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Open prostatectomy with a rectal balloon: A new technique to control postoperative blood loss.

Mohyelden K, Abdel-Kader O - Arab J Urol (2015)

Bottom Line: There was also a significant difference between the groups in the saline volume used for irrigation (11.4 vs. 2.5 L), catheter duration (5.7 vs. 4.3 days), and hospital stay (6.2 vs. 5.1 days), favouring group 2.There were no rectal complaints.The use of an inflated RB after TVP is a simple and safe procedure with no specific operative technique, that reduces postoperative blood loss, the incidence of blood transfusion, the volume of saline for irrigation, and shortens the catheterisation period and hospital stay, with no rectal complications.

View Article: PubMed Central - PubMed

Affiliation: Department of Urology, Fayoum University, Fayoum, Egypt.

ABSTRACT

Objectives: To evaluate a new technique, the rectal balloon (RB), to control blood loss after transvesical prostatectomy (TVP).

Patients and methods: Over 2 years 100 patients were prospectively randomised into two equal groups. All patients underwent TVP for their benign prostatic hyperplasia but a RB (a balloon fixed to a three-way Foley catheter tip by a plaster strip, making it airtight) was used in group 2. The RB was placed in the rectum opposing the prostate and inflated (pressure controlled) for 15 min. Haemoglobin levels were assessed before and after TVP. Blood transfusion, the amount of saline used for irrigation, duration of catheterisation, hospital stay, and rectal complaints were recorded. Patients were followed up at 1 and 3 months after TVP.

Results: The enucleated adenoma weight was 102 g in group 1 and 106 g in group 2. There was a significant difference between groups 1 and 2 in haemoglobin loss within the first 24 h after TVP, and in total loss, of 0.9 g and 0.2 g (P = 0.008), and 1.9 g and 1 g (P = 0.001), respectively. There was also a significant difference between the groups in the saline volume used for irrigation (11.4 vs. 2.5 L), catheter duration (5.7 vs. 4.3 days), and hospital stay (6.2 vs. 5.1 days), favouring group 2. Blood transfusions were needed in four patients in group 1 and one in group 2. There were no rectal complaints.

Conclusion: The use of an inflated RB after TVP is a simple and safe procedure with no specific operative technique, that reduces postoperative blood loss, the incidence of blood transfusion, the volume of saline for irrigation, and shortens the catheterisation period and hospital stay, with no rectal complications.

No MeSH data available.


Related in: MedlinePlus

(A) The RB assembled ready for use. (B) A patient undergoing TVP with the RB in situ. (C) An enucleated adenoma (78 g). (D) A radiograph showing the balloon in the rectum (with contrast medium between the two balloons of the RB, and in the balloon of the urethral catheter).
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f0015: (A) The RB assembled ready for use. (B) A patient undergoing TVP with the RB in situ. (C) An enucleated adenoma (78 g). (D) A radiograph showing the balloon in the rectum (with contrast medium between the two balloons of the RB, and in the balloon of the urethral catheter).

Mentions: Suprapubic and urethral catheters for irrigation were inserted, then the bladder made watertight and bladder irrigation started as a slow drip. A retropubic tube drain was fixed and the wound closed anatomically. A blood sample was then taken to estimate the haemoglobin level, from which the amount of blood lost during surgery was estimated. The patient was then discharged to the ward. A typical patient undergoing TVP with a RB is shown in Fig. 3.


Open prostatectomy with a rectal balloon: A new technique to control postoperative blood loss.

Mohyelden K, Abdel-Kader O - Arab J Urol (2015)

(A) The RB assembled ready for use. (B) A patient undergoing TVP with the RB in situ. (C) An enucleated adenoma (78 g). (D) A radiograph showing the balloon in the rectum (with contrast medium between the two balloons of the RB, and in the balloon of the urethral catheter).
© Copyright Policy - CC BY-NC-ND
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4561921&req=5

f0015: (A) The RB assembled ready for use. (B) A patient undergoing TVP with the RB in situ. (C) An enucleated adenoma (78 g). (D) A radiograph showing the balloon in the rectum (with contrast medium between the two balloons of the RB, and in the balloon of the urethral catheter).
Mentions: Suprapubic and urethral catheters for irrigation were inserted, then the bladder made watertight and bladder irrigation started as a slow drip. A retropubic tube drain was fixed and the wound closed anatomically. A blood sample was then taken to estimate the haemoglobin level, from which the amount of blood lost during surgery was estimated. The patient was then discharged to the ward. A typical patient undergoing TVP with a RB is shown in Fig. 3.

Bottom Line: There was also a significant difference between the groups in the saline volume used for irrigation (11.4 vs. 2.5 L), catheter duration (5.7 vs. 4.3 days), and hospital stay (6.2 vs. 5.1 days), favouring group 2.There were no rectal complaints.The use of an inflated RB after TVP is a simple and safe procedure with no specific operative technique, that reduces postoperative blood loss, the incidence of blood transfusion, the volume of saline for irrigation, and shortens the catheterisation period and hospital stay, with no rectal complications.

View Article: PubMed Central - PubMed

Affiliation: Department of Urology, Fayoum University, Fayoum, Egypt.

ABSTRACT

Objectives: To evaluate a new technique, the rectal balloon (RB), to control blood loss after transvesical prostatectomy (TVP).

Patients and methods: Over 2 years 100 patients were prospectively randomised into two equal groups. All patients underwent TVP for their benign prostatic hyperplasia but a RB (a balloon fixed to a three-way Foley catheter tip by a plaster strip, making it airtight) was used in group 2. The RB was placed in the rectum opposing the prostate and inflated (pressure controlled) for 15 min. Haemoglobin levels were assessed before and after TVP. Blood transfusion, the amount of saline used for irrigation, duration of catheterisation, hospital stay, and rectal complaints were recorded. Patients were followed up at 1 and 3 months after TVP.

Results: The enucleated adenoma weight was 102 g in group 1 and 106 g in group 2. There was a significant difference between groups 1 and 2 in haemoglobin loss within the first 24 h after TVP, and in total loss, of 0.9 g and 0.2 g (P = 0.008), and 1.9 g and 1 g (P = 0.001), respectively. There was also a significant difference between the groups in the saline volume used for irrigation (11.4 vs. 2.5 L), catheter duration (5.7 vs. 4.3 days), and hospital stay (6.2 vs. 5.1 days), favouring group 2. Blood transfusions were needed in four patients in group 1 and one in group 2. There were no rectal complaints.

Conclusion: The use of an inflated RB after TVP is a simple and safe procedure with no specific operative technique, that reduces postoperative blood loss, the incidence of blood transfusion, the volume of saline for irrigation, and shortens the catheterisation period and hospital stay, with no rectal complications.

No MeSH data available.


Related in: MedlinePlus