The Effects of Peri-Urethral Thrombin Instillation on Post-Operative Hematuria and Voiding Function in Patients with Benign Prostatic Hyperplasia (BPH) Undergoing Trans-Urethral Prostate Surgery

The Effects of Peri-Urethral Thrombin Instillation on Post-Operative Hematuria and Voiding Function in Patients with Benign Prostatic Hyperplasia (BPH) Undergoing Trans-Urethral Prostate Surgery

Background: To evaluate the efficacy of peri-urethral thrombin instillation at the surgical site after trans-urethral prostate surgery in benign prostatic hyperplasia (BPH), with the objective of reducing post-operative hematuria and preserving voiding function. Methods: The study was retrospectively analyzed a total of 122 patients who had trans-urethral prostate surgery between January 2019 and March 2023. Among these, 33 received thrombin instillation, while 89 did not receive it. In the test group, a mixture of 5 cc of saline solution and 5,000 IU of thrombin was instilled below the balloon, targeting the surgical site by inserting a 5 Fr feeding tube along with the Foley catheter. We compared hematologic data and uroflowmetry (UFM) between pre and post-operative periods, the duration of continuous bladder irrigation (CBI) and Foley catheter indwelling period. Results: The mean age and prostate size in the test group were 71.52±7.15 years and 54.05±24.73 g, while 71.38±8.22 years and 64.52±28.43 g in the control group. The prostate resected weight was 24.97±15.77 g and 27.58±17.00 g respectively. The hemoglobin and platelet levels were −1.05±0.81 g/dL and −42.79±35.59×103/L in the test group, and −1.08±0.97 g/dL and −27.93±40.49×103/L, in the control group. The test group showed better outcomes in CBI application time (21.31±12.15 hours) and Foley catheter indwelling time (50.97±14.63 hours) compared to the control group (34.42±22.68 hours and 70.33±33.95 hours) (P＜0.001). Conclusion: After trans-urethral prostate surgery, thrombin agent instillation can prevent post-operative hematuria and facilitate quicker recovery to daily activities.