Patterns of scrotal pain in a hospital setting

Introduction: Scrotal pain is a common urological condition. Common causes of scrotal pain are testicular torsion, epididymitis, epididymo-orchitis and occasionally due to post vasectomy pain, varicocele, testicular trauma etc. The objective of our study is to review the different disease patterns in patients presenting with scrotal pain in a tertiary care hospital.Methods: Patients presenting with scrotal pain to the out-patient clinic and the emergency department were included in the study. All patients were subjected to urinalysis and ultrasound of scrotum with color Doppler study when needed. Descriptive variables were studied and analyzed.Results: Eighty three patients were enrolled in the study during the period of one year. Age ranged from 13 to 72 years; most of the patients were less than 40 years and more than 20 years. Among this age group non-specific orchalgia was very common. Isolated epididymitis was seen in only 4 (4.81%) patients. Epididymo-orchitis was found in 16 (19.27%) patients. Torsion of testis was found in 6 patients (7.22%). The major bulk of the patients presenting with scrotal pain were nonspecific which was found in 39 (46.98%) and exact cause could not be found in them. Total of 15 (18%) patients had acute presentation.Conclusion: Management of Scrotal pain can be simple or at times organ threatening, proper diagnosis and treatment by clinical judgment and necessary investigation is very important.Journal of Society of Surgeons of NepalVol. 17, No. 2, 2014, Page: 31-34

Risk-based Management of Non-muscle Invasive Bladder Cancer: Experience from Tribhuvan University Teaching Hospital

Background Most of the recent evidences suggest for risk-based management of non muscle invasive bladder cancer (NMIBC) to reduce the risk of recurrence and progression. Objective This study was conducted to assess the recurrence and progression of non muscle invasive bladder cancer in Nepalese patients using European Organization for Research and Treatment of Cancer (EORTC) risk tables and to assess the effectiveness of intravesical therapy to reduce the risk of recurrence. Method A prospective observational single centre study was conducted at Tribhuvan University Teaching Hospital from January 2010- December 2012. Forty six patients with non muscle invasive bladder cancer who underwent transurethral resection of bladder tumor and completed two years follow up were included. According to the European Organization for Research and Treatment of Cancer (EORTC) risk table, the patients were divided into low, intermediate and high risk groups. The patients received postoperative adjuvant therapy and surveillance as per the European Association of Urology guidelines. Result Among the 46 patients, the overall two year recurrence and progression rate was 8 (17%) and 1 (2%) respectively. Out of seven patients in low risk category, none of them developed recurrence or progression of disease. Out of 15 patients in intermediate risk category the one year and two year recurrence rate was 13% and 20% respectively. Out of 24 patients in high risk category the one and two year recurrence rate was 17% and 21% respectively. The risk reduction by use of intravesical Bacillus Calmette Guerin (BCG) for recurrence in high risk category was 58% and 60% in first and second year respectively. In our study, the overall and individual risk group, the one and two year recurrence rate was lower than that predicted by European Organization for Research and Treatment of Cancer risk table. Conclusion Risk-based management of non muscle invasive bladder cancer by using the European Organization for Research and Treatment of Cancer risk table is a useful method of management, though its prediction rates are lower in Nepalese population.

Efficacy of Tamsulosin in relieving double-J stent-related symptoms: a randomized controlled study

Introduction: Ureteral stent placement is an increasingly common procedure in urological practice.They are used for both prevention and treatment of ureteral obstruction. Despite improved design and materials, many patients still develop stent-related symptoms which commonly affect quality of life and sometimes necessitate early removal. Tamsulosin improves stent-related symptoms and quality of life, and can be applied in routine clinical practice. In the present study, the effect of Tamsulosin in improving double-J stent-related symptoms and quality of life following ureteral stent placement was studied.Methods: This RCT was carried out in the Department of Surgery, Tribhuvan University Teaching Hospital, Kathmandu, Nepal from February 2015 to January 2016. Forty six patients were included in the study and randomized into Tamsulosin(T) group and Control(C) group each having 23 patients. In addition to standard postoperative care, Tamsulosin group received 0.4mg Tamsulosin daily and Paraceramol on demand and control group received only Paracetamol. Stent related symptoms and quality of life was assessed by IPSS at discharge (day2) and at the time of DJ stent removal (2 weeks). Pain was evaluated by VAS and analgesic requirement was documented. Data were analysed using SPSS 20, chi-square test and Student’s t- test was used. A p-value of <0.05 was considered significant.Results: Mean age in Tamsulosin group was 37.96±12.98 and Control group 36.43± 10.99(p=0.67).There was no significant difference in IPSS(p=0.141), QoL index (p=0.089) and VAS (p=0.59) in the two groups at the time of discharge.At the time of DJ stent removal, IPSS (p<0.001), QoL index (p<0.001), VAS (p=0.004) and analgesic needed (p<0.001) was significantly lower in T group than in C group.Conclusion: Tamsulosin lowers stent related symptoms, pain and improves quality of life in patients with indwelling DJ stent though the effect is not immediate.

