Abstract
Recent understanding of the pathogenesity of haemorrhagic tendency as well as advance of management of patients with this disease makes its surgical treatment possible. Since 1979 we have experienced three male patients with haemorrhagic tendency.
The first case was a bladder carcinoma with hemophilia A. He had been given 2500 unit of Conco-eight® (coagulation factor VIII) before transurethral resection of bladder tumor (TUR-Bt) and was given 1000 unit of Conco-eight® every eight to twelve hours for seven days postoperatively. The second case was a bladder carcinoma with von Willbrand disease. This case was also pretreated by Conco-eight® before operation and we had difficulty in controling his coagulopathy for one month postoperatively. The third case was a benign prostatic hypertophy with idiopathic thrombocytopenic purpura (ITP). He had been given a huge dose of gamma globulin for six days before operation and on the operation day his platelet count was normalized. Since his prostate was estimated to weight over 70g, suprapubic prostatectomy was selected.
All these three cases were operated uneventifully. From this experience we believe that with proper preoperative and postoperative management, patients with haemorrhagic tendency can be operated safely.
