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Assessing safety and feasibility of monopolar transurethral resection of the prostate without post-operative catheter
Abhineeth Kp1, Kumar Madhavan1, Devashish Kaushal1
1Urology, AIIMS Bhopal, Bhopal, Madhya Pradesh, India.
Introduction:
Traction on the per-urethral catheter is commonly employed after monopolar transurethral resection of the prostate (mTURP) to reduce bleeding. However, its efficacy and impact on postoperative pain remain uncertain. Further, there is limited evidence to suggest any benefit regarding post-operative blood loss.
Materials And Methods:
In a randomized controlled trial, 62 patients undergoing mTURP were assigned to either a traction (n = 30) or non-traction (n = 32) group. Blood loss, postoperative pain, and analgesic requirements were assessed between January 2022 and April 2023. {(IHEC-PGR/2021/DM/M.Ch/Jan/02), CTRI Registration: CTRI/2022/01/039199.}.
Results:
No significant differences were observed between the traction and non-traction groups regarding postoperative blood loss (p-value- 0.632), fall in hemoglobin (p-value- 0.719) and hematocrit (p-value- 0.937) levels, and length of postoperative hospital stay (p-value- 0.797). However, the traction group reported significantly higher postoperative pain scores (p-value < 0.001) and increased analgesic requirements (p-value < 0.001).
Conclusion:
The study suggests that 12-hours catheter traction after mTURP does not reduce blood loss and is associated with increased postoperative pain.
Insights
Catheter traction after monopolar transurethral resection of the prostate (mTURP) does not reduce blood loss. This practice, however, significantly increases postoperative pain and analgesic needs in patients.
Area of Science:
- Urology
- Surgical Innovation
- Patient Outcomes
Background:
- Catheter traction is frequently used post-monopolar transurethral resection of the prostate (mTURP) to minimize bleeding.
- The actual benefits of this practice on blood loss and its impact on patient discomfort remain unclear.
Purpose of the Study:
- To evaluate the efficacy of 12-hour per-urethral catheter traction in reducing postoperative blood loss following mTURP.
- To assess the effect of catheter traction on postoperative pain and analgesic requirements.
Main Methods:
- A randomized controlled trial involving 62 patients undergoing mTURP.
- Patients were allocated to either a catheter traction group (n=30) or a non-traction group (n=32).
- Key outcomes measured included blood loss, pain scores, and analgesic use.
Main Results:
- No statistically significant differences were found in postoperative blood loss, hemoglobin, hematocrit levels, or hospital stay duration between the groups.
- The catheter traction group experienced significantly higher postoperative pain scores.
- Patients in the traction group required significantly more analgesics.
Conclusions:
- Postoperative catheter traction for 12 hours after mTURP does not offer benefits in reducing blood loss.
- This intervention is associated with increased postoperative pain and a greater need for pain medication.
