Evaluation of current practices in routine preoperative crossmatching for transurethral resection of the prostate.

Abstract

Increasing demand for blood during elective surgery has led to attempts to rationalize routine preoperative crossmatching to those operations when there is a reasonable (greater than 30%) chance of it being required. Results of a questionnaire returned by 86% of the urology units in Great Britain show that 41% continue to crossmatch 2 units of blood before transurethral prostatectomy. A review of 301 transurethral prostatectomies performed with preoperative grouping and saving of blood showed that only 11% of the patients required transfusion. The need for transfusion was significantly associated with presentation in chronic or acute on chronic retention (p < 0.01), and the operative factors of weight of resection (p < 0.0001) and degree of hemostasis (p < 0.001). Therefore, a policy of routine preoperative blood grouping and saving is safe, and could be widely adopted, leading to financial saving and a decrease in wastage of blood that becomes too old to use.