RT Journal
A1 Lombardo LJ, Jr.
T1 FIbrinolysis in urologic patients
JF Journal of the American Medical Association
JO Journal of the American Medical Association
YR 1959
FD April 11
VO 169
IS 15
SP 1718
OP 1722
DO 10.1001/jama.1959.03000320020005
UL http://dx.doi.org/10.1001/jama.1959.03000320020005
AB Severe hemorrhages after prostatic surgery may be due to a fibrin-dissolving protease found in normal prostatic tissue. The intravascular release of enzyme activators from the prostate may also explain the chronic fibrinolysis that occurs in metastatic carcinoma of the prostate. Experiments in vitro showed that the activity of these enzymes can be opposed by inhibitors. The effectiveness of two preparations of toluidine blue as inhibitors was convincingly shown by observations of plasma fibrinogen levels in 3 groups of 30 patients undergoing prostatectomy. One group received an oral preparation, the second, a parenteral preparation. The third group served for comparison. Liquefaction of extravasated blood in the prostatic fossa was found to be a characteristic phenomenon, but the question is raised whether this may be an essential part of some reparative process. Two case histories illustrate the occurrence and treatment of hemorrhage after prostatectomy.