Publication:
Blood loss during and after transurethral resection of prostate: A prospective study

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2008

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Kathmandu University

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Abstract Objectives: Transurethral resection of prostate (TURP) is the gold standard treatment for symptomatic prostatic bladder outlet obstruction. Haemorrhage during and after TURP can lead to signi cant morbidity and mortality. The purpose of this study was to assess the in uence of anaesthesia, operating time, weight of resected prostatic tissue and its histology on blood loss during and after TURP and to revisit the available body of evidence in the literature of urology. Materials and methods: This is a prospective study of a cohort of 100 consecutive patients who had undergone TURP over a period of one year, where the data was collected on a performa speci cally designed for the study, which included the type of anaesthesia administered, resection time, amount of blood lost during and after TURP, weight of the resected prostatic tissue and histology. Results: Sixty seven patients underwent TURP under spinal anaesthesia (SA) and 33 under general anaesthesia (GA). The median intraoperative (SA: 89.95 (5-936); GA: 105.40 (5-517) mls), postoperative (SA: 72.37 (15-387); GA: 136.43 (11-969) mls) and total (SA: 162.32 (29-1200); GA: 241.83 (21-1251) mls) blood losses were not signi cantly different between the two groups (95% C.I. -9.90 to 19.22, p= 0.46). The total operating time (SA: 29.70 (10-55); GA: 29.80 (10-65) minutes) and weight of resected prostate (SA: 21.90 (3-45); GA: 18.00 (4-60) gms) were similar between the two groups. There was a trend towards increased blood loss when BPH was associated with prostatitis (N=8). Of these, 3 patients required blood transfusion as compared to 1 patient in rest of the group, although this was not statistically signi cant (95% C.I - 67.2 to 1120.4, p = 0.87). Conclusions: The intraoperative, postoperative and total blood losses related to TURP were not in uenced by the type of anaesthesia, resection time, weight of the resected prostate and the histology. Key Words: Transurethral resection of prostate, blood loss, anaesthesia, prostatitis, carcinoma, aspirin

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Shrestha BM, Prasopshanti K, Matanhelia SS, Peeling WB Consultant Surgeons, Department of Urology, Royal Gwent Hospital, Newport, Gwent, UK.

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