[Topical use of thrombin in prostatic surgery].

We describe the usefulness of topical application of thrombin as a hemostatic aid in prostatic surgery. We used a specially designed 3-way bag catheter, one way of which opened to the prostatic fossa. After enucleation of the prostate suprapubically, we inserted the bag catheter into the bladder before any hemostatic procedure was performed on the prostatic fossa, inflated the bag, gently pulled down the catheter against the prostatic fossa, and then injected the thrombin solution (5,000 units/5 cc. X 2) into the fossa. Fifty patients were randomized into two groups; the "thrombin" method group and the hemostatic "ligature" group, and compared. The "thombin" method group showed statistically significant superiority to the "ligature" method group in reduced operation time and operative bloodloss. On the contrary, the duration of postoperative hematuria was longer with the "thrombin" method but not significantly. Even the prolonged duration of hematuria, however, produced no clinical problems. Hypofibrinogenemia and poor conditions of drug storage lowered its efficacy. These points should be remembered when using thrombin.