The effect of fibrinogen concentrate on perioperative bleeding in transurethral resection of the prostate: A double blind placebo-controlled and randomized study

Hemorrhage during transurethral resection of the prostate (TUR-P) has always been a concern. Several studies have shown that pre-operative administration of fibrinogen concentrate has promising results in reducing hemorrhage in cardiac surgery.

This study investigated the hemostatic effect of fibrinogen concentrate administration on reducing the bleeding amount during TUR-P in patients with benign prostatic hyperplasia.

Sixty men with benign prostatic hyperplasia, who were chosen to undergo TUR-P, entered this prospective randomized double-blind placebo-controlled pilot study. The participants were randomly assigned to two groups: treatment (n=31) and placebo (n=29). They received an infusion of 2 gr fibrinogen concentrate (treatment group) or normal saline (placebo group) before surgery. Data regarding bleeding amount, the operation and complications were recorded and analyzed.

No difference was observed in bleeding during (521 mL vs. 557 mL) and after (291 mL vs. 341 mL) the surgery between fibrinogen and placebo groups, respectively. This lack of difference was also seen in operation time (43 vs. 42 minutes), irrigating fluid volume used during (17 L vs. 19 L) and after operation (29 L vs. 28 L), and resected adenoma volume (19 gr vs. 19 gr). The mean blood pressure was also similar in both groups as a confounding factor in the bleeding amount.

Preoperative administration of fibrinogen concentrate had no significant influence on intra- and post-operative bleeding in TUR-P surgery. This article is protected by copyright. All rights reserved.

Journal of thrombosis and haemostasis : JTH. 2016 Jan 26 [Epub ahead of print]

Mohammad Soleimani, Navid Masoumi, Navid Nooraei, Alireza Lashay, Mohammad Reza Safarinejad

Department of Urology, Shahid Modarress Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran., Department of Anesthesiology, Shahid Beheshti University of Medical Sciences, Tehran, Iran., Clinical Center for Urological Disease Diagnosis, Private Clinic Specializing in Urological and Andrological Genetics, Tehran, Iran.