Is Planned Continuous Irrigation Indicated for Haemorrhage following Transurethral Resection of the Prostate?

Mobb, Gillian E.; Farrar, David J.

doi:10.1111/j.1464-410x.1993.tb16070.x

Cited by 5 publications

(2 citation statements)

References 7 publications

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“…The incidence of clot retention after TURP was reported to be 3.3% in a large, multicenter retrospective study 3. A high risk of postoperative bleeding, and thus clot retention, has been correlated with a greater size of the resected prostate, longer operative time, and positive preoperative urine culture 4–6. CBI is also used for intravesical delivery of pharmacologic agents, such as amphotericin B irrigation for candida cystitis 7–9.…”

Section: Introductionmentioning

confidence: 99%

An improved delivery system for bladder irrigation

Moslemi

Rajaei²

2010

TCRM

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IntroductionOccasionally, urologists may see patients requiring temporary bladder irrigation at hospitals without stocks of specialist irrigation apparatus. One option is to transfer the patient to a urology ward, but often there are outstanding medical issues that require continued specialist input. Here, we describe an improved system for delivering temporary bladder irrigation by utilizing readily available components and the novel modification of a sphygmomanometer blub. This option is good for bladder irrigation in patients with moderate or severe gross hematuria due to various causes.Materials and methodsIn this prospective study from March 2007 to April 2009, we used our new system in eligible cases. In this system, an irrigant bag with 1 L of normal saline was suspended 80 cm above the indwelled 3-way Foley catheter, and its drainage tube was inserted into the irrigant port of the catheter. To increase the flow rate of the irrigant system, we inserted a traditional sphygmomanometer bulb at the top of the irrigant bag. This closed system was used for continuous bladder irrigation (CBI) in patients who underwent open prostatectomy, transurethral resection of the prostate (TURP), or transurethral resection of the bladder (TURB). This high-pressure system is also used for irrigation during cystourethroscopy, internal urethrotomy, and transurethral lithotripsy. Our 831 eligible cases were divided into two groups: group 1 were endourologic cases and group 2 were open prostatectomy, TURP, and TURB cases. The maximum and average flow rates were evaluated. The efficacy of our new system was compared prospectively with the previous traditional system used in 545 cases.ResultsIn group 1, we had clear vision at the time of endourologic procedures. The success rate of this system was 99.5%. In group 2, the incidence of clot retention decreased two fold in comparison to traditional gravity-dependent bladder flow system. These changes were statistically significant (P = 0.001). We did not observe any adverse effects such as bladder perforation due to our high-pressure, high-flow system.ConclusionA pressurized irrigant system has better visualization during endourologic procedures, and prevents clot formation after open prostatectomy, TURP, and TURB without any adverse effects.

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Section: Introductionmentioning

confidence: 99%

An improved delivery system for bladder irrigation

Moslemi

Rajaei²

2010

TCRM

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“…Hemorrhage management has as yet only been dealt with in passing in the literature. Nevertheless, mentioned: endoscopic coagulations in 0.5-5.8%, and open revisions in 0.2% [4,36,37,[41][42][43][44]. In the present study, postoperative coagulation was carried out in 9.1% of the cases on the day of operation when appropriate cri teria were met (see above).…”

Section: Complications Risk Factorsmentioning

confidence: 99%