Okorie Chukwudi O, Pisters Louis L
Pan African Academy of Christian Surgeons at Banso Baptist Hospital, Kumbo, Cameroon.
Can J Urol. 2010 Aug;17(4):5255-8.
Hemostasis during suprapubic prostatectomy for benign prostatic hyperplasia (BPH) is commonly affected by placing sutures at the 5 o'clock position and the 7 o'clock position of the bladder neck. However, the urethral arterial branches of the inferior vesical artery that supplies the prostate extend from the 1 o'clock to 5 o'clock position and from the 7 o'clock to 11 o'clock position of the bladder neck, with the largest branches located posteriorly. This study analyses the effect of a modified suprapubic prostatectomy technique, which covered the area from the 1 o'clock position to the 11 o'clock position, on postoperative blood hemoglobin levels, as a reflection of hemorrhage control.
This was a single-center, retrospective study of 47 patients who underwent suprapubic prostatectomy for BPH. Hemostatic sutures included the main areas of anatomic distribution of the urethral arterial branches of the inferior vesical artery. Preoperative and postoperative blood hemoglobin levels and perioperative complications were recorded.
The mean decrease in blood hemoglobin was 1.06 mg/dL. Only three patients had clot retention, and these clots were easily flushed out. None of the patients required a blood transfusion.
The modified suprapubic prostatectomy technique for BPH enhances hemostatic control and reduces the need for a blood transfusion.
良性前列腺增生（BPH）耻骨上前列腺切除术中的止血通常受膀胱颈5点和7点位置缝合的影响。然而，供应前列腺的膀胱下动脉的尿道动脉分支从膀胱颈的1点延伸至5点以及从7点延伸至11点位置，最大的分支位于后方。本研究分析了一种改良的耻骨上前列腺切除术技术（该技术覆盖从1点位置到11点位置的区域）对术后血红蛋白水平的影响，以此作为出血控制情况的反映。
这是一项针对47例行耻骨上前列腺切除术治疗BPH患者的单中心回顾性研究。止血缝线包括膀胱下动脉尿道动脉分支的主要解剖分布区域。记录术前和术后血红蛋白水平以及围手术期并发症。
血红蛋白平均下降1.06mg/dL。仅3例患者有血块残留，且这些血块易于冲洗排出。无一例患者需要输血。
改良的BPH耻骨上前列腺切除术技术可增强止血控制并减少输血需求。
