Relationship between Preoperative Risk Factors and Need for Blood Transfusion in Transurethral Resection Of The Prostate (TURP)
DOI:
https://doi.org/10.51985/Keywords:
Aged; Blood Transfusion; Hemoglobin; Prostatic Hyperplasia; Transurethral Resection of ProstatAbstract
Objective: To assess the incidence of blood transfusion after transurethral resection of the prostate (TURP) and to examine the relationship between preoperative risk factors and need for blood transfusion.
Study design and Setting: Descriptive study conducted in the Department of Urology, The Indus Hospital and health network, Karachi from 1st Sep’ 2024 to 28th Feb’ 2025.
Methodology: Sixty patients who underwent TURP after approval by the IRB. Patients with bleeding diatheses, anticoagulant use within the previous 2 weeks prior to surgery or preoperative treatment with 5-alpha reductase inhibitors were excluded. The data was written on predesigned proforma and analyzed by using SPSS V.26. Risk factors were evaluated in patients who needed transfusion. Univariate analysis was performed by descriptive statistics and Chi-square or Fischer’s exact test as appropriate, the level of significance adopted being p<0.05.
Results: Sixty patients were enrolled with a mean age of 67 ± 7.29 years. Hemoglobin and hematocrit decreased from 13.1 ± 1.42 g/dl and 39.7 ± 4.27% preoperatively to 12.3 ± 1.61 g/dl and 37.1 ± 4.68% postoperatively, with median reductions of 0.7 g/dl and 2.35%, respectively. Hypertension (28.2%) and diabetes (15.4%) were the most common comorbidities; 39.7% had none. Only one patient (1.7%) required transfusion, associated with indwelling catheter, prior TURP, short symptom duration, and prostate size of 40–60 g. No significant association between risk factors and transfusion was observed.
Conclusions: The rate of transfusion after TURP was low, Universal cross-matching and prearrangement of blood in all patients are probably not indicated
References
1. Kim J, Alrumaih A, Donnelly C, Uy M, Hoogenes J,
Matsumoto ED. The impact of tranexamic acid on perioperative
outcomes in urological surgeries: a systematic review and
meta-analysis. Can Urol Assoc J. 2023 Jun; 17(6):205-16.
DOI: https://doi.org/10.5489/cuaj.8254
2. Vanderbruggen W, Van Poppel H, Oudenhoven L, et al. The
effect of tranexamic acid on perioperative blood loss in
transurethral resection of the prostate: a double-blind,
randomized controlled trial. Prostate. 2023 Aug 21. DOI:
https://doi.org/10.1002/pros.246163. Pastene B, Bernard R, Colin M, et al. Patient Blood
Management in transurethral resection surgery: overview and
strategy analysis from a French tertiary hospital. Adv Ther.
2023 Apr; 40(4):1830-37.
4. Porto JG, Bhatia AM, Bhat A, et al. Evaluating transurethral
resection of the prostate over twenty years: a systematic
review and meta-analysis of randomized clinical trials. World
J Urol. 2024 Nov; 42(1):639. DOI: https://doi.org/10.1007/
s00345-024-05332-3
5. Kuo LY, Kuo J, Silverman J, et al. Comparison of perioperative
bleeding risk between direct oral anticoagulants in transurethral
resection of prostate. BJU Int. 2024 Aug; 134(1):30-37. DOI:
https://doi.org/10.1111/bju.16478
6. Eraky AM, Rubenstein SC, Khan A, Mokhtar Y, Gregorich
NM. Non-surgical bleeding and transurethral resection of the
prostate (TURP) syndrome after TURP surgery: a case report
and literature review. Pathophysiology. 2024 Jul; 31(3):367-
75. DOI: https://doi.org/10.3390/pathophysiology31030027
7. Lotterstätter M, Seklehner S, Wimpissinger F, et al.
Transurethral resection of the prostate in 85+ patients: a
retrospective, multicentre study. World J Urol. 2022; 40(2):
DOI: https://doi.org/10.1007/s00345-022-04179-w
8. Adhikari B, Shrestha A, Basnet RB, Shrestha PM, Gharti BB,
Shah AK. Monopolar transurethral resection of prostate for
benign prostatic hyperplasia in patients with and without
preoperative urinary catheterisation: a prospective comparative
study. Cureus. 2021 Jul 28; 13(7):e16705. DOI: https://doi.org/
10.7759/cureus.16705
9. Hughes T, Harper P, Somani BK. Treatment algorithm for
management of benign prostatic obstruction: an overview of
current techniques. Life. 2023 Oct 18; 13(10):2077. DOI:
https://doi.org/10.3390/life13102077
10. Miernik A, Gratzke C. Current treatment for benign prostatic
hyperplasia. Dtsch Arztebl Int. 2020 Dec; 117(49):843-54.
