscopic Surgery 648; Protocol for the Trainee and Students 648 Promode Ranjan Singh Contraindications 650; Dose and Duration of Therapy 651 xxix Contents 101. Urological Equipment 652 102. Irrigating Solutions for Urological Endoscopic Surgery 664 103. Clean Intermittent Self-catheterization 666 Mir Ehteshamul Haque Telescopic System 652; Urological Equipment for Lower Tract 653; Equipment for Upper Tract 657; General Equipment in Urology Operation Theater 658; Sterilization and Care of Endoscopic Instruments 660; Sterilization Methods for Urological Endoscopes 661 Nurul Hooda, Md Abdul Awal Characteristics of Ideal Irrigating Solution for Transurethral Resection 664 Shailesh Raina, BK Dastur History 666; Effects of Intermittent Catheterization 666; Prerequisites of Clean Intermittent Self-catheterization 666; Catheters and Catheter Care 667; Follow-up 668; Complications 668 Section 16: Operative Urology 104. Circumcision 673 105. Penile Zipper Injury 677 106. Suprapubic Urinary Bladder Catheterization 679 107. Cystoscopy 684 108. Ureteroscopy 689 109. Acute Hemodialysis Vascular Access 695 110. Transrectal Ultrasound Guided Prostate Biopsy 698 111. Urethral Dilatation 703 112. Vasectomy: No Scalpel Method 705 Mohsin Uddin Ethical Issues 673; Indications 673; Routine Circumcision 673; Caution 674; Circumcision for Patients with Phimosis 674 Shahidul Islam Sugom Prelude 677; Management 677; Complications 677 SM Mahbub Alam, AKM Zamanul Islam Bhuiyan Anesthesia 679; Equipment 679; Positioning 680; Technique 680; Complications 680; Open Suprapubic Cystostomy 681 MA Salam, Shadrul Alam Indications of Cystoscopy 684; Sterilization of Cystoscope 684; Chromocystoscopy 687; Complications 687; Narrow Band Imaging 688 SA Khan, Jahangir Kabir, M Hasan Akther History of Ureteroscope 689; Indication of the Procedure 690; Work-up 690; Diagnostic Ureteroscopy 690; Therapeutic Ureteroscopy 691; Postoperative Care 692; Complications of Ureteroscopy 692 Muhammad Hossain Prevention of Complications 697 MA Salam Techniques of Transrectal Ultrasound-guided Prostate Biopsy 698; Complications 701; Future Guidelines 702 MA Salam, MA Wahab Indications 703; Patient Preparation 703; Technique 703 Ahsan Kabir Indications 705; Anesthesia 705; Equipment 705; Positioning 706; Technique 706; Complications 707; Postvasectomy Success Rates 707 xxx Principles and Practice of Urology 113. Transurethral Resection of the Prostate and Bladder Neck Incision 709 114. Bladder Tumor: Endoscopic Assessment and Treatment 725 115. Ureterolithotomy 734 116. Radical Nephrectomy 741 117. Radical Orchiectomy 748 118. Varicocelectomy 752 119. Radical Cystoprostatectomy 756 120. Radical Retropubic Prostatectomy 770 121. Pyeloplasty 777 Deen Sharma History 709; Differential Diagnosis 709; Basic Applied Anatomy for Benign Prostatic Hyperplasia 711; Equipment, Irrigation, Diathermy, Surgeon’s Chair 711; Technique of Transurethral Resection of the Prostate 711; Postoperative Care 715; Histology of Transurethral Resection Chips 716; Immediate Complications of Transurethral Resection of the Prostate 716; Late Complications of Transurethral Resection of the Prostate 718; Transurethral Resection in Carcinoma of the Prostate 720; Transurethral Resection of the Prostate in Chronic Bacterial Prostatitis 720; Transurethral Resection of the Prostate in Prostatic Abscess 720; Transurethral Resection of the Prostate in Hypertrophy of the Bladder Neck 720 Makarand V Khochikar Bladder Tumor (Endoscopic Assessment) 725; Urethroscopy 726; Cystoscopy 726; Bimanual Examination 727; Biopsy Technique 727; Cytology 729; Resection of Bladder Tumor 730; Special Points of Technique 731 Prem Nath Dogra History of the Procedure 