[Assessment of effectiveness and security of bladder neck cerclage after transvesical prostatectomy]

The Bladder neck cerclage diminishes the risk of bleeding after transvesical prostatectomy, but it increases the risk of suffering postoperative bladder neck sclerosis. Our objective is to value the effectiveness and therapeutic security of the temporary bladder neck cerclage after transvesical prostatectomy.

It was carried out a prospective and longitudinal study in a cohort of 25 age patients mean age 68,5 years (standard deviation, 2,6 years), subjected to transvesical prostatectomy (Freyer) with bladder neck cerclage using polipropilene number 1 suture, that was retired at the 24 hours of the surgery. To value the hemostatic utility of bladder neck cerclage, it was measured the hematocrit and hemoglobin concentration at the 24 hours of the intervention. To evaluate the appearance of obstructive sequels, the maximum urinary flow was measured three months after the surgery.

It was observed a mean hematocrit at the 24 hours of surgery of 7,3%, and a mean decrease of the hemoglobin at the 24 hours of the surgery of 2,7 gr/dl. In any cases the postoperative hemoglobin concentration was inferior to 8 mg/dl, therefore, it was not necessary transfusion. The uroflowmetry carried out at 3 months of surgery showed that 24 of the 25 intervened patients presented a maximum flow superior to 15 ml/sg.

The temporary bladder neck cerclage is a good hemostatic technique. The precocious cercalge retreat avoids the late sequels (bladder neck sclerosos), that originates the permanent cerclage.