Abstract
Purpose
To determine retrospectively the perioperative management and outcome of transurethral prostate/bladder surgery (TURP, TURB) and transrectal prostate biopsy in hemophiliacs.
Methods
Thirty-seven hemophilic patients underwent TURP (12 patients), TURB (13 patients), or transrectal prostate biopsy (12 patients) with proactive hemostaseological management (i.e., factor supply, close meshed hemostaseological analysis). Thirty-seven non-hemophiliac patients served as matched pairs who matched for age, gender, accompanying diseases, and the type of surgical procedure. The resulting pairs were analyzed for duration of surgery, hospital stay, and complications.
Results
Average TURP length in hemophiliacs was 77.92 min, in the matched pairs group TURP 67.08 min (p = 0.487). Mean TURB length in hemophiliacs was 43.46 min versus 35.38 min in controls (p = 0.678). More important, the length of hospital stay was significant longer in the hemophiliacs undergoing TURP compared to non-hemophiliac control group (12.08 days vs. 5.83 days; p < 0.001). In TURB patients, similar results were found (11.15 days hemophiliacs vs. 6.15 controls; p = 0.018). Regarding complications (bleeding, hemorrhage, readmission), no significant difference between the groups was obtained.
Conclusion
Urological interventions in hemophiliac patients with factor supply have the same risk for postoperative complications as in non-hemophiliacs. The only significant difference between hemophiliacs and non-hemophiliacs was the length of hospital stay.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Lee CA, Lillicrap D, Astermark J (2006) Inhibitor development in hemophiliacs: the roles of genetic versus environmental factors. Semin Thromb Hemost 32(Suppl 2):10–14
Bolton-Maggs PH, Stobart K, Smyth RL (2004) Evidence-based treatment of haemophilia. Haemophilia 10(Suppl 4):20–24
Hoyer LW, Scandella D (1994) Factor VIII inhibitors: structure and function in autoantibody and hemophilia A patients. Semin Hematol 31:1–5
Furie B, Limentani SA, Rosenfield CG (1994) A practical guide to the evaluation and treatment of hemophilia. Blood 84:3–9
Craddock CG, Fenninger LD, Simmons B (1948) Hemophilia: problem of surgical intervention for accompanying diseases review of the literature and report of a case. Ann Surg 128:888–903
Ingerslev J, Hvid I (2006) Surgery in hemophilia. The general view: patient selection, timing, and preoperative assessment. Semin Hematol 43:S23–S26
Rudowski WJ (1981) Moynihan Lecture, 1980. Major surgery in haemophilia. Ann R Coll Surg Engl 63:111–117
Benoit G, Lambert T, Blanchet P, Laurian Y, Lasjaunias P, D’Oiron R, Eschwege P, Langloys J, Droupy S, Kriaa F, Jardin A (2000) Which urologic treatment alternatives are there for the hemophiliac patient? Prog Urol 10:388–396
Goldmann G, Holoborodska Y, Oldenburg J, Schaefer N, Hoeller T, Standop J, Kalff JC, Hirner A, Overhaus M (2010) Perioperative management and outcome of general and abdominal surgery in hemophiliacs. Am J Surg 199(5):702–707
Conflict of interest
All authors have no conflict of interest.
Author information
Authors and Affiliations
Corresponding author
Additional information
S. Rogenhofer and S. Hauser contributed equally.
Rights and permissions
About this article
Cite this article
Rogenhofer, S., Hauser, S., Breuer, A. et al. Urological surgery in patients with hemorrhagic bleeding disorders Hemophilia A, Hemophilia B, von Willebrand disease: a retrospective study with matched pairs analysis. World J Urol 31, 703–707 (2013). https://doi.org/10.1007/s00345-012-0988-9
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00345-012-0988-9