Adrenal histoplasmosis : a rare cause of bilateral adrenomegaly

Histoplasmosis is an opportunistic infection caused by a dimorphic fungus Histoplasma capsulatum. Histoplasmosis causing bilateral adrenal involvement is rare and usually occurs only in immunocompromised individuals with disseminated disease.  Here we report a case of bilateral adrenal histoplasmosis with disseminated disease in an immunocompetent patient.

Change in storage symptoms after transurethral resection of prostate: a prospective observational study

Introduction: Patients with enlarged prostate generally rate their storage symptoms (frequency, urgency and nocturia) as the most bothersome as these symptoms interfere more with daily activities and have huge impact on quality of life. Effect of transurethral resection of prostate (TURP) on storage symptoms is unknown. Objective of the study is to assess the change in storage symptoms in patients undergoing TURP.Methods: A prospective observational study was conducted at the author’s institute from August 2011 to July 2012. Patients undergoing TURP for moderate to severe lower urinary tract symptoms (LUTS) secondary to benign enlargement of prostate were included. Patients were evaluated by International prostate symptom score (IPSS) questionnaires. The question number 2, 4 and 7 of the IPSS questionnaire gave the storage symptom subscore (0-15). After initial evaluations, the patients underwent TURP. After 3 months, the IPSS was reevaluated and the change in storage symptom was analyzed.Results: A total of 57 patients who had undergone TURP were eligible for final data analysis. Majority of the patients had severe bothersome LUTS with mean IPSS score of 24.6±6. The baseline storage symptom subscore was 11.1±3. After 3 months of follow-up, there was significant decrease in total IPSS score and both of its subscores. On comparing the mean change in storage and voiding subscore, there was less decrement in storage subscore which was statistically significant (p=0.001). Conclusions: This study showed that after TURP change in voiding subscore occurs more than storage subscore and storage symptoms may not revert to normal.

Clinicopathological Pattern of Penile Cancer in a Tertiary Care Centre in Nepal

INTRODUCTION

Carcinoma of penis is an uncommon entity. The higher incidence in developing country may be because of poor hygiene, less common practice of circumcision and unsafe sexual practice. Timely diagnosis and intervention gives the patient a chance of cure. Data on penile cancer is sparse from Nepal so treatment of penile cancer in our centre is presented here.

METHODS

This was a retrospective cross-sectional study done at Urology unit of Department of Surgery of Tribhuvan University Teaching Hospital, Nepal from November, 2007 to December, 2013. Data was retrieved from case records and those with penile carcinoma were included. Patient demographics, lesion characteristics, mode of treatment with outcome measures were noted and analyzed.

RESULTS

Total 17 patients underwent treatment for primary penile lesion. Mean age of the patients was 51.5 years. Penile growth was the most frequent presentation with five patients coming with more than one symptom. The most common site was over glans of penis (n=13) with the mean size of 3.55 cm. Partial penectomy was offered in 16 with one patient undergoing circumcision only. Inguinal lymph node dissection was done in four patients. Squamous cell carcinoma was the histological diagnosis in 15 patients.

CONCLUSIONS

Penile carcinoma is primarily a disease of old. Growth over glans penis is the most common presentation and partial penectomy is feasible in most of the patients to allow oncological cure while preserving the organ for its native function.

Nephron sparing surgery in a tertiary care center in Nepal--an initial experience

BACKGROUND

Malignant renal mass accounts for 2 to 3% of all malignant diseases in adults. Radical surgery used to be the treatment of choice with high propensity to develop chronic kidney disease in the compromised contralateral kidney. Currently, nephron sparing surgery is considered to be the standard of care with equivalent oncological outcome.

METHODS

This was a retrospective chart review of patients with renal mass less than seven cm in size who had open nephron sparing surgery from July 2012 to Sep 2013 at Tribhuvan university teaching hospital, Nepal. Latest follow up either from record or over telephone was documented.

