title: Blood loss comparison during transurethral resection of prostate and high power GreenLight(™) laser therapy using isotopic measure of red blood cells volume.
abstract: BACKGROUND
  Transurethral resection of the prostate (TURP) remains the gold standard in the operative management of symptomatic benign prostatic hyperplasia (BPH). The main morbidity of TURP is bleeding, which leads to clot retention and blood transfusion. Newer techniques have appeared, and photovaporization of the prostate (PVP) with the GreenLight™ laser has been developed to reduce the morbidity of bladder outflow surgery. Isotopic measurements of total red cell volume and total blood volume (BV) are a recommended reference technique to evaluate bleeding occurring during endoscopic ablation of the prostate. Here, we compare blood loss during PVP and TURP using an isotopic method.
  
  
  METHODS
  Eighteen patients underwent PVP, and 20 patients underwent a TURP for symptomatic BPH by one surgeon. The two groups were comparable in demographic data; however, prostate volume was significantly higher in the PVP group. BV was measured pre- and postoperatively using the isotope technique.
  
  
  RESULTS
  The total BV was measured to have increased by 362 mL in PVP group compared with a loss of 315 mL in TURP group (p=0.001). The difference in total red cell volume increased by 148 mL in PVP group compared with a loss of 216 mL in TURP group (p=0.005).
  
  
  CONCLUSIONS
  Using the isotope method, we have shown a significant difference in postoperative blood loss between TURP and PVP. Our study is the first to use an isotopic method to measure the blood loss during PVP. This technique needs further standardization before being introduced into routine clinical practice.
authors.affiliation: Department of Urology, University Hospital of Tours, Tours, Loire Valley, France. f.bruyere@chu-tours.fr
authors.forename: Franck
authors.initials: F
authors.lastname: Bruyère
authors.forename: Damien
authors.initials: D
authors.lastname: Huglo
authors.forename: Benjamin
authors.initials: B
authors.lastname: Challacombe
authors.forename: Olivier
authors.initials: O
authors.lastname: Haillot
authors.forename: Chantal
authors.initials: C
authors.lastname: Valat
authors.forename: Nicolas
authors.initials: N
authors.lastname: Brichart
mesh_terms: D000368:Aged; D016063:Blood Loss, Surgical; D002860:Chromium Radioisotopes; D004911:Erythrocyte Volume; D006801:Humans; D007553:Isotope Labeling / Q000379:methods*; D053685:Laser Therapy / Q000009:adverse effects*; D008297:Male; D011470:Prostatic Hyperplasia / Q000097:blood / Q000601:surgery; D020728:Transurethral Resection of Prostate / Q000009:adverse effects*; D016896:Treatment Outcome
chemical_list: D002860:Chromium Radioisotopes