DOI: https://doi.org/10.3238/arztebl.2020.0843
11. Young MJ, Elmussareh M, Morrison T, Wilson JR. The
changing practice of transurethral resection of the prostate.
Ann R Coll Surg Engl. 2018 Mar; 100(4):326-9. DOI:
https://doi.org/10.1308/rcsann.2018.0054
12. Issa MM. Technological advances in transurethral resection
of the prostate: bipolar versus monopolar TURP. J Endourol.
2008 Aug; 22(8):1587-96. DOI: 10.1089/end.2008.0192
13. Shrestha BM, Prasopshanti K, Matanhelia SS, Peeling WB.
Blood loss during and after transurethral resection of prostate:
a prospective study. Kathmandu Univ Med J (KUMJ). 2008
Jul-Sep;6(23):329-34. DOI: https://doi.org/10.3126/ kumj.v6i3.
1707
14. Smith H, Falconer R, Szczachor J, Ahmad S. Routine
preoperative group and save for TURP and TURBT – need
and cost-effectiveness. J Clin Urol. 2018 Jan;11(1):33-7. DOI:
https://doi.org/10.1177/2051415817717908
15. Olapade-Olaopa EO, Solomon LZ, Carter CJ, Ahiaku EK,
Chiverton SG. Haematuria and clot retention after transurethral
resection of the prostate: a pilot study. Br J Urol. 1998 Nov;
82(5):624-7. DOI: 10.1046/j.1464-410x.1998.00824.x
16. Levin K, Nyren O, Pompeius R. Blood loss, tissue weight
and operating time in transurethral prostatectomy. Scand J
Urol Nephrol. 1981; 15(3):197-200. DOI: 10.3109/ 00365598
109179602
17. Kirollos MM, Campbell N. Factors influencing blood loss in
transurethral resection of the prostate (TURP): auditing TURP.
Br J Urol. 1997; 80(1):111-5. DOI: 10.1046/j.1464-410x.1997
.00253.x
18. Li Z, et al. Venous thromboembolism and bleeding after
TURP: effect of preoperative antithrombotic therapy history
on bleeding and VTE. J Clin Med. 2023;12(2):417. DOI:
https://doi.org/10.3390/jcm12020417
19. Smith H, Falconer R, Szczachor J, Ahmad S. Routine
preoperative group and save for TURP and TURBT – need
and cost effectiveness. Journal of Clinical Urology.
2017;11(1):33-37. doi:10.1177/2051415817717908
20. Lee SH, Cho E, Park JH, Lee JY, Hong JH, Han H. Addressing
desaturation in a tracheal stenosis patient using the transnasal
humidified rapid-insufflation ventilatory exchange technique
during tracheostomy: A case report. Medicine (Baltimore).
2023;102(31):e34567. DOI:
21. John A, Mian M, Sreedharan S, Kahokehr AA. The impact
of the coronavirus disease 2019 pandemic on elective urological
procedures in Australia. Asian J Urol. 2022;9(1):35-41. DOI:
https://doi.org/10.1016/j.ajur.2021.07.001
22. Salehi M, Imani B, Zandi S, et al. Effect of tranexamic acid
dissolved in warm, cold, and room-temperature irrigation
fluid on complications during and after TURP surgery: A
double-blind, randomized clinical trial. Afr J Urol. 2025;31:4.
Downloads
Published
Issue
Section
License

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
Journal of Bahria University Medical & Dental College is an open access journal and is licensed under CC BY-NC 4.0. which permits unrestricted non commercial use, distribution and reproduction in any medium, provided the original work is properly cited. To view a copy of this license, visit https://creativecommons.org/licenses/by-nc/4.0