Browsing by Author "Harbans Bansal"

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Clinical epidemiology of young men with lower urinary tract symptoms: The SciCOM 3 project
(Wolters Kluwer Medknow Publications, 2025) Sanjay Sinha; Sameer Trivedi; Ankur Mittal; Girdhar Singh Bora; Rishi Nayyar; Pawan Vasudeva; Anita Patel; Harbans Bansal; Vijay Kumar Sarma Madduri; Niraj Kumar; Swarnendu Mandal; Vikash Kumar; Sujith Mathew Jose; Girish G. Nelivigi; Anil Elhence; Harprit Singh
Introduction: A study was performed to determine the most common and most bothersome symptoms and clinical associations in young men (18-40 years) presenting with lower urinary tract symptoms (LUTS). Methods: Cross-sectional study was conducted across 16 centers. Urinary symptoms, impact of bladder problems, bowel symptoms, erectile dysfunction, premature ejaculation, bladder pain, non-bladder myofascial pain, and general well-being were assessed by validated questionnaires. Results: A total of 448 men (median age 30 years) were included. Nocturia ≥1 (89.1%) and feeling of incomplete bladder evacuation (76.6%) were the most common symptoms while the most bothersome symptoms were daytime frequency and nocturia (median score 5; interquartile range 2-8, for both) on the International Consultation on Incontinence Questionnaire for Male LUTS questionnaire. Bladder symptoms were associated with severe or many severe problems (response 5 or 6, on the Patient Perception of Bladder Conditions Questionnaire) in 17.8% of the patients. Men between 18 and 20 years reported greater bother with their bladder condition. Normal erections and 'very good' control over ejaculation were reported by 49.8% and 15.6%, respectively. Constipation and loose stools were reported by 22.8% and 12.9%, while bladder pain and non-bladder myofascial pain were reported by 72.5%, and 48.2%, respectively. 17.0% of the patients reported low scores on the WHO-5 Well-Being Scale. Two distinct patient clusters were identified. A larger cluster (63.9%) that presented with voiding symptoms and urgency but fewer sexual or pain symptoms, and a smaller cluster that showed pronounced sexual symptoms, pain, daytime frequency, and nocturia. Conclusions: The most common urinary symptoms in young men are nocturia and a sense of incomplete evacuation. Daytime frequency and nocturia are the most bothersome symptoms. It is important to assess associated symptoms in young men presenting with LUTS. © 2025 Indian Journal of Urology.
Does the consistency of stools define a distinct patient cohort in young men presenting with severe lower urinary tract symptoms?
(Wolters Kluwer Medknow Publications, 2025) Sanjay Sinha; Ankur Mittal; Sameer Trivedi; Harbans Bansal; Girdhar Singh Bora; Rishi Nayyar; Pawan Vasudeva; Anita Patel; Vijay Kumar Sarma Madduri; Niraj Kumar; Swarnendu Mandal; Vikash Kumar; Sujith Mathew Jose; Girish G. Nelivigi; Anil Elhence; Harprit Singh
Introduction: Constipation has long been recognized to be associated with lower urinary tract symptoms (LUTS). However, there is little clinical data on bowel symptoms in young men who present with LUTS. This study analyses the association of stool consistency with severe LUTS in young men. Methods: This study is a secondary analysis of SciCOM 3 study examining young men presenting with LUTS. Stool consistency was recorded by the Bristol Stool Chart and classified into hard stools (Class 1, 2), normal stools (Class 3, 4), and loose stools (Class 5–7). LUTS, sexual dysfunction, bladder pain, non-bladder myofascial pain, perception of problems related to the bladder, and general well-being were captured by questionnaires along with basic clinical data. The poorest score on every question of each questionnaire was categorized as “severe”. Results: Four hundred and forty-eight young men (18–40 years; median 30 years, interquartile range 25–35 years) were studied across 16 centers. Stool consistency was hard, normal, and loose in 105 (23.4%), 284 (63.4%), and 59 (13.2%), respectively. Constipation was not associated with severe LUTS. Loose stools showed an association with six of the 13 questions on the International Consultation on Incontinence Questionnaire for male LUTS. Erectile dysfunction, bladder and nonbladder pain, and general well-being were found to be associated with loose stools but not with constipation. On multinomial logistic regression analysis, recurrent urinary tract infection and low body mass index were associated with hard stools, while low maximum flow rate, severe erectile dysfunction, and severe myofascial pain were associated with loose stools. Conclusions: Loose stools are an important association in young men presenting with severe LUTS. © 2025 Indian Journal of Urology.
