Management of bleeding, transfusion requirement and removal of catheters in transurethral prostate resection.

Abstract

The objective of the present study was to establish the therapeutic value of early coagulation of severe postoperative bleeding after transurethral prostate resection in unselected patients. In a prospective study of 772 prostate resections carried out in 617 patients, bleeding complications, hemostatic measures, blood transfusions, catheter removals, and catheter-related and general complications were registered, and the factors influencing them were analyzed. Severe postoperative bleeding was coagulated endoscopically on the day of the operation in 70 resections (9.1%), and after removing the catheter in a further 19 cases (2.7%). Blood was transfused perioperatively in 14 patients (2.3%): in 11 patients (2.0%) because of preoperative anemia, and in 3 patients (0.3%) because of postoperative hemorrhage. In 96.3% of the resections, the catheter was removed on the first postoperative day, and in the last year of the study in 99.3% of the cases. Neither additional hemostasis nor early catheter removal had disadvantageous consequences. Transurethral prostate resections can be performed without any blood transfusion in more than 99.0% of patients without preexisting risk when severe postoperative hemorrhage is coagulated at an early stage. Moreover, this enables early catheter removal, after 24 h at the latest, in more than 99.0% of the cases.