Estimation of Blood Loss and Factors Influencing Blood Loss in Transurethral Resection of Prostate: A Prospective Study

Abstract

BACKGROUNDTransurethral resection of the prostate remains the gold standard treatment of BPH. Though, the mortality of TURP has decreased to less than 1%, the significant morbidity of the bleeding complications still persists. Hence, blood losses must be replaced promptly to ensure an optimal blood volume and oxygen transport. The aim of this study is to study the factors influencing blood loss during TURP. MATERIALS AND METHODSThis is a prospective study on patients with BPH treated with transurethral resection of prostate at Kilpauk Medical College and Government Royapettah Hospital between January 2012 and February 2013. Patient who require surgery because of severe symptoms or retention of urine secondary to BPH were included in this study. Total number of patients included in the study is 40. Informed consent was obtained from all patients. RESULTSOut of multiple variables analysed in 40 patients, it is concluded from our study that the extent of blood loss associated with TURP is multifactorial and it is impossible to measure the effects of single factor (e.g. local vascularity) while controlling all others. The 'P' value was significant for the weight of resected tissue and longer operative time. Hence, a meticulously performed TURP with reasonable speed and attention to details is the way forward in reducing perioperative blood loss. CONCLUSIONThe extent of blood loss associated with TURP is multifactorial and it is impossible to measure the effects of single factor (e.g. local vascularity) while controlling all others. Of the measured factors, the weight of resected tissue and longer operative time are clearly most important factors which significantly increase the blood loss. Hence, a meticulously performed TURP with reasonable speed and attention to details is the way forward in reducing perioperative blood loss.