Efficacy and Safety of Monopolar Transurethral Resection of the Prostate on Bleeding Control in the Treatment of Benign Prostatic Obstruction: Is It Still a Good Option in Developing Countries?
Journal Title: The Bulletin of Urooncology - Year 2020, Vol 19, Issue 3
Abstract
Objective: The objective of this study is to investigate the bleeding control safety along with the need for preoperative blood preparation and postoperative blood transfusion in the transurethral resection of the prostate with monopolar system (M-TURP) for the treatment of benign prostatic obstruction (BPO). Materials and Methods: We retrospectively analysed 379 patients with BPO who underwent M-TURP procedure between January 2016 and December 2019 at a single centre. Importantly, we collected the demographic data, use of 5-alpha-reductase inhibitor (5-ARI), postoperative haemoglobin (Hb) and haematocrit levels, platelet counts, and transfusion rates of these patients. Results: The minimum, maximum and the mean ages of the patients were 43, 79 and 67.44±7.74 years, respectively. The minimum, maximum and the mean prostate volumes of the patients measured via transrectal ultrasonography were 30, 95 and 53.42±18.12 mL, respectively. In total, 99 patients (26.1%) had received 5-ARI for at least three months before surgery. The mean decrease of the preoperative Hb in the postoperative 48th hour was 0.99±0.87 gr/dL. Only 9 patients (2.4%) received the transfusion of blood products (erythrocytes or fresh frozen plasma). The preoperative Hb level was inversely and significantly correlated with the decrease in postoperative Hb and the need for transfusion (p<0.05). The preoperative use of 5-ARI was not associated with postoperative decrease in Hb and the need for transfusion. The preoperative cut-off value of Hb for predicting a substantial decrease in Hb and transfusion need after M-TURP was calculated as 12.45 gr/dL with a sensitivity and specificity of 77.8% and 86.8%, respectively. Conclusion: M-TURP is still a safe and effective option in BPO treatment in developing countries. Importantly, we do not recommend the routine preoperative blood preparation in index patients with Hb level higher than 12.45 gr/dL.
Authors and Affiliations
Serkan Akan, Caner Ediz, Eymen Özer, Mehmet Pehlivanoğlu, Hasan Hüseyin Tavukçu, Kazım Kıymaz, Ömer Yılmaz
Keywords
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- EP ID EP688794
- DOI 10.4274/uob.galenos.2020.1655
- Views 134
- Downloads 0
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