Factors influencing blood loss in transurethral resection of the prostate (TURP): auditing TURP

Kirollos, Magdi M.; Campbell, N.

doi:10.1046/j.1464-410x.1997.00253.x

Cited by 43 publications

(22 citation statements)

References 2 publications

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“…As such, SPUS shows promise as a modality to support modern surgical techniques like TURP for the management of BPH in sub-Saharan Africa. This study found a strong correlation (q = 0.98) between the preoperative volume of prostate using SPUS and TRUS, as in previous studies [5,7,8,[11][12][13][14]. Agreement between modalities was also strong, based on Bland-Altman analysis [10], with zero bias and upper and lower limits of agreement less than ±15 mL.…”

Section: Discussionsupporting

confidence: 86%

“…Differences between measurements are plotted against the mean of the measurements. The mean difference (bias) between volume of the enucleated adenoma and the preoperative prostate volume estimate was -12.5 and -12.4 mL for TRUS and SPUS, respectively studies found somewhat larger difference in means of prostate volume between SPUS and TRUS of 10 mL [12] and 8 mL [7], which might be explained by radiologist experience or patient characteristics. Preoperative assessment of prostate volume assists clinicians in assigning patients to TURP or to open prostatectomy.…”

Section: Discussionmentioning

confidence: 85%

“…The gold standard TRUS is also discomforting, especially in patients with anal diseases such as hemorrhoids, anal fissures, and anal fistulae, as well as patients with a low-pain threshold. On the other hand, suprapubic ultrasound (SPUS) is more widely available, acceptable and affordable [7,8] but requires validation against accepted gold standard imaging modalities in resource-constrained settings.…”

Section: Introductionmentioning

confidence: 99%

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Validation of supra-pubic ultrasonography for preoperative prostate volume measurement in sub-Saharan Africa

et al. 2010

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Section: Discussionsupporting

confidence: 86%

Section: Discussionmentioning

confidence: 85%

Section: Introductionmentioning

confidence: 99%

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Validation of supra-pubic ultrasonography for preoperative prostate volume measurement in sub-Saharan Africa

et al. 2010

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“…However, transurethral resection of larger prostates is associated with a higher incidence of bleeding requiring transfusion, with the weight of resected tissue being the most important measureable factor in determining blood loss. 5 In one series, 85% of patients needed transfusion when resection exceeded 80 g of prostate. 6 Various prophylactic measures have been employed to reduce peri-operative bleeding including cessation of anticoagulant medical therapies such as aspirin products and warfarin.…”

Section: Discussionmentioning

confidence: 99%

Postoperative haemorrhage following transurethral resection of the prostate (TURP) and photoselective vaporisation of the prostate (PVP)

Lynch

Sriprasad

Thompson³

2010

Ann R Coll Surg Engl

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Ann R Coll Surg Engl 2010; 92: 555-558 555There are several techniques of transurethral prostatic surgery including the traditional transurethral resection of the prostate (TURP) and newer techniques including holmium laser enucleation of the prostate (HoLEP), Green-light laser photoselective vaporisation of the prostate (PVP) and the Gyrus bipolar system. The number of TURPs is falling 1 and there is no doubt that newer techniques are being accepted as established alternatives. Bleeding is one of the main complications after any modality of endoscopic prostatectomy, including TURP. The incidence of blood loss requiring transfusion is reported to be 0.4-7.1%, 2,3 with rates declining with evolving technology despite an increasingly aged population having prostatic surgery.The experience of surgeons dealing with troublesome bleeding is now, therefore, much less. The conservative, resuscitative and endoscopic measures to deal with bleeding are well established and understood. However, there are occasions when this is not sufficient to stop what may be life-threatening haemorrhage and many surgeons may now be unfamiliar with the surgical technique of packing the prostatic cavity to arrest bleeding when other measures have failed. In this paper, we have reviewed all TURP and PVP procedures over a 3-year period and identified those patients who required surgical intervention postoperatively to arrest continuing haemorrhage and in particular describe open packing of the prostate. Patients and MethodsWe retrospectively reviewed a 3-year period where 437 TURPs and 590 PVPs were performed for lower urinary tract symptoms (LUTS) and for urinary retention in our institution. Of patients who underwent TURP, 19 needed a cystoscopy in the immediate postoperative period for persistent bleeding despite conservative measures such as catheter traction and manual bladder washouts. Two patients who , is uncommon but a significant and life-threatening problem. The knowledge and technical experience to deal with this complication may not be wide-spread among urologists and trainees. We describe our series of TURPs and PVPs and the incidence of postoperative bleeding requiring intervention. PATIENTS AND METHODS We retrospectively reviewed 437 TURPs and 590 PVPs over 3 years in our institution. We describe the conservative, endoscopic and open prostatic packing techniques used for patients who experienced postoperative bleeding. RESULTS Of 437 TURPs, 19 required endoscopic intervention for postoperative bleeding. Of 590 PVPs, two patients were successfully managed endoscopically for delayed haemorrhage at 7 and 13 days post-surgery, respectively. In one TURP and one PVP patient, endoscopic management was insufficient to control postoperative haemorrhage and open exploration and packing of the prostatic cavity was performed. CONCLUSIONS Significant bleeding after endoscopic prostatic surgery is still a potentially life-threatening complication. Prophylactic measures have been employed to reduce peri-operative bleeding but persistent ble...

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“…M. Kirollos and N. Campbell, 9 Jan Eken Gren, Robert G. Hahn 10 and Gordon 11 had not taken the factor for the study.…”

Section: Gland Size and Calculated Blood Lossmentioning

confidence: 99%

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

Vetrichandar¹,

B²

2016

jemds

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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.

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Factors influencing blood loss in transurethral resection of the prostate (TURP): auditing TURP

Cited by 43 publications

References 2 publications

Validation of supra-pubic ultrasonography for preoperative prostate volume measurement in sub-Saharan Africa

Validation of supra-pubic ultrasonography for preoperative prostate volume measurement in sub-Saharan Africa

Postoperative haemorrhage following transurethral resection of the prostate (TURP) and photoselective vaporisation of the prostate (PVP)

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

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