Dorsal onlay lingual mucosal graft urethroplasty for urethral strictures in women
(2010) Girish K. Sharma; Ashwani Pandey; Harbans Bansal; Sameer Swain; Suren K. Das; Sameer Trivedi; Udai S. Dwivedi; Pratap B. Singh
Objective To describe the technique and results of dorsal onlay lingual mucosal graft (LMG) urethroplasty for the definitive management of urethral strictures in women. Patients And Methods In all, 15 women (mean age 42 years) with a history suggestive of urethral stricture who had undergone multiple urethral dilatations and/or urethrotomy were selected for dorsal onlay LMG urethroplasty after thorough evaluation, from October 2006 to March 2008. After a suprameatal inverted-U incision, the dorsal aspect of the urethra was dissected and urethrotomy was done at the 12 o'clock position across the strictured segment. Tailored LMG harvested from the ventrolateral aspect of the tongue was then sutured to the urethrotomy wound over an 18 F silicone catheter. Results The preoperative mean maximum urinary flow rate of 7.2 mL/s increased to 29.87 mL/s, 26.95 mL/s and 26.86 mL/s with a 'normal' flow rate curve at 3, 6 and 12 months follow-up, respectively. One patient at the 3-month follow-up had submeatal stenosis and required urethral dilatation thrice at monthly intervals. At the 1-year follow-up, none of the present patients had any neurosensory complications, urinary incontinence, or long-term functional/aesthetic complication at the donor site. Conclusion LMG urethroplasty using the dorsal onlay technique should be offered for correction of persistent female urethral stricture as it provides a simple, safe and effective approach with durable results. © 2010 BJU International.
Dorsal onlay lingual mucosal graft urethroplasty: Comparison of two techniques
(2008) Pratap B. Singh; Suren K. Das; Abhay Kumar; Girish K. Sharma; Ashwani K. Pandey; Samir Swain; Harbans Bansal; Sameer Trivedi; Udai S. Dwivedi
Objectives: To compare the results of two different techniques of dorsal onlay lingual mucosal graft (LMG) urethroplasty for anterior urethral strictures. Methods: Thirty patients underwent dorsal onlay LMG urethroplasty by Barbagli's technique (group I) and 25 through a ventral sagittal urethrotomy approach (group II). All of the patients were followed up with a pericatheter urethrography at 3 weeks, retrograde urethrography with micturating cystourethrography and uroflowmetry at 3, 6 and 12 months. Results: Mean follow up was 22 months and 13 months in group I and II, respectively. The mean peak flow rate increased from 4.2 mL/s preoperatively to 35.5, 25.06 and 25 mL/s at 3, 6, and 12 months, respectively, in group I and from 7.8 mL/s to 34.2, 28.4 and 26.2 mL/s at 3, 6 and 12 months, respectively, in group II. Five patients in group I and two patients in group II had an anastomotic stricture at 12 months. Meatal narrowing was seen in five patients in group I and three patients in group II. The overall success rate was 83.4% and 76.6% in group I and 90% and 80% in group II at 6 and 12 months, respectively. One patient had chordee in group I and no patient had chordee in group II. There was a shorter operative time and less blood loss in group II. Conclusions: Dorsal onlay LMG urethroplasty through a ventral sagittal approach is better than the Barbagli's technique in terms of results and complications. © 2008 The Japanese Urological Association.
