Prostatic Fossa Gauze-Packing in the Prevention of Blood Clot Obstruction of the Bladder after Transvesical Prostatectomy
Keywords: Prostate, Hyperplasia, Transvesical, Excessive bleeding, Prostatic gauze-packing, Bladder obstruction
AbstractBACKGROUND: Clot obstruction often complicates transvesical prostatectomy. Any measure that prevents this will be a great relief to both surgeon and patient.
OBJECTIVE: To demonstrate that packing the prostatic fossa with roller gauze bandage after transvesical prostatectomy can prevent post-operative clot blockage of bladder drainage.
METHODS: Charts of all patients who had transvesical prostatectomy at Jasman Hospital Udo by me from 1988 to 1997 were sorted into two groups , Group A, not packed and Group B, packed. Information sought included patient’s age, type of prostatectomy performed, whether the prostatic fossa was packed or not , average duration of catheter drainage, and complications.
RESULTS: There were 68 patients who had no fossa packing and 72 in Group B with fossa packing. The age range of the two groups A and B were respective 45–85year-old and 50–83 years. In both groups the highest number of patients was in the 60 t0 79 age bracket (48 in group A , 70%, and 56 in group B (78%). Bladder blockage occurred in 32(47%) patients
without packing and none (0%) in group B with packing. Average duration of bladder drainage was 14 days in each group. There was no persisting vesico-cutaneous fistula. Temporary urinary incontinence occurred in three (3%) patients who had no packing and in five (7%) with packing.
CONCLUSION: Gauze-packing of the prostatic fossa during transvesical prostatectomy can prevent bladder obstruction from clot retention without undue complications.