RESULTS

Eight patients (mean age 45 years, male: female ratio1:1.6) underwent nephron sparing surgery over the specified period. Mean size of tumor was 4.75 cm. Mean ischemia time was 16.37 min. Histopathological diagnosis was benign in two and renal cell carcinoma in six patients.

CONCLUSIONS

Nephron sparing surgery is safe in low stage renal tumors. It also prevents unnecessary nephrectomy in benign lesions and prevents negative sequelae of long term chronic renal impairment in remaining contralateral kidney.

Phaeochromocytoma in Nepal--a single centre experience

BACKGROUND

Phaeochromocytomas are rare tumors of chromaffin cells of neural crest that classically present with symptoms of catecholamine excess such as palpitations, headache and sweating. They are diagnosed by measuring plasma or urinary levels of catecholamines or their metabolites. Anatomic localization is done by computed tomographic scan or magnetic resonance imaging, or meta-iodobenzyl guanidine scan in certain cases. Adequate preoperative catecholamine blockade prevents perioperative hemodynamic instability.

OBJECTIVES

To study the clinical spectrum and management of phaeochromocytomas in a tertiary care centre, Tribhuvan University Teaching Hospital, in Nepal.

METHODS

Retrospective review of case records of histologically proven cases of phaeochromocytomas from 2008 -2011 was done, and data collected on clinical spectrum, diagnostic modalities, perioperative management and follow-up.

RESULTS

Twelve cases of phaeochromocytomas were operated. The mean age was 36.41+/-14.07 years. There were 2 bilateral phaeochromocytomas and 1 extraadrenal paraganglioma. Apart from the common symptoms of catecholamine excess, patients had atypical presentations like psychiatric manifestations and blurred vision. A combination of urinary Vanillyl Mandelic Acid and computed tomographic scan was used for diagnosis, and open surgery was done in all cases. Pre-operative blood pressure control was achieved by prazocin or calcium channel blockers. Ten patients had intraoperative surge in blood pressure. There were no major morbidity or mortality. Three patients had high blood pressure postoperatively, but were effectively managed with antihypertensives.

CONCLUSION

Phaeochromocytomas can have variable presentation. Good preoperative preparation and perioperative management can result in an excellent outcome.

Primary mucinous adenocarcinoma of the renal pelvis and ureter

Mucinous adenocarcinomas of the renal pelvis and ureter are among the rarest upper urinary tract neoplasm. We report a case of multifocal primary mucinous adenocarcinoma of the renal pelvis and ureter occurring in association with a staghorn calculus and pyonephrosis. A 68 year old man had suffered from right flank pain and upper abdominal swelling for one year. After a series of investigation, a right staghorn stone with pyonephrosis leading to non-functioning kidney was found. Right nephrectomy was performed. The pathological report showed mucinous adenocarcinoma with ureteric margin positive for tumour deposits. Patient was reoperated; right ureterectomy with removal of bladder cuff was done. Although uncommon, the possibility of a tumor should be kept in mind especially in patients with a long standing urolithiasis accompanied by hydronephrosis and/or infection.

Pattern of renal cell carcinoma - a single center experience in Nepal

BACKGROUND

Renal tumor is the 13th most common malignancy in the world and more than 90% of renal tumors are renal cell carcinomas. As there is no data available on renal cell carcinoma in Nepal, hence this study was undertaken to analyze the patterns of renal cell carcinoma in patients with renal mass at a tertiary level hospital in Nepal.

OBJECTIVES

To analyze the patterns of renal cell carcinoma in patients with renal mass at a tertiary level hospital in Nepal.

METHODS

The case records of 50 consecutive patients with renal cell carcinoma presenting at the Tribhuvan University Teaching Hospital, Kathmandu from July 2006 to June 2011 were retrospectively evaluated for presenting symptoms, physical finding, investigation and histopathology report.

RESULTS

Out of 50 patients, 64% were male and 36% were female. The age ranged between 11 to 78 years (mean ± SD: 55 ± 15 years). Fifty four percent of patients were smokers. Incidentally tumor was detected in 40% cases by ultrasonography and the typical triad was present in only 4%. The tumor was occupying upper pole in 40% of cases. The tumor size ranged from 3 to 15 cm (mean ± SD: 7.3 ± 2.9 cm). Histopathologically, 76% of the patient had organ confined renal cell carcinoma (T1- 2 N0 M0). Clear cell was the most common type seen in 86%. Fuhrman nuclear grade 2 was found in 50%.

