Intraprostatic Fossa Foley Balloon Tamponade: A Novel Technique for Controlling of Life-Threatening Bleeding During Simple Prostatectomy

Prostatectomy is one of the most common urologic procedures. Although TURP is now considered the standard procedure, open prostatectomy still plays a major role in urology. Simple prostatectomy should be considered when the obstructive tissue is estimated to weigh more than 75 g, bladder diverticula, large bladder calculi, ankylosis of the hip or other orthopedic conditions that prevent proper positioning for TURP, recurrent or complex urethral conditions such as urethral stricture or previous hypospadias repair are other indications [1]. However, blood loss is now minimal during prostatectomy and the need for a blood transfusion is uncommon but excessive hemorrhage had been a major concern [1] and during enucleating of prostatic adenoma, profuse bleeding can occur [2] by having all of these in view the 2003 American Urological Association guideline on the management of BPH reports a blood transfusion rate as high as 27 % [3]. The most difficult situation one might face is profuse bleeding from the prostatic fossa with no obvious bleeding site. This usually happens after removal of very large adenomas and in patients with anticoagulation therapy or those who receives NSAIDs. In our experience this kind of bleeding did not respond to simple suture ligature or electrocautery.