[Macroscopic haematuria after transurethral resection of the prostate]

Although macroscopic haematuria during the month following transurethral resection of the prostate, due to sloughing of necrotic tissue, is a phenomenon well known to urologists since introduction of endoscopic resection, its pathophysiological and epidemiological characteristics are poorly defined. The objective of this retrospective study was to define the incidence of serious macroscopic haematuria after transurethral resection of the prostate (TURP) and to identify the risk factors for macroscopic haematuria.

The hospital database was used to identify patients treated by TURP between 1997 and 2004 and rehospitalized during the 31 days following the procedure. Files of patients presenting with haematuria and bladder clots were selected and analysed.

Ten of a series of 624 patients undergoing TURP were hospitalised for bladder clots and their case files were analysed: median age: 72 years, median duration of TURP: 45 min and median weight of resection: 12 g. The operators' experience and the duration of post-TURP catheterization were not informative. In 2 cases, prostate cancer was diagnosed after analysis of resection chips. Two patients were treated by anticoagulants. Patients were essentially rehospitalized during the 2nd week (median: 11th day). A bladder catheter for was inserted for lavage in each case. No patient required reoperation or removal of clots under general anaesthesia. Two patients were transfused.

We did not identify any risk factor for sloughing leading to macroscopic haematuria during the month following TURP. Macroscopic haematuria justifying rehospitalization is a rare event. However, in view of this low incidence, optimal analysis could only be performed in the context of a national prospective register.