Lingual Mucosal Graft Urethroplasty for Anterior Urethral Strictures
(2009) Suren K. Das; Abhay Kumar; Girish K. Sharma; Ashwani K. Pandey; Harbans Bansal; Sameer Trivedi; Udai S. Dwivedi; Visweswar Bhattacharya; Pratap B. Singh
Objective: To evaluate the effectiveness of a lingual mucosal graft (LMG) urethroplasty for anterior urethral strictures and the donor site complications. Methods: A total of 30 patients underwent urethroplasty for anterior urethral strictures using dorsal on-lay of a LMG from March 2006 to December 2006. Most patients had balanitis xerotica obliterans as the etiology. The mean stricture length was 10.2 cm (range 3.7-16.5). Postoperatively, all patients underwent pericatheter urethrography at 3 weeks, followed by retrograde urethrography with micturating cystourethrography, and uroflowmetry at 3 and 6 months. Repeat uroflowmetry was done as, and when, required. Results: The mean period of follow-up was 9 months (range 4-12). The overall success rate was 83.3%. The mean peak flow rate increased postoperatively from 4.36 mL/s to 35.5 mL/s at 3 months and 25.06 mL/s at 6 months of follow-up. One patient developed repeat stricture at the anastomotic site, and 4 patients developed recurrent meatal stenosis. Conclusions: The results of LMG urethroplasty were comparable to that of buccal mucosal graft urethroplasty. LMG is easy to harvest. Most importantly, the donor site complications were minimal without any functional or esthetic deficiency. © 2009 Elsevier Inc. All rights reserved.
Our modified technique of total posterior reconstruction in open retropubic radical prostatectomy
(2009) Ashwani K. Pandey; Girish K. Sharma; Harbans Bansal; Samir Swain; Sameer Trivedi; Udai S. Dwivedi; Pratap B. Singh
Aim: We compared the outcome of retropubic radical prostatectomy with or without our modified technique of total posterior reconstruction. The technique differs from the standard technique in the form of reconstruction of retrotrigonal tissue using a detrusor muscular flap. The free end of the flap is sutured to the Denonvillier's fascia to complete posterior reconstruction. Materials and Methods: From August 2006 to July 2008, 32 patients with localized prostate carcinoma who underwent radical retropubic prostatecto-my were prospectively evaluated in 2 groups operated on by 1 surgeon. The first 22 patients underwent standard technique of radical retropubic prostatectomy and subsequently we used and are now using a modified technique. The first 10 patients operated on by the modified technique are included in the present study. Both groups were compared for postoperative continence. Continence was assessed using quality of life questionnaires. A patient was considered incontinent if he had to change more than 1 pad per 24 h. Results: Continence rates in group 1 were 72.73, 81.82, 86.40 and 95.46% at 1, 3, 6, and 12 months follow-up respectively as opposed to 80, 90, 90, and 100% respectively in group 2 patients. Conclusion: Total posterior reconstruction is an effective way to achieve an early return of continence. © 2009 S. Karger AG, Basel.
Polyscope: A new era in flexible ureterorenoscopy
(2011) Harbans Bansal; Samir Swain; Girish K. Sharma; Mikhil Mathanya; Sameer Trivedi; Udai S. Dwivedi; Pratap B. Singh
Introduction: Despite improvements in instrumentation and technology in flexible ureteroscopy, the issue of procedural and off-procedural damage remains a problem. The aim of our study was to highlight our initial experience in flexible ureteroscopy using polyscope, a new advancement in the era of flexible ureterorenoscopy. Materials and Methods: In this study, we used an 8F modular flexible, steerable polyscope for diagnostic purposes and Dormia basket removal for small renal stones. Three outer disposable catheters were used with proper sterilization in 22 cases. Results: The polyscope was used in six cases of undiagnosed hematuria, and biopsy was taken from pelvic growth in one patient, which turned out to be transitional-cell carcinoma. Polyscope was used for removal of residual stones or small stones (<1 cm) using Dormia basket in 16 cases (from August 2008 to July 2009). The mean stone size was 7.5 mm. The vision achieved was excellent in all the cases. Conclusions: Minimally invasive techniques are preferred for treatment of renal stones. The problem of lower caliceal stone access has been solved with the primary and secondary deflection of modern flexible ureteroscopes. The modular design of polyscope makes it a more cost-effective option. Relatively cheap and disposable multilumen catheters preclude the need for sterilization of optic cable, thus decreasing the chances of handling-related damages. The chance of instrument-related infection is minimal. Besides, it can be used as a semirigid ureteroscope should the need arises. Copyright 2011, Mary Ann Liebert, Inc.
