Control of bleeding in transversical prostatectomy at the University Teaching Hospital

Abstract

With increasing age BPH causes a lot of morbidity in men. At UTH 40% of the patients in the urology clinic are those with BPH. Treatment of this condition is both by medical and surgical. The goal of surgery is to remove the obstructing mass from within the capsule. This can be removed by several methods. Selection of an open versus closed method depends on the surgeon's preference, skill, size of the prostate and associated anatomical features.Transurethral resection of the prostate has become the gold standard as a treatment mode of BPH as there is a reduction in surgical risks particularly as regards blood loss. However, at UTH, TVP remains the main mode of treatment for BPH. It is for the same reason that a study looking at bleeding control in TVP was carried out at UTH.A total number of 50 patients were evaluated in the study and these were patients with confirmed BPH. Details of each patient were collected including pre and postoperative assessment. This was a prospective study.Blood for hemoglobin and hematocrit was collected both pre-operatively and post operatively. The difference between pre operative haemoglobin/hematocrit and postoperative haemoglobin/hematocrit was calculated. The minimum and maximum haemoglobin recruited for study were lOg/dl and 15.2g/dl respectively.It was found that the mean difference between pre operative hemoglobin and postoperative haemoglobin was 1.686g/dl. The most frequent pre operative and post operative hemoglobin difference was 1.8g/dl, which represented 12% of the total number of patients studied.Considering the above results, TVP with control of bleeding by suturing the prostatic bed from 3 to 9 O'clock reduces the amount of blood loss and that it can be rendered safe modality for treating BPH.