Evaluating coagulation in prostatectomy

Introduction: There is contradictory evidence regarding blood-loss and its aetiology in prostate surgery. Objectives: Documenting whether changes in coagulation are associated with prostatectomy by ordinary laboratory tests and comparing them to those obtained in thromboelastography (TEG). Methods: A pilot prospective observational study was thus conducted. 27 patients were included form whom blood samples were taken at three different times (before surgery, 1 hour and 2 hours after surgery). Results: Baseline coagulation profile was normal, but there was a statistically significant rise in D-dimer in the next samples. Ly 30 rose during times 1 and 2, but such rise in absolute numbers was still within normal ranges. No correlation was found between traditional coagulation tests and thromboelastography except for pt and R values; however, although correlation was statistically significant, there was not enough power to affirm that these values were clearly correlated. Conclusions: A fibrinolytic state appears to follow prostatic surgery as documented by traditional coagulation test, although these findings did not seem to correlate with the amount of bleeding. No abnormal values were found in thromboelastography thereby supporting its use for evaluating significant coagulation abnormalities and as a guide for administering blood products.