The Effect of Aminocaproic Acid on Bleeding Following Transurethral Prostatectomy

Post‐operative blood loss after transurethral prostatectomy is dependent on in situ fibrinolysis

“…However, these results are conflicting, because some authors have reported a significant reduction in blood Bleeding is one of the most important problems associated with TURP; although haemostasis is usually loss [6,7], while others have shown no significant eCect of anti-fibrinolytic agents [8,9]. suBcient during surgery, re-bleeding may continue for several days, requiring blood transfusions and sometimes…”

“…Conclusion The post-operative blood loss after TURP is changes related to post-operative blood loss. Measurements of the urinary concentrations of free significantly related to an increase of the urinary fibrinolytic activity and the enhanced fibrinolytic t-PA activity, t-PA antigen, free u-PA activity, u-PA antigen and fibrin degradation products (FbDP) were activity is probably caused by t-PA. Keywords In situ fibrinolysis, blood loss, transurethral determined and the area under the curve for each of these quantities correlated with the post-operative prostatic resection blood loss.antifibrinolytic drugs on post-operative blood loss [6][7][8][9]. …”

Blood Loss, Tissue Weight and Operating Time in Transurethral Prostatectomy

“…This amount depends on many factors, including size of the gland, duration of the operation and skill of the surgeon. In reports in the literature on bleeding during TURP, the blood loss generally is related to the weight of the resected tissue (Madsen & Strauch, 1966;Madsen & Madsen, 1976). Nesbit, Carter, Tudor & McClellan (1966) quoted the report by Thompsen that blood loss during TURP was in direct proportion to operating time, but themselves found no relationship between blood loss and operating time or weight of tissue.…”

The Effect of Dicynene on Blood Loss during and after Transurethral Resection of the Prostate

“…Bruce, Zoras and Still (1960) observed a 50 % reduction in pre-and postoperative blood loss with controlled hypotension but this carries a risk of cerebral and myocardial infarction in elderly men (Madsen and Madsen, 1967).Many drugs have been tried to reduce postprostatectomy haemorrhage but none has been of any use : e.g., carbazochrome salicylate (Frank and Lloyd, 1959), Kutapressin (Weisenthal et al, 1961), Premarin (Madsen et al, 1964), polyoestradiol phosphate (Madsen el al., 1968) and aprotinin (Pearson, 1969). Only epsilon aminocaproic acid (Lawrence, Ward, McQuaid and Holdom, 1966;Madsen and Strauch, 1966; Vinnicombe and Shuttleworth, 1966) has been found to reduce postoperative blood loss by 30 % to 60 % but it has no effect on bleeding during operation.Diethylammonium 1, 4-dihydroxy-3-benzone sulphate (dicynone, Dicynene) was introduced in 1959 by Regne and Laporte. Animal experiments and clinical trials in patients suggested that it increased platelet adhesiveness, the rate of release of intrinsic thromboplastin and the capillary resistance, and reduced the bleeding time.The increased platelet adhesiveness did not apparently increase the incidence of deep venous thrombosis (Negus, Pinto and Brown, 1969).Clinical reports have been very favourable in vascular and middle ear surgery, and in surgery of the buccal cavity (Arias, 1966;Guerrier, 1966;Held, 1966).…”

“…Many drugs have been tried to reduce postprostatectomy haemorrhage but none has been of any use : e.g., carbazochrome salicylate (Frank and Lloyd, 1959), Kutapressin (Weisenthal et al, 1961), Premarin (Madsen et al, 1964), polyoestradiol phosphate (Madsen el al., 1968) and aprotinin (Pearson, 1969). Only epsilon aminocaproic acid (Lawrence, Ward, McQuaid and Holdom, 1966;Madsen and Strauch, 1966;Vinnicombe and Shuttleworth, 1966) has been found to reduce postoperative blood loss by 30 % to 60 % but it has no effect on bleeding during operation.…”