Short Urethral Catheter Traction Time after TUR-P: Does its effect outcome?
Keywords:
short, urethral, traction time, TUR-PAbstract
Problem: Various techniques of urethral catheter traction after Transurethral Prostatectomy (TUR-P) were written on various literatures. Prolonged traction prevented bleeding but it may cause discomfort and pressure necrosis. In Campbellûs urology 9th edition suggested traction time for 7 minutes and we changed our technique to short traction time.
Objective: To study the prevalence of bleeding after short urethral catheter traction time after TUR-P.
Patients and methods: We retrospectively studied data from medical record during May 2008-January 2009, 25 patients age 57-93 years (mean 72.8 years) underwent TUR-P and urethral catheter traction 7-10 minutes. After the operation, all patients had continuous bladder irrigation. Data collection included indications for surgery, operative time, resected prostatic tissue, blood transfusion and postoperative bleeding.
Result: Major Indication was urinary retention 56% (14 cases). The mean operative time was 67 minutes (25-125) and the mean resected prostatic tissue was 17 grams. (1.5-75). Two cases (8%) needed intraoperative blood transfusion. None had active bleeding that need re-traction or electrocoagulation. Two cases (8%) had clot retention and needed manual bladder irrigation.
Conclusion: Short urethral catheter traction times (7-10 minutes) after TUR-P was good technique even in large prostate glands and prevented patient discomfort.
References
Fitzpatrick JM. Minimally invasive and endoscopic management of benign prostatic hyperplasia. In: Wein AJ, Kavoussi LR, Novick AC, Partin AW, Peters CA, ed. Campbellûs urology. 9 ed. Philadelphia: Saunders 2007: p.2803-44.
Holtgrewe HL, Valk WL. Factors influencing the mortality and morbidity of transurethral prostatectomy: a study of 2,015 cases. J Urol. 1962; 87: 450-9.
Borboroglu PG, Kane CJ, Ward JF, Roberts JL, Sands JP. Immediate and postoperative complications of transurethral prostatectomy in the 1990s. J Urol. 1999; 162(4): 1307-10.
Mebust WK, Holtgrewe HL, Cockett AT, Peters PC. Transurethral prostatectomy: immediate and postoperative complications. A cooperative study of 13 participating institutions evaluating 3,885 patients. J Urol. 1989; 141(2): 243-7.
Melchior J, Valk WL, Foret JD, Mebust WK. Transurethral prostatectomy: computerized analysis of 2,223 consecutive cases. J Urol. 1974; 112(5): 634-42.
Holtgrewe HL. Transurethral prostatectomy. Urol Clin North Am. 1995; 22(2): 357-68.
Mebust WK. Transurethral prostatectomy. In: Marshall FF, ed. Operative urology. Philadelphia: WB Saunders 1991: p.298-304.
Walker EM, Bera S, Faiz M. Does catheter traction reduce post-transurethral resection of the prostate blood loss? Br J Urol. 1995; 75(5): 614-7.
Santarosa RP, Te AE, Kaplan SA. Transurethral resection of the prostate. In: Krane RJ, Siroky MB, Fitzpatrick JM, ed. Operative urology. Surgical skills Pensnylvania Churchill Livingstone 2000: page 247-54.
Schiff JD, Te AE. Electrosurgery of the Prostate. Improvements in TUR-P Treatments and Outcomes. In: Smith AD , Badlani G, Bagley D,Clayman RV, Docimo SG, Jordan GH, et al, ed. SMITHûS Textbook of ENDOUROLOGY. 2 ed. London: BC Decker Inc Hamilton 2006: p.645-52.
Blandy J.P. Transurethral resection of the Prostate gland. Operative urology. Melbourne Blackwell scientific publications 1978: 142-56.