734; Etiology 734; Presentation 734; Indications 735; Relevant Anatomy 735; Contraindications 735; Laboratory Studies 735; Imaging Studies 735; Other Tests 735; Treatment 735; Open Ureterolithotomy 737; Follow-up 739; Complications of Ureterolithotomy 739 Ganesh Gopalakrishnan Indications 741; History of the Procedure 742; Work-up 742; Technique of Radical Nephrectomy 743; Techniques of Open Radical Nephrectomy 744; Postoperative Complications 745; Outcome and Prognosis 746 Prem Nath Dogra Etiology of Testicular Cancer 748; Pathology of Testicular Cancer 748; Differential Diagnoses 748; Presentation of Testicular Cancer 748; Indications for Radical Orchiectomy 748; Work-up 749; Surgery 749; Complications 750; Outcome and Prognosis 750 Mir Ehteshamul Haque Cause 752; Pathophysiology 752; Diagnosis 753; Treatment 753 MA Salam Indications for Radical Cystectomy 756; Indications for Urethrectomy 756; Work-up 756; Biopsy for Bladder Cancer (Transurethral Resection of Bladder Tumor) 757; Radical Cystoprostatectomy 758; Radical Cystectomy in Women 761; Laparoscopic or Robot-assisted Laparoscopic Cystectomy 762; Postoperative Care 766; Complications 767; Outcome and Prognosis 767; Alternative Therapy 767 Hemant B Tongaonkar History of Radical Retropubic Prostatectomy 770; Work-up 770; Preoperative Care 771; Division of the Puboprostatic Ligaments and Control of the Dorsal Venous Complex 771; Complications 773; Outcome and Prognosis 774; Follow-up 774; Future and Controversies 774 Rajeev Kumar Pathophysiology 777; Work-up 777; Preoperative Preparation 778; Postoperative Details 780; Outcome and Prognosis 781 xxxi Contents 122. Retroperitoneal Lymph Node Dissection 782 123. Endoscopic or Intracorporeal Lithotripsy 785 124. Laparoscopic Cystoprostatectomy with Urinary Diversion 790 125. Evolution of Laparoscopic Technique in Urology 794 126. Outline of Laparoscopic Urological Surgery 800 127. Laparoscopic Adrenalectomy 809 128. Laparoscopic Radical Nephrectomy 813 129. Laparoscopic Nephron Sparing Surgery 817 130. Laparoscopic Nephroureterectomy 821 131. Laparoscopic Pyeloplasty 827 132. Robotic Radical Prostatectomy 832 Muhammad Choudhury Open Technique of Retroperitoneal Lymph Node Dissection 782; Follow-up 783 Mahesh R Desai Various Energy Sources Used in Urinary Stone Management 785; Indications and Technique of Management of the Urinary Stones 786; Postoperative Care 788; Complications 788 Muhammad Choudhury History 790; Preoperative Preparation 790; Technique for Laparoscopic Cystoprostatectomy 790 MA Salam History of Laparoscopy 794; Preoperative Patient Management 795; Instrumentation for Developing the Extraperitoneal Space 796; Laparoscopic Hand Instruments 797; Port Removal and its Closure 798 Shailesh Puntambekar History of Laparoscopy 800; Physiology 801; Preoperative Preparation 802; Laparoscopic Video Instrumentation and Cart 806; Postoperative Care 807; Complications 807; Future of Laparoscopy 807 Muhammad Choudhury Techniques of Laparoscopic Adrenalectomy 809; Hand-assisted Laparoscopic Surgery 811 Ganesh Gopalakrishnan Definition 813; History 813; Approaches for Laparoscopic Nephrectomy 813; Retroperitoneoscopic Laparoscopic Nephrectomy 815; Complications 815; Outcomes 816 Shailesh Puntambekar Indications 817; Technique of Laparoscopic Partial Nephrectomy 817 SA Khan, MA Salam History 821; Technique of Laparoscopic Nephroureterectomy 821; Management of the Distal Ureter 821 NP Gupta Diagnosis 827; Indications 827; Complications 829 NP Gupta Techniques of Radical Prostatectomy 833; Robotic Radical Prostatectomy 834; Robotic Transperitoneal Approach 834; Lymph Node Dissection and Development of the Extraperitoneal Space 835; Advantages and Disadvantages of