The value of frusemide in 110 consecutive prostatectomies

Abstract

One hundred and ten patients undergoing open prostatectomy had an induced diuresis using frusemide. The results of this treatment are reviewed. Seventy-one patients (65 per cent) presented as emergencies with acute retention, while the remainder presented with chronic retention or prostatism. The average age was 69 years, and 25 patients (23 per cent) were aged 75 years or more. Only rarely was a patient refused operation because of confinement to bed or failing mental faculties. Blood-loss, fluid and elctrolyte balance, and postoperative urinary infection were studied in detail, and the following points are emphasized:— The average postoperative 24-hour urinary out-put was 4·5 litres, 40 per cent of which was passed in the first 3 hours when the danger of clot retention is greatest.Clot retention was eliminated as a problem, and bladder wash-outs were not necessary.The average blood replacement was 1·05 U., and the average fall in postoperative haemoglobin level was 1·1 g.The postoperative urinary infection rate was low, being 8 per cent at 1 week after operation.A low morbidity was recorded and the mortality was 0·9 per cent. A vigorous diuresis induced by frusemide after suitable fluid loading is both effective and safe. It is a distinct advance over previous methods used.