Estimation of blood loss by video-assisted transurethral resection of the prostate

Background: Patients undergoing transurethral resection of the prostate sometimes loose large amounts of blood intraoperatively. We studied the accuracy of visual estimation of blood loss using a video-assisted operative technique. Methods: 220 consecutive patients with elective TUR-P were studied. Blood loss was measured in the operating theatre using a Hemocue photometer. After the operation, the surgeon was asked to estimate blood loss. Results: Blood loss was under- or overestimated by more than 300 ml in 7.7% of the patients. The average measured blood loss was 313 +/- 414 ml. 59.9% of the patients lost less than 200 ml, and 18.6% lost more than 500 ml. Patients with a prostate volume of more than 75 ml lost more blood. Blood loss was also smaller in patients with carcinomas. Conclusion: Measurement of blood loss intraoperatively during transurethral resection of the prostate is recommended.