Robotics Versus Laparoscopy 836 133. Laparoscopic Orchidopexy Jahangir Kabir, NI Bhuiyan 838 xxxii Principles and Practice of Urology Section 17: Reconstructive Urology 134. Urethral Strictures and Management 843 135. Reconstruction of Urinary Bladder (Cystoplasty) 861 136. Urinary Diversion 868 137. Urinary Fistula 883 Sanjay Kulkarni History 843; Definition 843; Applied Anatomy of Male Urethra and Distal Sphincter Mechanism 843; Female Urethra and Distal Sphincter Mechanism 845; Patch Urethroplasty of the Fossa Navicularis 849; Urethroplasty 851; Onlay Graft Orientation 855; Oral Complications after Buccal Mucosal Harvesting 856; Complications 858; Outcome and Prognosis 858; Postoperative Erectile Dysfunction 859; Future of Urethral Stricture Management 860 MA Salam Types of Cystoplasty 861; Indications of Cystoplasty 861; Contracted Bladder 861; Overactive Bladder 861; Augmentation Cystoplasty 862; Substitution Cystoplasty 864; Postoperative Management 865; Complications of Cystoplasty 866; Quality of Life 867 MA Salam Definition 868; History of the Procedure 869; Indications 869; Classification of Urinary Diversion 869; Work-up 870; Principles of Noncontinent Urinary Diversion 870; Principles of Continent Urinary Diversion 873; Selection of Types of Urinary Diversion 875; Preoperative Preparation and Care of Patients for Urinary Diversion/Orthotopic Bladder 877; Postoperative Care of Urinary Diversion/Orthotopic Bladder 878; Early Complications of Urinary Diversion/Orthotopic Bladder 879; Late Complications of Urinary Diversion/Orthotopic Bladder 879; Outcome and Prognosis of Urinary Diversion/Orthotopic Bladder 881; Future of Urinary Diversion/Orthotopic Bladder 881 K Sasidharan Vesicovaginal Fistula 883; Cystoscopy and Vaginoscopy 884; Principle of Operative Management 885; Urethrovaginal Fistula 886; Ureterovaginal Fistula 887; Prostatic Fistula 888; Transrectal Repair 888; Vesicoenteric Fistulas 889; Renal and Upper Urinary Tract Fistulas 890; Fistula of Urinary Diversion 890 Section 18: Transplant 138. Renal Physiology 895 139. Acute Kidney Injury 898 140. Chronic Kidney Disease 913 141. Immunosuppression in Renal Transplantation 920 142. Retroperitoneoscopic Donor Nephrectomy 924 Nurjahan Begum Matiur Rahman Definition 898; Epidemiology 898; Causes 899; Pathophysiology 901; Diagnosis 903; History 903; Management of Acute Kidney Injury 907; Renal Replacement Therapy 909 Harun-ur-Rashid Pathophysiology 913; Work-up 914; Management of Chronic Kidney Disease and End-stage Renal Disease 915; Management of the Coexisting Disease or Abnormalities in Chronic Kidney Disease 918; Mortality/Morbidity 918; Prevention 918; Complications 918; Prognosis 918 Muhammad Rafiqul Alam History 920; Drugs Used for Immunosuppression 920; Biologic Agents 921; Primary Immunosuppressive Agents 922; Infection and Malignancy Issues 923 Pranjal R Modi Technique 924; Hand-assisted Retroperitoneoscopic Donor Nephrectomy 926; Complications 926 xxxiii Contents 143. Renal Transplantation Surgery 928 144. Transperitoneal Donor Laparoscopic Nephrectomy 941 145. Medical Complications of Renal Transplants 944 MA Salam History of Kidney Transplant 928; Concept of Histocompatibility 928; Identification of Suitable Donor 930; Nephrectomy for Live Donor 931; Antegrade Pyelography 937; Surgical Complications 937; Skin Cancers 939; Outcome of Renal Transplantation 939 Mahesh R Desai History of Lap Donor Nephrectomy 941; Complications 943 Harun-ur-Rashid Post-transplantation Morbidity and Mortality 944; Important History in Transplantation Complications 945; Renal Transplantation Complications 945; Chronic Allograft Injury 946; Management Strategies for Common Presentations 947 Section 19: