title: Open prostatectomy with a rectal balloon: A new technique to control postoperative blood loss.
abstract: OBJECTIVE
  To evaluate a new technique, the rectal balloon (RB), to control blood loss after transvesical prostatectomy (TVP).
  
  
  METHODS
  Over 2 years 100 patients were prospectively randomised into two equal groups. All patients underwent TVP for their benign prostatic hyperplasia but a RB (a balloon fixed to a three-way Foley catheter tip by a plaster strip, making it airtight) was used in group 2. The RB was placed in the rectum opposing the prostate and inflated (pressure controlled) for 15 min. Haemoglobin levels were assessed before and after TVP. Blood transfusion, the amount of saline used for irrigation, duration of catheterisation, hospital stay, and rectal complaints were recorded. Patients were followed up at 1 and 3 months after TVP.
  
  
  RESULTS
  The enucleated adenoma weight was 102 g in group 1 and 106 g in group 2. There was a significant difference between groups 1 and 2 in haemoglobin loss within the first 24 h after TVP, and in total loss, of 0.9 g and 0.2 g (P = 0.008), and 1.9 g and 1 g (P = 0.001), respectively. There was also a significant difference between the groups in the saline volume used for irrigation (11.4 vs. 2.5 L), catheter duration (5.7 vs. 4.3 days), and hospital stay (6.2 vs. 5.1 days), favouring group 2. Blood transfusions were needed in four patients in group 1 and one in group 2. There were no rectal complaints.
  
  
  CONCLUSIONS
  The use of an inflated RB after TVP is a simple and safe procedure with no specific operative technique, that reduces postoperative blood loss, the incidence of blood transfusion, the volume of saline for irrigation, and shortens the catheterisation period and hospital stay, with no rectal complications.
authors.affiliation: Department of Urology, Fayoum University, Fayoum, Egypt.
authors.forename: Khaled
authors.initials: K
authors.lastname: Mohyelden
authors.affiliation: Suez Canal University Hospital, Egypt.
authors.forename: Osman
authors.initials: O
authors.lastname: Abdel-Kader
keywords: BPH; Open prostatectomy; PVR, postvoid residual urine volume; Qmax, maximum urinary flow rate; RB, rectal balloon; Rectal balloon; Surgical management; TVP, transvesical prostatectomy; Transvesical