COAGULATION TESTS IN PREDICTING HEMORRHAGE AFTER PROSTATIC RESECTION

It is known that disseminated intravascular coagulation (DIC) can cont ribute towards blood loss after transurethral resection of the prostat e because of the absorption of various prostatic substances. The aim o f the present study was to establish whether simple coagulation tests (prothrombin time/activated partial thromboplastin time) carried out i mmediately after surgery would be useful in predicting those patients who bleed excessively after prostatic resection due to DIC. Criteria t o determine significant post-operative haemorrhage were defined. Of 11 0 patients entered into the study, 34.5% had significant post-operativ e bleeding and 74% of these had an abnormal prothrombin time (greater- than-or-equal-to 15 s) immediately after surgery. An abnormal prothrom bin time was associated with the resection of large prostates but coul d also predict the risk of bleeding independent of the resected weight ; 18% of patients with an abnormal prothrombin time were also found to have an abnormal activated partial thromboplastin time and all of the se had significant blood loss. A group of patients with an abnormal pr othrombin time and a resected dry weight greater-than-or-equal-to 35 g was identified as a high risk group.