Comparison of balloon tamponade after transurethral resection of the prostate using Foley’s catheter filled with 30- and 50-ml sterile water - A retrospective cohort study

Abstract

Background: Venous hemorrhage in resected area is a common complication after transurethral resection of prostate (TURP) which could lead to significant blood loss resulting in blood transfusion. The temporary traction using balloon tamponade is a widely used technique to stop such bleeding but no definite balloon volume has been proposed.
Objective: To compare incident of significant post-TURP hemorrhage defined by the need for bladder irrigation and need for blood transfusion between 24-Fr Foley’s catheter traction at
bladder neck with 30 ml and 50 ml balloon of sterile water. Material and method: Data of all participants underwent TURP procedure from January 2017 to January 2020 were retrospectively reviewed. Inclusion criteria are patient who underwent TURP which received Foley’s catheter traction with 30 ml and 50 ml. balloon of sterile water, and age of 50-90. Exclusion criteria are pathologic result of malignancy and cases which resected prostate were less than 10 g. Demographic data such as age, comorbidity and current benign prostatic hyperplasia (BPH) medication were recorded. Perioperative parameters such as
type of polarity of resectoscope, type of anesthesia, operative time, need for bladder irrigation, need for blood transfusion and pathological reports were collected and analyzed.
Results: Of all 211 patients underwent TURP, 189 patients met the inclusion criteria, 23 patients were excluded according to exclusion criteria and 166 patients were eligible for analysis. No statistically significant different in age, rate of receiving alpha blocker or 5-ARI, polarity of resectoscope and operative time are founded. Need for bladder irrigation (p-value 0.64) and blood transfusion (p-value 0.22) are also not significantly different between traction with 30 and 50ml volume of balloon.
Conclusion: In case of benign prostatic BPH, the 50 ml-balloon traction of bladder neck post
TURP has no benefit to prevent hemorrhage more than 30 ml balloon traction