Purpose: To share our
experience on 42 consecutive cases of open suprapubic prostatectomy done without
blood transfusion or continuous bladder irrigation.
collected data on forty-two consecutive trans vesical Prostatectomies that were
done using a modified suprapubic prostatectomy technique from May 2016 to Sept
2017(group 2), were compared with an older series of transvesical
Prostatectomies done from January 2003 to April 2016, using the traditional 5
and 7 o’clock haemostatic sutures (group 1).
Results: The groups were
similar with respect to age, BMI, PSA, enucleated prostate volume, duration of
surgery and commorbidities. The mean change in haematocrit in group 2 was 6.0(±2.8) compared to 6.6(±4.3)
in group 1; P=.446. The mean duration of admission was 16.5(±9.6) days in group 1, compared to 6.94(±0.6) days in group 2; P=.000. The clot retention rate
in group 1 was 36.3% compared to 9.8% in group 2; P=.000. The overall
complication rate in group 1 was 37.6% (59/157) compared to 23.8 %( 10/42) in
group 2; P=.034. The transfusion rate in group 1 was 37.3 % with a mean blood
transfusion of 1.14(±1.5) pints compared to zero
blood transfusion in group 2; P=.000. There were 9 mortalities in group 1,
compared to zero mortality in group 2; P=.000.
Conclusion: The modified
suprapubic prostatectomy technique was associated with better haemostasis. It
enabled open suprapubic prostatectomy without bladder irrigation and blood
transfusion and was associated with improved surgical outcomes compared to the
traditional 5 and 7 o’clock haemostatic suture technique.
Keywords: Blood Transfusion;
Continuous Bladder Irrigation; Haemostasis; Open Suprapubic Prostatectomy; Surgical