前立腺摘除術における新しい止血法 --経精管止血剤注入法--

Abstract

There have been many methods attempted to control bleeding in prostatectomy of any type. Among them, hemostatic bags, hemostatic ligatures, or cryogenic approach have been prevalent. This paper deals with a new method by which bleeding after suprapubic prostatectomy was considerably lessened. After conventional prostatectomy, vas deferens was exposed bilaterally in the scrotum. The epididymal side was ligated to prevent epididymitis. A small polyethylene tube was inserted toward the seminal vesicle through a transverse incision made just above the ligation site. The wound was closed leaving intubated vasostomy. Through the tubes of both sides, hemostatic agents such as AC-17 and Manetol (Bayer) were intermittently injected postoperatively for 3 to 6 days. Postoperative seminal vesiculograms suggested that the drugs might be partly absorbed by the seminal vesicle and have infiltrated into the surrounding tissue but mostly reached the, prostatic bed in high concentration.