SURGICAL TECHNIQUE: HAEMOSTATIC TECHNIQUE FOR SUPRAPUBIC PROSTATECTOMY

Aim: It is a haemostatic technique aiming at insertion of stitches in a special fashion to entangle the prostatic vessels at their anatomical sites before enucleation. The ureters are 100% safeguarded with the aid of Mannitol spirting diuresis test occlusion. Materials and Methods: Eighteen patients with benign prostatic hypertrophy B.P.H. have undergone the haemostatic technique Fig. 1 during the period 1999-2003 with an age range (58 - 81). The stitches are put in two circular insersions at 2 vertical levels 1 cm distal to the ureteric orifices at 5 and 7 O clock positions; the sites of prostatic vessels (1, 2). The stitches are only tightened when the spirting Mannitol diuresis is maintained. This provides 100% protection against ureteral obstruction. Results: There is a remarkable reduction of intra and post-operative bleeding. This gives a unique chance for dissection under clear vision. The urinary sphincter is preserved and the bladder outlet is better cared of. None of the patients required blood transfusion intra-operatively. Conclusions: The haemostatic technique before enucleation has provided a Suprapubic Prostatectomy without hemorrhage and without entrapment of the ureters