Urethral catheter traction reduces bleeding compared with suturing of prostatic vesical junction during suprapubic prostatectomy: a randomized clinical trial study.
OBJECTIVE
To determine whether catheter traction during suprapubic prostatectomy can be beneficial in reducing intraoperative and postoperative bleeding.


METHODS
A total of 156 patients with lower urinary tract symptoms who had indications for open prostatectomy were enrolled in the study from September 2004 to January 2006. Of the patients, 78 underwent open prostatectomy with suturing at the prostatic vesical junction (group 1) and 78 were treated with urethral catheter traction to control bleeding (group 2). The duration of operation, duration of hospital stay, intraoperative blood loss, hemoglobin decrease, and weight of resected prostate were recorded in both groups. Three months later, we followed up patients with the International Prostate Symptom Score questionnaire, maximal flow rate measurement, and cystoscopic examination.


RESULTS
The mean operative time was 59 +/- 7 minutes and 40 +/- 9 minutes (P = .015) and the mean hospital stay was 3.7 +/- 0.24 days and 4.4 +/- 0.46 days (P = .09) in groups 1 and 2, respectively. The mean blood loss during surgery was 279 +/- 155 mL and 219 +/- 139 mL (P = .04) and the mean hemoglobin decrease was 2.3 +/- 1.4 g/dL and 1.6 +/- 1.5g/dL (P = .04) in groups 1 and 2, respectively. The mean weight of the prostate was not significantly different statistically between the 2 groups at 63 +/- 23 g and 64 +/- 19 g in groups 1 and 2, respectively (P = .8). The urethrocystoscopy examination at 3 months postoperatively revealed bladder neck contractures in 6.41% of the patients in group 1 and 3.85% in group 2.


CONCLUSIONS
The results of our study have shown that urethral catheter traction diminishes bleeding compared with suturing at the prostatic vesical junction during suprapubic prostatectomy.
Department of Surgery, Division of Urology, Shiraz University of Medical Sciences, Faghihi Hospital, Shiraz, Iran.
Mehdi
M
Shirazi
Sina
S
Ghaffari
Abbas
A
Hassanpour
Mehdi
M
Salehipoor
Mohammad Amin
MA
Afrasiabi
D000368:Aged; D016063:Blood Loss, Surgical / Q000517:prevention & control*; D006489:Hemostatic Techniques; D006801:Humans; D008297:Male; D008875:Middle Aged; D019106:Postoperative Hemorrhage / Q000517:prevention & control*; D011446:Prospective Studies; D011467:Prostate / Q000601:surgery*; D011468:Prostatectomy / Q000379:methods*; D013536:Suture Techniques; D001743:Urinary Bladder / Q000601:surgery*; D014546:Urinary Catheterization