Abstract

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• OBJECTIVES:

  Hemostasis during suprapubic prostatectomy for benign prostatic hyperplasia (BPH) is commonly affected by placing sutures at the 5 o'clock position and the 7 o'clock position of the bladder neck. However, the urethral arterial branches of the inferior vesical artery that supplies the prostate extend from the 1 o'clock to 5 o'clock position and from the 7 o'clock to 11 o'clock position of the bladder neck, with the largest branches located posteriorly. This study analyses the effect of a modified suprapubic prostatectomy technique, which covered the area from the 1 o'clock position to the 11 o'clock position, on postoperative blood hemoglobin levels, as a reflection of hemorrhage control. METHODS: This was a single-center, retrospective study of 47 patients who underwent suprapubic prostatectomy for BPH. Hemostatic sutures included the main areas of anatomic distribution of the urethral arterial branches of the inferior vesical artery. Preoperative and postoperative blood hemoglobin levels and perioperative complications were recorded.

  RESULTS:

  The mean decrease in blood hemoglobin was 1.06 mg/dL. Only three patients had clot retention, and these clots were easily flushed out. None of the patients required a blood transfusion.

  CONCLUSIONS:

  The modified suprapubic prostatectomy technique for BPH enhances hemostatic control and reduces the need for a blood transfusion.