Uro-oncology 146. Renal Tumors 951 147. Renal Cell Carcinoma 956 148. Urothelial Cancer 974 149. Upper Tract Transitional Cell Tumors 979 150. Bladder Cancer 989 151. Prostate Cancer 1019 Jagdeesh N Kulkarni Benign Tumors 951; Other Rare Benign Renal Tumors 953 Muhammad Choudhury Pathophysiology 956; Work-up of Renal Cell Carcinoma 957; Work-up 958; Classification 959; Types of Renal Tumors 959; Multikinase Inhibitors 967; Biologic Therapies 969; Summary of Treatment of Renal Cell Carcinoma 970 MA Salam Normal Urothelium 974; Risk Factors and Pathogenesis 974; Histopathology 975; Treatment Options for Urothelial Cancer 977; Prognosis of Urethelial Cancer 978 MA Salam, Golam Mowla Chowdhury Prelude 979; Epidemiology 979; Etiology 979; Pathophysiology 979; Diagnostic Procedures 983; Staging 984; Treatment 985; Complications 987; Follow-up 987 MA Salam External Beam Radiation Therapy 990; Pathology 990; Transitional Cell Carcinoma 991; Work-up of Patient with Bladder Cancer 994; Imaging for Bladder Cancer 995; Radical Cystoprostatectomy (Men) 1006; Anterior Pelvic Exenteration (Women) 1006; Urinary Diversions 1008; Neobladder 1009; First-line Chemotherapy for ‘Fit’ Patients 1013; Adenocarcinoma of the Bladder 1013 Christopher Cheng, MA Salam History of Prostate Cancer 1019; Etiology of Prostate Cancer 1020; Pathophysiology of Prostate Cancer 1022; Prostatic Intraepithelial Neoplasia 1023; Work-up and Histologic Findings 1026; Management of Prostate Cancer 1028; Radical Prostatectomy 1029; Follow-up of Prostate Cancer Patients 1035; Castrate-resistant Prostate Cancer 1036 xxxiv Principles and Practice of Urology 152. Testicular Cancer 1041 153. Penile Cancer 1058 MA Salam, Sajid Hasan Epidemiology 1041; WHO Classification of Testicular Tumors 1043; Etiological Factors In Testicular Tumor 1044; Investigations 1045; Ct/Mri/Pet 1046; Staging of Testicular Tumor 1047; Treatment 1048; Chemotherapy Regimens 1052; Follow-up of Testicular Cancer 1054; Complications 1055; Prognosis 1055 MA Salam, Mohammad Shafiqur Rahman Applied Anatomy of Penis 1059; Problem 1059; Emotional and Physical Burden of Penile Cancer and its Treatment 1059; Epidemiology 1059; Etiology 1060; Pathology 1060; Penile Malignant Tumor 1060; Presentation 1061; Work-up 1061; Histological Diagnosis and Staging 1062; Treatment 1063; Complications 1067; Prevention of Penile Cancer 1067 Section 20: Reproductive Urology 154. The Testis and Epididymis 1073 155. Peyronie’s Disease 1076 156. Male Infertility 1081 157. Assisted Reproduction Technology 1100 158. Erectile Dysfunction 1105 159. Penile Prosthesis Implantation 1120 160. Ejaculatory Disorders 1126 Laila Anjuman Banu Macroscopic Anatomy 1073; Histology 1073; The Vas Deferens and Seminal Vesicle 1074 MA Salam, Kazi Rafiqul Abedin Pathophysiology 1076; Causes of Peyronie’s Disease 1077; Work-up 1077; Treatment 1077; Prognosis and Complications 1079 Rajeev Kumar Work-up 1083; Respiratory Disease 1085; Physical Examination for Male Infertility 1085; Causes of Male Infertility 1086; Other Tests 1092; Treatment 1094 Rupin Shah Cause of Infertility 1100; Diagnostic Tests 1100; Treatment 1102; Assisted Reproductive Techniques 1103 Rupin Shah Prevalence 1105; Risk Factors for Erectile Dysfunction 1105; Physiology of Erection 1107; Etiology of Erectile Dysfunction 1108; Work-up of Erectile Dysfunction 1108; Causes of Erectile Dysfunction 1109; Sexual Function Score 1110; Evaluation of Erectile Dysfunction 1110; Management of Erectile Dysfunction 1112 Rupin Shah History of the Procedure 1120; Selection of Prosthesis 1122 Rupin Shah Mechanism of Ejaculation 1126; Classification and Etiology 1126 Index 1131
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