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World J Clin Urol. Nov 24, 2015; 4(3): 108-114
Published online Nov 24, 2015. doi: 10.5410/wjcu.v4.i3.108
Is continuous bladder irrigation after prostate surgery still needed?
Chukwudi Ogonnaya Okorie
Chukwudi Ogonnaya Okorie, Department of Surgery, Federal Teaching Hospital, Abakaliki 102, Ebonyi State, Nigeria
Chukwudi Ogonnaya Okorie, Department of Surgery, Ebonyi State University, Abakaliki 102, Ebonyi State, Nigeria
Author contributions: Okorie CO collected the data and wrote the paper.
Conflict-of-interest statement: The author declares no conflict of interest for this article.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Chukwudi Ogonnaya Okorie, MD, PhD, Department of Surgery, Federal Teaching Hospital, Abakaliki 102, Ebonyi State, Nigeria. okorieco@mail.ru
Telephone: +234-70-33647464
Received: May 20, 2015
Peer-review started: May 20, 2015
First decision: August 19, 2015
Revised: October 17, 2015
Accepted: November 13, 2015
Article in press: November 17, 2015
Published online: November 24, 2015
Processing time: 193 Days and 23.1 Hours
Abstract

Continuous bladder irrigation (CBI) is commonly prescribed after certain prostate surgeries to help prevent the clot formation and retention that are frequently associated with these sometimes hemorrhagic surgeries. However, it remains unknown how effective CBI is in preventing clot formation/catheter blockage because these complications still frequently occur in the presence of CBI. On the other hand, the outcome of prostate surgeries has significantly improved over the years, and these surgeries have generally become much safer and, in many hands, less hemorrhagic. Newer surgical options such as holmium laser enucleation of the prostate with associated improved hemorrhagic control have also been introduced, further creating the opportunity to eliminate CBI. Furthermore, there is a lack of review articles on CBI. Hence, this article will review the evolution and contemporary role of CBI in prostate surgeries. To eliminate CBI after prostate surgeries, it is important to achieve good hemostasis during the surgeries. Having in place a policy of non-irrigation after prostate surgeries is also important if less CBI is to be the norm. A non-irrigation policy will hopefully help reduce those cases of CBI prescribed out of long-standing surgical tradition while allowing for cases prescribed out of compelling necessity. The author’s policy of a consistent non-CBI during prostate surgeries over the last 9 years will be highlighted.

Keywords: Continuous bladder irrigation; Bladder irrigation; Bladder washout; Benign prostatic hyperplasia; Prostatectomy; Transurethral resection of the prostate; Holmium enucleation of the prostate

Core tip: Continuous bladder irrigation (CBI) has been part and parcel of some prostate surgeries and might have been more relevant during the era of unpredictable hemostatic control. Hemostatic control during prostate surgeries has significantly improved, and new technologies with associated improved hemostasis have been introduced. Hence, CBI can be safely avoided in most prostate surgeries, especially when good hemostasis has been achieved and a policy to pursue the non- CBI pathway is in place.