CONCLUSION

Many of the renal cell carcinoma are detected incidentally, at an early stage and are of clear cell subtype.

Urological complication after kidney transplantation

BACKGROUND

Renal transplantation is a regular service at Tribhuvan University Teaching Hospital and complications have been known to occur after it. This study was conducted to assess complications after transplantation.

OBJECTIVES

To determine the incidence of urological complications after living related renal transplantation at Tribhuvan University Teaching Hospital.

METHODS

A clinical study was performed (from August 2008 to July 2010) which included 50 living-related renal transplantations at Tribhuvan University Teaching Hospital. All the donors and recipients were evaluated preoperatively with necessary investigations and followed up postoperatively with standard hospital transplant protocol. The incidence of urological complications were documented and analyzed.

RESULTS

Fifty living-related, renal transplantations were carried out during the study period. Seven doors had minor post operative complications; three had post operative fever, two had chest infections and each one had superficial surgical site infections and severe pain at incision site. Ureteroneocystostomy was performed with double J stent in all recipients. Urological complications were noted in 12 (24%) recipients. Clinical significant hematuria occurred in four cases. One patient had ureteric necrosis and urinary leak which required re-exploration post operatively. Two patients developed delayed ureteric stricture which were managed by antegrade Double J stenting and ureteric reimplantation. Peri-graft abscess occurred in two cases, which were drained percutaneously. surgical site infections was seen in one case.

CONCLUSIONS

Urological complications are inevitable in renal transplantation and our complications rate appears similar to that reported in literature.

Penile fracture at Tribhuvan University Teaching Hospital: a retrospective analysis

Fracture of the penis is rupture of the tunica albuginea and the usual cause is abrupt bending of the erect penis by blunt trauma. Trauma during sexual relation is responsible for approximately one third of all cases. The incidence of urethral injuries associated with this condition ranged from 2.0% to 38.0%. Twelve patients who presented to emergency over a period of 4 years with diagnosis of penile fracture were reviewed retrospectively. Patient's profile and all relevant data were noted from charts. The etiology of fracture was related to coital activity in 6 (50.0%) cases while other denied such act. Surgery was performed on all the patients and discharged from hospital on removal of urethral catheter. Follow up continued until restoration of normal penile function without complaint. So fracture of the penis is an injury that can be diagnosed clinically and needs emergency surgical correction for better result.

Lymph node biopsies: a hospital based retrospective study

INTRODUCTION

Lymphadenopathy is a common clinical finding at the outpatient setting that may be caused by a vast array of disease processes.

METHODS

A retrospective study to analyze the histopathological diagnosis of lymph node biopsies with respect to age, sex, and site was conducted. All the lymph nodes sent for histopathological examination from August 2003 to 2007 were included.

RESULTS

Of all patients with enlarged lymph nodes, 49% were males (mean age: 34.52 years) and 51% were females (mean age: 38.1 years). The most common diagnosis was tubercular lymphadenitis (42%), followed by non-specific (reactive) lymphadenitis (23%), metastatic deposits (10%), non-specific granuloma (3%), NHL (2%), and lymphadenitis due to various other causes (7%). Thirteen percent of the biopsied lymph nodes were normal in morphology. Most common site of lymph node enlargement was neck (44%) followed by mesentery (19%) and axilla (16%). Most of the patients were in the age group of 21-30 years (20%).

CONCLUSIONS

The neck lymph nodes were the most commonly sent nodes for histopathological examination and tuberculosis was the most common diagnosis.

Lymph Node Biopsies: A Hospital Based Retrospective Study

Abstract

Retrospective analysis of management of patients presenting with acute urinary retention due to benign prostatic hyperplasia: a hospital based study

OBJECTIVES

To analyze current practice of management of acute urinary retention (AUR) in men above 40 years of age at B.P.Koirala Institute of Health Sciences, Nepal.

MATERIALS AND METHODS

A total of 68 patients (aged 50-91 years) presenting with indwelling catheter for AUR were included in the study. Because of lack of clear guideline and limited health care facility in our setup trial without catheter (TWOC) was given selectively depending mainly on preexisting symptoms. AUR presumed to be due to urinary tract infection received only antibiotic and others diagnosed of benign prostatic hyperplasia (BPH) received alpha 1 blocker prior to TWOC. TWOC was given 3-15 days after such treatment. Those satisfied without catheter for at least a week were considered successful TWOC.

