[Hemorrhagic complications after an operation for adenomectomy]

The authors observed 49 patients aged 65-83 years with benign prostatic hyperplasia (BPH) before and after adenomectomy. It was found that prognosis of hemorrhagic complications of adenomectomy in early and late postoperative period demands a comprehensive assessment of coagulation and anticoagulation systems (fibrinolytic activity, first of all), ultrasound investigation (size of BPH), blood count and urinalysis (absence of residual inflammation of the urinary tract). Postoperative severe hemorrhage was observed in patients with changes in several parameters. It also was related to size of BPH and preoperative fibrinolytic activity. Early postoperative hemorrhages were more frequent than late (34.6% against 10%, respectively). 17 patients had micro- or macrohematuria, 2 patients developed massive blood loss. All the hemorrhagic patients had preoperative hemostasis disorders manifesting primarily as enhanced fibrinolytic activity and reduced fibrinogen concentrations.