[Clinical experience with three cases of haemorrhagic tendency--bladder carcinoma with hemophilia A, a bladder carcinoma with von Willebrand disease and a benign prostatic hypertrophy with idiopathic thrombocytopenic purpura (ITP)].
Recent understanding of the pathogenicity of haemorrhagic tendency as well as advance of management of patients with this disease makes its surgical treatment possible. Since 1979 we have experienced three male patients with haemorrhagic tendency. The first case was a bladder carcinoma with hemophilia A. He had been given 2500 unit of Conco-eight (coagulation factor VIII) before transurethral resection of bladder tumor (TUR-Bt) and was given 1000 unit of Conco-eight every eight to twelve hours for seven days postoperatively. The second case was a bladder carcinoma with von Willebrand disease. This case was also pretreated by Conco-eight before operation and we had difficulty in controlling his coagulopathy for one month postoperatively. The third case was a benign prostatic hypertrophy with idiopathic thrombocytopenic purpura (ITP). He had been given a huge dose of gamma globulin for six days before operation and on the operation day his platelet count was normalized. Since his prostate was estimated to weight over 70 g, suprapubic prostatectomy was selected. All these three cases were operated uneventfully. From this experience we believe that with proper preoperative and postoperative management, patients with haemorrhagic tendency can be operated safely.
Department of Urology, Kobe University School of Medicine.
K
K
Minayoshi
H
H
Okada
T
T
Nakanishi
S
S
Arakawa
O
O
Matsumoto
S
S
Kamidono
N
N
Yamanaka
J
J
Ishigami
M
M
Hazama
D000328:Adult; D000368:Aged; D006467:Hemophilia A / Q000150:complications*; D006474:Hemorrhagic Disorders; D006801:Humans; D008297:Male; D011182:Postoperative Care; D011300:Preoperative Care; D011470:Prostatic Hyperplasia / Q000150:complications / Q000601:surgery*; D011696:Purpura, Thrombocytopenic / Q000150:complications*; D001749:Urinary Bladder Neoplasms / Q000150:complications / Q000601:surgery*; D005719:gamma-Globulins / Q000008:administration & dosage; D014842:von Willebrand Diseases / Q000150:complications*
D005719:gamma-Globulins