The efficacy of fibrin glue injection in the prostatic fossa on decreasing postoperative bleeding following transurethral resection of prostate

Authors

1 Isfahan Kidney Transplantation Research Center, Isfahan University of Medical Sciences, Isfahan, Iran

2 Department of Urology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

Abstract

Background: To evaluate the efficacy of fibrin glue injection in the prostatic fossa at the end of transurethral resection of prostate (TURP), in decreasing postoperative bleeding in patient with benign prostatic hyperplasia (BPH).
Materials and Methods: In this prospective randomized clinical trial, sixty patients with BPH, who were a candidate for TURP, were randomly divided into two equal groups. In the intervention group, 10cc of fibrin glue was injected in the prostatic fossa at the end of the surgery; through a 5 Fr feeding tube attached to Foley catheter and its tip was proximal to the balloon of catheter. The other thirty patients created the control group. Hemoglobin (Hb) level and lower urinary tract symptoms (LUTS) score were recorded before and 6, 24, 48 h, and 5 days after TURP.
Results: The mean age of the patients and prostate volumes were comparable between the groups. The mean Hb level before and 6 h after TURP were not different between the two groups, however, 24 and 48 h and 5 days after TURP, there was a significant difference as well as a higher decrease in the mean Hb level of the control group (P = 0.023). The mean LUTS score was not statistically different between the two groups.
Conclusion: Fibrin glue injection in the prostatic after TURP reduces postoperative bleeding without any effect on LUTS score in patients with BPH.

Keywords

1.
Wein AJ. Campbell-walsh Urology. 10th ed. Philadelphia: Saunders Elsevier; 2012. p. 2678.  Back to cited text no. 1
    
2.
Hahn RG, Nilsson A, Farahmand BY, Persson PG. Blood haemoglobin and the long-term incidence of acute myocardial infarction after transurethral resection of the prostate. Eur Urol 1997;31:199-203.  Back to cited text no. 2
[PUBMED]    
3.
Decaestecker K, Oosterlinck W. Transurethral resection of the prostate in recurrent acute bacterial prostatitis. Urol Int 2015;94:442-4.  Back to cited text no. 3
[PUBMED]    
4.
Rannikko A, Pétas A, Taari K. Tranexamic acid in control of primary hemorrhage during transurethral prostatectomy. Urology 2004;64:955-8.  Back to cited text no. 4
    
5.
Ketabchi AA, Ketabchi M, Barkam M. The effect of modified TURP (M-TURP) in intra and postoperative complications. Nephrourol Mon 2013;5:758-61.  Back to cited text no. 5
[PUBMED]    
6.
Lira-Dale A, Maldonado-Ávila M, Gil-García JF, Mues-Guizar EH, Nerubay-Toiber R, Guzmán-Esquivel J, et al. Effect of intraprostatic epinephrine on intraoperative blood loss reduction during transurethral resection of the prostate. Int Urol Nephrol 2012;44:365-9.  Back to cited text no. 6
    
7.
Eder F, Meyer F, Nestler G, Halloul Z, Lippert H. Sealing of the hepatic resection area using fibrin glue reduces significant amount of postoperative drain fluid. World J Gastroenterol 2005;11:5984-7.  Back to cited text no. 7
[PUBMED]    
8.
Naitoh Y, Kawauchi A, Kamoi K, Soh J, Okihara K, Hyon SH, et al. Hemostatic effect of new surgical glue in animal partial nephrectomy models. Urology 2013;81:1095-100.  Back to cited text no. 8
[PUBMED]    
9.
Luke M, Kvist E, Andersen F, Hjortrup A. Reduction of post-operative bleeding after transurethral resection of the prostate by local instillation of fibrin adhesive (Beriplast). Br J Urol 1986;58:672-5.  Back to cited text no. 9
[PUBMED]    
10.
Burnett AL, Wein AJ. Benign prostatic hyperplasia in primary care: What you need to know. J Urol 2006;175 (3 Pt 2):S19-24.  Back to cited text no. 10
    
11.
Reich O, Gratzke C, Bachmann A, Seitz M, Schlenker B, Hermanek P, et al.; Urology Section of the Bavarian Working Group for Quality Assurance. Morbidity, mortality and early outcome of transurethral resection of the prostate: A prospective multicenter evaluation of 10,654 patients. J Urol. 2008;180:246-9.  Back to cited text no. 11
    
12.
Gasser G, Mossig H, Fischer M, Eidler R, Kläring W, Lurf H. Modification of suprapubic prostatectomy using a biological gluing technic. Wien Klin Wochenschr 1983;95:399-403.  Back to cited text no. 12
    
13.
Vecsey D. New method of hemostasis with adhesives in adenomectomy. Z Urol Nephrol 1980;73:57-62.  Back to cited text no. 13
[PUBMED]