DefinePK

Research Objective

To determine and compare the frequency of postoperative requirement of additional analgesia and the mean length of hospital stay in patients undergoing transurethral resection of the prostate (TURP) with and without postoperative catheter traction.

Methodology

Analytical Cross Sectional Study conducted in the Department of Urology, Allied Hospital, Faisalabad, from December 2023 to March 2024. 48 male patients with comparable baseline characteristics (age, preoperative prostate size) undergoing TURP and experiencing significant postoperative hematuria (grade 2) were enrolled and divided into two groups (A and B, 24 patients each). Group A received postoperative catheter traction, while Group B did not. Both groups received diclofenac sodium for pain management. Pain was assessed using a Visual Analogue Scale (VAS) every 6 hours for the first 24 hours, with additional analgesia provided for moderate-severe pain. Hospital stay duration and complications were recorded. Data was analyzed using SPSS V-25, with chi-square tests for qualitative variables and t-tests for quantitative variables.

Methodology Flowchart

                        graph TD;
    A["Enroll 48 TURP patients with hematuria"] --> B["Divide into two groups"A: Traction, B: No Traction""];
    B --> C["Administer standard analgesia"];
    C --> D["Assess pain via VAS"];
    D -- Moderate-Severe Pain --> E["Provide additional analgesia"];
    D -- Mild Pain --> F["Continue standard analgesia"];
    E --> G["Record analgesia requirement"];
    F --> G;
    G --> H["Record hospital stay duration"];
    H --> I["Record complications"];
    I --> J["Analyze data SPSS, Chi-square, t-test"];
    J --> K["Compare groups for analgesia and hospital stay"];                    

Discussion

Postoperative catheter traction, while a popular technique to reduce postoperative hemorrhage after TURP, is associated with increased morbidity, including a higher requirement for additional analgesia and a prolonged hospital stay. The study's findings are consistent with previous research, suggesting that the benefits of catheter traction in reducing bleeding may be outweighed by its negative impact on patient recovery and healthcare costs. The decision to use catheter traction should be individualized, considering its associated morbidities.

Key Findings

79.16% of patients in Group A (with catheter traction) required additional postoperative analgesia compared to 29.16% in Group B (without catheter traction) (p=0.0001). The mean hospital stay for Group A was 4.04 ± 0.65 days, while for Group B it was 3.25 ± 0.65 days (p=0.0001). No adverse events or complications were reported in either group.

Conclusion

Postoperative catheter traction after TURP is associated with significant morbidity, including increased need for analgesia and longer hospital stays. It is advisable to consider less morbid and better-studied interventions for reducing TURP-related hemorrhage.

Fact Check

1. Sample Size: The study enrolled a total of 48 patients, divided equally into two groups of 24 each. (Confirmed)
2. Analgesia Requirement: 79.16% of patients with catheter traction required additional analgesia, compared to 29.16% without. (Confirmed)
3. Mean Hospital Stay: The mean hospital stay was 4.04 days for the traction group and 3.25 days for the non-traction group. (Confirmed)

Mind Map