Intravesical Blood Clot Retention? How We Manage It, a Tertiary Hospital Preference

Authors

  • Tetuka Bagus Laksita Urology department, Dr. Soetomo Academic General Hospital, Faculty of medicine, Airlangga University
  • Fikri Rizaldi Urology department, Dr. Soetomo Academic General Hospital, Faculty of medicine, Airlangga University

DOI:

https://doi.org/10.21776/ub.jkb.2021.031.03.8

Keywords:

Cystoscopy, haematuria, intravesical blood clot retention

Abstract

Intravesical blood clot retention is one of the Urological emergencies. Ongoing haematuria and blood clot formation in the bladder obstruct the urine outflow and lead to urinary retention, abdominal pain, anemia, urinary tract infection (UTI), and renal function deterioration. Most of the cases required cystoscopy blood clot evacuation and definitive surgery to stop the ongoing bleeding. This study aimed to discover the demography, characteristics, management, and complication of patients with intravesical blood clot retention in Dr. Soetomo General Acadenic Hospital, Surabaya from January 2017 until April 2020. This is an observational study, a retrospective-descriptive design. We conducted a review on the medical records of 97 patients, 76 males and 21 females with an average age of 54.9 years old. Of all patients initially treated conservatively using normal saline irrigation with a large three-way catheter (22-24 fr), four were successfully treated without surgery, and 89 patients underwent cystoscopy and definitive surgery. The mean operation time was 69,6 minutes, with an average blood clot volume of 167,7 ml (25-600 ml). Sources of bleeding were mostly originated from malignancy (58%), Benign Prostatic Hyperplasia (BPH) (10%), and hemorrhagic cystitis (7%).  The most common comorbidity found was hypertension (13) and chronic kidney disease (10). Based on our experience, managing intravesical blood clot retention with cystoscopy continued with definitive surgery in a one-step procedure is a good approach. Urological malignancy is the most frequent abnormality that causes intravesical blood clot retention.

Downloads

Download data is not yet available.

Author Biographies

Tetuka Bagus Laksita, Urology department, Dr. Soetomo Academic General Hospital, Faculty of medicine, Airlangga University

Urology Resident

Fikri Rizaldi, Urology department, Dr. Soetomo Academic General Hospital, Faculty of medicine, Airlangga University

Urology Staf at Dr. Soetomo Academic General Hospital

References

Bolenz C, Schröppel B, Eisenhardt A, Schmitz-Dräger BJ, and Grimm MO. The Investigation of Haematuria. Deutsches Ärzteblatt International. 2018;115(48):801–807.

Aydin C, Senturk AB, Akkoc A, Topaktas R, Aydın ZB, and Ekici M. Clot Retention: Our Experiences with a Simple New Technique of Evacuation with a Thoracic Catheter. Cureus. 2019; 11(3): 1–10.

Wallad CK, Santoso J, and Adi K. Efikasi Penggunaan Nasogastric Tube Pada Evakuasi Bekuan Darah Saat Cystoscopy. Indonesian Journal of Urology. 2016; 23(2): 118-121.

Kementerian Kesehatan Republik Indonesia. Bunga Rampai Fakta Tembakau dan Permasalahannya di Indonesia Tahun. Jakarta: Tobacco Control and Support Centre-IAKMI; 2015.

Wein AJ, Kavoussi LR, Partin AW, and Peters CA. Campbell-Walsh Urology. 11th edition. United States: Elsevier; 2015.

Yu HT, Kim TH, Uhm JS, et al. Clinical Significance of Haematuria in Atrial Fibrillation with Oral Anticoagulation Therapy. Circulation Journal. 2017; 81(2): 158-164.

Yeoh M, Lai NK, Anderson D, and Appadurai V. Macroscopic Haematuria A Urological Approach. Australian Family Physician. 2013; 42(3): 123-126.

Yu HS, Ham WS, Hah YS, Lees CK, Jang WS, and Cho KS. Simple, Safe, and Successful Evacuati6on of Severe Organized Clot Retention Using a Catheter Connected with Wall Suction: Suction and Fishing Method. Urology. 2011; 78(5): 1199-1202.

Babu BS, Haritha B, Daasaradhi B, and Ramana BR. Clot Retention - A Simple New Method of Evacuation with Out Toomey's or Ellick's: A Clinical Study. International Journal of Clinical Study. 2015;3(8):45-47.

Bansal A, Jhanwar A, Prakash G, and Sankhwar S. Chylous Clot Removal Using Morecellator: A Novel Method. SM Journal of Urology. 2017; 3(1): 1-2.

Miyamae K, Otsuka T, Otsuka Y, Nagayoshi M, and Hamada Y. Clinical Study of Bladder Tamponade Resulting from Clots of Blood. Nihon Hinyōkika Gakkai zasshi. The Japanese Journal of Urology. 2006; 97(5): 743-747.

Uǧuralp S, Gürbüz N, and Baysal T. Treatment of Clot Retention with Intravesical Streptokinase Instillation: A Case Report. Turkish Journal of Medical Science. 2003; 33(3): 187-189.

Thevarajah A. Massive Haematuria with Clot Retention: Management Options. The Sri Lanka Journal of Surgery. 2012; 30(2): 18-19.

Downloads

Published

2021-02-27

Issue

Vol. 31 No. 3 (2021)

Section

Research Article

License

Authors who publish with this journal agree to the following terms:

  1. Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
  2. Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
  3. Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access).