The effect of fibrinogen concentrate on perioperative bleeding in transurethral resection of the prostate: a double-blind placebo-controlled and randomized study.
Background: Hemorrhage during transurethral resection of the prostate (TUR?P) has always been a concern. Several studies have shown preoperative administration of fibrinogen concentrate to have promising results in reducing hemorrhage in cardiac surgery.
Objectives: To investigate the hemostatic effect of fibrinogen concentrate administration on reducing the amount of bleeding during TUR?P in patients with benign prostatic hyperplasia.
Methods: Sixty men with benign prostatic hyperplasia, who were chosen to undergo TUR?P, entered this prospective randomized double?blind placebo?controlled study. The participants were randomly assigned to two groups: treatment (n = 31) and placebo (n = 29). They received an infusion of 2 g of fibrinogen concentrate (treatment group) or normal saline (placebo group) before surgery. Data regarding the amount of bleeding, the operation and complications were recorded and analyzed.
Results: No difference was observed in bleeding between the fibrinogen and placebo groups during (521 mL versus 557 mL, respectively) and after (291 mL versus 341 mL, respectively) surgery. This lack of difference was also seen in operation time (43 min versus 42 min), irrigating fluid volume used during (17 L versus 19 L) and after (29 L versus 28 L) surgery, and resected adenoma volume (19 g versus 19 g). The mean blood pressure was also similar in both groups as a confounding factor for the amount of bleeding.
Conclusion: Preoperative administration of fibrinogen concentrate had no significant influence on intraoperative and postoperative bleeding in TUR?P surgery.