RESULTS

The data was available for 68 patients (mean age 66.1 years). Of 15 patients treated with antibiotic alone, 11 (73.3 %) had successful TWOC. Of 57 with presumptive diagnosis of BPH, 68.9% (31 of 45) had successful TWOC. Mean age, symptom score and prostate volume were higher for patients with unsuccessful TWOC.

CONCLUSION

Selective TWOC may be imperative to minimize unnecessary suffering from AUR in less easily accessible health care facilities like ours. It may also reduce total cost of treatment.

Renocolic fistula following percutaneous nephrostomy: a case report

Renocolic fistula is a rare clinical entity. In the past, its incidence was high due to infection, especially tuberculosis, and renal stone complications; which gradually reduced with advancements in antimicrobial therapy and better stone management. The incidence of renocolic fistulae, specifically iatrogenic one, has re-emerged due to minimally invasive renal surgery and regular percutaneous nephrostomy placement for various reasons. We reported a case of fifty-five-years-old gentleman who presented to emergency room with left lithiasic pyonephrosis for which percutaneous nephrostomy was placed. Follow up antegrade pyelography diagnosed hydronephrotic left kidney with stone in renal pelvis with fistula communicating to descending colon. Contrast enhanced computer tomography revealed left non excreting kidney with retrorenal colon and percutaneous nephrostomy tube passing through the descending colon. The final diagnosis of post percutaneous nephrostomy renocolic fistula with non excreting left kidney was made and treated with ligation of fistulous tract and nephrectomy. Patient had uneventful recovery and histopathology showed chronic pyelonephritis.

Quality assurance in the management of peritonitis: a prospective study

The aim of this study was to assess the quality of care indicators in the management of peritonitis. A total of 124 cases with diagnosis of secondary and tertiary peritonitis were included. Detailed clinical history, examination, relevant investigations and details of operative findings were noted. The following quality indicators-surgical consultation time, waiting period for surgery, diagnostic accuracy, antibiotic utilization pattern, morbidity, mortality, length of hospital stay, and accessibility of service to patients were assessed. The mean age of patient was 37.4 years with male to female ratio of 4.4:1. More than half of the patients (51.6%) surgical consultation time was less than half an hour. Majority of patients (67.7%) were operated only after 6 hours. Duodenal ulcer perforation was the commonest etiology for peritonitis and the clinical diagnostic accuracy was 97.3%. The commonest bacteria isolated from peritoneal fluid culture was E. coli which was sensitive to Amikacin mostly. The overall morbidities were seen in 20.1% of patients and burst abdomen was the leading complication. A total of 8 patients (6.4%) died in this study and when Mannheim's peritonitis index (MPI) score was compared, score of more than 26 was found to be a significant predictor of mortality (p<0.0001). Most of the patients after reaching the tertiary care hospital were managed satisfactorily. Though there are lots of parameters that still need to be improved.

Epidemiological and bacteriological profile of burn patients at Nepal Medical College Teaching Hospital

This study was conducted to know the epidemiological and bacteriological profile of burn patients at Nepal Medical College Teaching Hospital. The charts of 50 burn patients admitted in department of surgery were reviewed retrospectively. All the epidemiological characteristics, mode of injury, time taken to reach hospital and involved body surface areas were noted. The charts were also reviewed for bacterial isolates from burn wounds and its sensitivity pattern for various antibiotics. Data was analyzed using the statistical package for social sciences (SPSS) for Windows. The mean age of patients was 31.8 years with male:female ratio of 1.3:1. Half of the patients were from Kathmandu. Fifty two percent of patients directly came to our hospital while rests were referred from other hospitals. The average time taken to reach hospital was 11.3 hours. Those patients who were referred from outside the valley took longer time (p = 0.002). Flame burn was the leading cause for injury (66.0%) followed by scald burn (16.0%), electric burn (14.0%) and acid burn (4.0%). Staphylococcus aureus (28.0%) was the commonest organism isolated from wound swab culture. Others were Klebsiella (16.0%), Pseudomonas (13.0%), Proteus (13.0%) and E.coli (13.0%). No growth was noted in 17.0% of patients. During the treatment, 14.0% of patients died and 4.0% left against medical advice. Remaining patients were discharged after complete recovery. Body surface area involvement was found to be a significant predictor of mortality (p < 0.001) and the length of hospital stay was significantly low for them (p = 0.05).

