What is it about?
This clinical trial investigated the effects and possible adverse effects of fibrinogen concentrate on the amount of bleeding in men undergoing TUR-P.
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Why is it important?
Prostatectomy by transurethral resection of the prostate (TUR-P) has been used for decades and is still considered to be the standard surgery. A major complication during and immediately after TUR-P surgery is bleeding, which results in morbidity. Some medications and methods have been recommended to reduce the amount of bleeding, such as improving surgical technique and skill and using innovative resection devices such as bipolar or laser-equipped resectoscopes. Furthermore, non-surgical approaches, including intravesical aminocaproic acid, intravenous estrogen administration, intraprostatic vasopressin, fibrin adhesive, phenol solution, and preoperative finasteride or tranexamic acid administration, have also been tried. Although finasteride and tranexamic acid yield favorable results, they need to be prescribed before surgery. They are ineffective in the emerging bleeding conditions during and after surgery.
Perspectives
This is a new topic in urology surgery and, because the use of TUR-P is extensive, and because its effect in decreasing patient morbidity is undeniable, it is likely to be widely accepted by urologists. Looking at treatment costs, each vial of Haemocomplettan P costs approximately 400 US$ (costing 10 US$ for a patient with Iran’s health insurance coverage). This is far less than the costs of admission and blood products, so, considering its benefits, it is cost-efficient.
Dr Mohammad Reza Safarinejad
University of Medical Sceices
Read the Original
This page is a summary of: The effect of fibrinogen concentrate on perioperative bleeding in transurethral resection of the prostate: a double-blind placebo-controlled and randomized study, Journal of Thrombosis and Haemostasis, February 2017, Wiley,
DOI: 10.1111/jth.13575.
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