title: Management of bleeding, transfusion requirement and removal of catheters in transurethral prostate resection.
abstract: OBJECTIVE
  The objective of the present study was to establish the therapeutic value of early coagulation of severe postoperative bleeding after transurethral prostate resection in unselected patients.
  
  
  METHODS
  In a prospective study of 772 prostate resections carried out in 617 patients, bleeding complications, hemostatic measures, blood transfusions, catheter removals, and catheter-related and general complications were registered, and the factors influencing them were analyzed.
  
  
  RESULTS
  Severe postoperative bleeding was coagulated endoscopically on the day of the operation in 70 resections (9.1%), and after removing the catheter in a further 19 cases (2.7%). Blood was transfused perioperatively in 14 patients (2.3%): in 11 patients (2.0%) because of preoperative anemia, and in 3 patients (0.3%) because of postoperative hemorrhage. In 96.3% of the resections, the catheter was removed on the first postoperative day, and in the last year of the study in 99.3% of the cases. Neither additional hemostasis nor early catheter removal had disadvantageous consequences.
  
  
  CONCLUSIONS
  Transurethral prostate resections can be performed without any blood transfusion in more than 99.0% of patients without preexisting risk when severe postoperative hemorrhage is coagulated at an early stage. Moreover, this enables early catheter removal, after 24 h at the latest, in more than 99.0% of the cases.
authors.affiliation: Department of Urology, St. Nikolaus Stiftshospital, Bonn University Academic Teaching Hospital, Andernach, Germany.
authors.forename: V
authors.initials: V
authors.lastname: Lent
authors.forename: A
authors.initials: A
authors.lastname: Neuss
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001803:Blood Transfusion; D016558:Hemostasis, Endoscopic; D006801:Humans; D008297:Male; D008875:Middle Aged; D019106:Postoperative Hemorrhage / Q000209:etiology / Q000628:therapy*; D011446:Prospective Studies; D011468:Prostatectomy / Q000009:adverse effects*; D013997:Time Factors; D014546:Urinary Catheterization / Q000009:adverse effects*