Leiomyoma of breast: a report of rare case

Leiomyoma is a benign smooth muscle neoplasm. They can occur in any organ, but the most common forms occur in the uterus, small bowel and the esophagus. Leiomyoma of breast is a rare benign non epithelial tumor. Most leiomyomas in the breast are found in the subareolar region. There are few cases being reported in the literature. Here we report a case of 52 years old lady who presented to us with a painless right sided breast lump. There was no history of nipple discharge, trauma or use of oral contraceptive pills. Excisional biopsy revealed a growth pattern of interlacing fascicles of smooth-muscle cells consistent with leiomyoma of breast.

Correlation of prostate volume with international prostate symptom score and quality of life in men with benign prostatic hyperplasia

The aim of this study was to correlate the prostate volume with international prostate symptom score (IPSS) and quality of life (QOL). Hundred consecutive patients diagnosed as having benign prostatic hyperplasia were included. All patients were interviewed using standardized questionnaires for International Prostate Symptom Score, which include one single disease-specific quality of life question. Transabdominal ultrasonogram was used to assess the prostatic volume. Data was analyzed using the statistical package for social sciences (SPSS) for Windows. The mean age and median duration of symptom was 67.5 years and 12.0 months respectively. The mean volume of prostate was 42.5 cm3. Most of the patients had severe symptoms with mean IPSS of 23.5 and single disease-specific QOL score of 5.2. The correlation between the prostate volume and age, IPSS, and QOL score were not statistically significant except for two domains; incomplete emptying and nocturia that appear to be correlated with prostate volume. The correlation between IPSS and QOL score was strong. Similarly, correlation between QOL score and age was significant but weak. In conclusion, prostate volume had no correlation with age, symptom score, and quality of life score. So prostatic size should not be an only and important consideration; moreover, we should assess the impact of symptoms while treating the cases.

Inactivation kinetics of Escherichia coli by pulsed electron beam

A novel and compact low-energy (keV) high-power pulsed electron beam (e-beam) that utilizes a secondary emission electron gun (SEEG) was designed and constructed. Escherichia coli JM 109 at a concentration of 10(6) CFU/mL was spread-plated on Luria-Bertani (LB) medium and subjected to the SEEG e-beam. The e-beam was administered as 1 or 5 pulses. The duration of a single pulse was constant at 5 micros, e-beam current density was constant at 25 mA/cm2, and e-beam energy varied between 60 and 82.5 keV. Following treatment with the SEEG e-beam, survivors of the irradiated E. coli samples were enumerated by a standard 10-fold dilution and spread-plated. The survivor curves were plotted on logarithmic scale as a function of e-beam dose. The D10-values were calculated as a negative reciprocal of the slope of the survivor curves. The D10-values for E. coli inactivated with 1- and 5-pulse SEEG e-beam were 0.0026 and 0.0217 Gy, respectively. These D10-values were considerably lower than published D10-values for E. coli inactivated with conventional high-energy continuous e-beam, likely due to shorter exposure time (t), greater current density (J), and a pulse mode of the SEEG e-beam. The SEEG e-beam showed promising results for microbial inactivation in a nonthermal manner; however, due to low energy of the SEEG e-beam, current applications are limited to surface decontamination. The SEEG e-beam may be an efficient processing step for surface inactivation of food-borne pathogens on ready-to-eat products, including fresh and leafy vegetables.

Change in urinary symptoms and quality of life in men with benign prostatic hyperplasia after transurethral resection of prostate

The aim of this study was to determine the improvement in symptoms and quality of life in men with Benign Prostatic Hyperplasia (BPH) after transurethral resection of prostate (TURP). Fifty consecutive patients fit for undergoing TURP for BPH were included in this study. All patients were assessed prior to definitive surgical treatment using standardized questionnaires of international prostate symptom score (IPSS) which includes single disease-specific quality of life (QOL) score. Follow up of these patients was done at three months with same questionnaires. Data was analyzed using the statistical package for social sciences (SPSS) for Windows. The mean age and duration of symptom was 68.3 years and 26.7 months respectively. The average volume of prostate was 46.1 cm3. Preoperative IPSS and QOL score were 23.4 and 5.2 respectively; 56.6% of the score was contributed by obstructive symptoms. At three months follow up, the mean IPSS reduced down to 7.9 and QOL score improved to 1.5. The average change in IPSS and QOL score were 15.6 and 3.6; these changes were statistically significant and correlated with preoperative symptom severity. Most of the patients presented with severe symptom associated with decreased QOL. After TURP, there was significant improvement in IPSS and QOL scores. The improvement was graded as good out come and strongly related to preoperative symptom severity.