Retrograde radical cystectomy and ileal neourethra add to achieve immediate continence in patients undergoing orthotopic ileal neobladder
(2009) Pratap B. Singh; Harbans Bansal; Girish K. Sharma; Ashwani K. Pandey; Samir Swain; Sameer Trivedi; Udai S. Dwivedi
Objective: Main concern in the patients undergoing orthotopic neobledder construction following radical cystectomy has been urinary incontinence and need of clean self in-termittent catheterization. Our objective is to assess conti-nence rate associated with technique of retrograde radical cystectomy and ileal neobladder with ileal neourethra as compared to the standard antegrade technique. Methods: We retrospectively analysed the results of 130 patients who underwent radical cystectomy and ileal neobladder in our department during last 19 years. First 32 patients underwent classical antegrade cystectomy and ileal neobladder construction as described by Hautmann et al. Last 98 patients underwent retrograde radical cystectomy followed by ileal neobladder with ileal neourethra construction. Results: Continence rates were much better in the patients undergoing retrograde radical cystectomy and ileal neobladder with neourethra formation without any added morbidity. Our immediate daytime continence rates improved from 81 to 94% and nocturnal rates from 53 to 91%. Most of our patients are having adequate neobladder capacity and functional urethral length. Conclusions: Retrograde method of radical cystectomy preserves the rhabdosphincter with preservation of good length of urethra. Ileal neourethra further increase urethral length. Spherical shape of neobladder leads to complete emptying of bladder without need of clean self intermittent catheterization. Copyright © 2009 S. Karger AG, Basel.
Secondary hydronephrosis in young men presenting with lower urinary tract symptoms: Results of the SciCOM 3 project
(Wolters Kluwer Medknow Publications, 2025) Sanjay Sinha; Sameer Trivedi; Ankur Mittal; Anita Patel; Girdhar Singh Bora; Rishi Nayyar; Pawan Vasudeva; Harbans Bansal; Vijay Kumar Sarma Madduri; Niraj Kumar; Swarnendu Mandal; Vikash Kumar; Sujith Mathew Jose; Girish G. Nelivigi; Anil Elhence; Harprit Singh
Introduction: Secondary hydronephrosis is an uncommon but potentially serious complication of lower urinary tract dysfunction. This study examines clinical associations of young men with lower urinary tract symptoms (LUTS) presenting with hydronephrosis. Methods: Secondary analysis of multicentric study examining young men presenting with LUTS. LUTS, stool consistency, sexual dysfunction, bladder pain, nonbladder myofascial pain, perception of problems related to the bladder, and general well-being were captured by questionnaires along with basic clinical data. Hydronephrosis was presumed to be secondary to lower urinary tract dysfunction if there was ureteric dilatation, it was asymptomatic, and there was no other reason based on clinical judgment. Results: Hydronephrosis was noted in 26/442 men (5.9%). Men with hydronephrosis had lower body mass index (BMI), longer duration of symptoms, larger postvoid residual (PVR), and were more likely to be diabetic and/or have a history of urinary infection (all P < 0.05). Association was noted with need to strain, reduced strength of stream, sense of incomplete evacuation, urgency, and urgency incontinence (all P < 0.05). On multivariate logistic regression analysis, BMI (P = 0.007) and PVR (P = 0.010) were independently associated. One-unit reduction in BMI was associated with 30% increase in odds of hydronephrosis, while 100 ml increase in PVR was associated with 82% increase. Receiver operator curve analysis yielded BMI ≤23 and PVR ≥80 ml as predictive of hydronephrosis. Conclusions: Secondary hydronephrosis is seen in a small number of young men with LUTS. Such men show a distinct clinical profile that can offer clinical clues useful in the algorithm for evaluation. © 2025 Indian Journal of Urology.