Modified Denis technique: a simple solution for maximal hemostasis in suprapubic prostatectomy.
OBJECTIVE
To describe our experience with a modified Denis technique for hemostasis in suprapubic prostatectomy.


METHODS
We reviewed the charts of 78 patients who underwent suprapubic prostatectomy using a modified Denis technique between September 1996 and June 2001. After adenomectomy, we performed a bladder neck removable partition purse-string suture, and the prostatic fossa was drained. Patients were followed up for hemorrhagic complications and bladder neck strictures for 12 months.


RESULTS
The mean intraoperative hemorrhage amount was 264 mL (range 160 to 510). The postoperative irrigating fluid volume was 2000 mL (range 500 to 4500), and the bladder irrigation duration was 24 hours in 70 patients (89.8%) and 48 hours in 8 patients (10.2%). Postoperative hemorrhage, measured by the prostatic fossa drain, was 0 mL in 48 patients and had a mean value of 55 mL (range 10 to 90) in 30 patients. No hemorrhagic complication was noted. None of our patients had transfusion, bladder clot formation, or late hemorrhage. One case (1.3%) of bladder neck stricture developed.


CONCLUSIONS
This modified Denis technique is very effective and easy to perform and to learn. It has solved all our hemorrhagic problems in suprapubic prostatectomy.
Department of Urology, Military Hospital Moulay Ismail, Meknes, Morocco.
Mohammed
M
Lezrek
Ahmed
A
Ameur
Juan Miguel
JM
Renteria
Haj Ahmed
HA
El Alj
Amoqurane
A
Beddouch
D000368:Aged; D000369:Aged, 80 and over; D016063:Blood Loss, Surgical; D006487:Hemostasis / Q000502:physiology*; D006489:Hemostatic Techniques; D006801:Humans; D008297:Male; D008875:Middle Aged; D019106:Postoperative Hemorrhage; D011468:Prostatectomy / Q000379:methods*; D013536:Suture Techniques; D020728:Transurethral Resection of Prostate / Q000379:methods; D001743:Urinary Bladder / Q000601:surgery