Lack of correlation between blood fibrinolysis and the immediate or post‐operative blood loss in transurethral resection of the prostate

Abstract

Objective To evaluate whether the activation of the increase in systemic t-PA activity and t-PA antigen, coinciding with a significant drop in PAI activity. Postextrinsic tissue-type plasminogen activator-related fibrinolysis is implicated in the blood loss in patients operatively, PAI activity and PAI-1 antigen increased. The formation of plasmin was indicated by a fall in with benign prostatic hyperplasia, undergoing transurethral prostatic resection (TURP).the plasma concentration of Plg activity and Plgantigen and a 2 -AP but which increased significantly Patients and methods TURP was performed in 24 men and the operative and post-operative blood loss deterat the end of the study period. Increased systemic fibrinolytic activity was further confirmed by a marked mined. The activation of the tissue-type plasminogen activator-related fibrinolysis was followed using new increase in fibrin d-dimer and FbDP. There was no correlation between the AUC in the operative period sensitive and specific assays, and the changes related to the blood loss. Measurements of the plasma concenof any of the fibrinolytic variables and the measured blood loss. In the post-operative period, t-PA antigen trations of free tissue-type plasminogen activator (t-PA) activity, tissue-type plasminogen activator (t-PA) anti-(P=0.004), PAI activity (P=0.043), PAI-1 antigen (P=0.016) and a 2 -AP (P=0.047) all correlated with gen, plasminogen activator inhibitor (PAI) activity, plasminogen activator inhibitor 1 (PAI-1) antigen, the post-operative blood loss, while there was no correlation between fibrin d-dimer or FbDP and plasminogen (Plg) activity, plasminogen (Plg) antigen, a 2 -antiplasmin (a 2 -AP), d-dimer and fibrin degradation blood loss. Conclusion The fibrinolytic system is activated during products (FbDP) were all determined and the area under the curve (AUC) for each of these quantities and after TURP, but the increased activity is not of pathophysiological importance for the blood loss. correlated with the blood loss. Results TURP was followed by a marked activation of Keywords Fibrinolysis, blood loss, transurethral prostatic resection the fibrinolytic system. There was an immediate [9][10][11][12]. Only a few have attempted to ascertain whether

BPH Tranexamic acid decreases blood loss during transurethral resection of the prostate (TUR-P)

“…Urine and urothelium contain high concentrations of plasminogen activators that facilitate the lysis of clots [4]. Therefore, administration of antifibrinolytic agents might be beneficial in reducing the amount of postoperative blood loss resulting from TURP.…”

Bleeding and activation of coagulation during and after transurethral prostatectomy: importance of the acute‐phase response and prostate specific antigen?

“…The haemoglobin concentration decreased throughout the study period, as did the haematocrit ( Table 1). The results were evaluated both with (+) and without (−) correction for haemodilution, the method of correction having been described earlier [ 8].…”

“…At the end of TURP all patients were given loop diuretics (bumetanid 1 mg) intravenously, and a 22 F two‐way catheter inserted and retained in situ until the urine was clear. The removed tissue was weighed and the blood loss calculated as described previously [ 8].…”

The impact of irrigating fluid absorption on blood coagulation in patients undergoing transurethral resection of the prostate

“…Bell et al [19] reported that the thromboelastogrphy (TEG) parameters reflect a hypercoagulable state during and after TURP and that this change is caused by the inhibition of the fibrinolytic system. Conversely, Nielsen et al [20] concluded that the fibrinolytic system is activated during TURP due to surgical trauma. Although these 2 studies demonstrated conflicting results regarding the change of the fibrinolytic system, both of these reports failed to provide information about the amount of irrigating fluid used and absorbed.…”