Technical consideration in radical retropubic prostatectomy: blood loss after ligation of dorsal venous complex.

The estimated blood loss and blood transfused in 641 patients undergoing bilateral pelvic lymphadenectomy and radical retropubic prostatectomy were analyzed to compare ligation and nonligation of the deep dorsal venous complex. Group 1 (325 men) had no attempt at deep dorsal vein ligation and group 2 (316) had ligation of the deep dorsal venous complex. Group 2 was subdivided into group 2a-137 men in whom an attempt at a nerve-sparing procedure was made and group 2b-179 in whom no such attempt was made. Estimated intraoperative blood loss was significantly different between the groups: group 1--mean loss 1,262 ml. and group 2--mean loss 1,020 ml. (p less than 0.0001). The amounts of blood transfused intraoperatively were significantly different: group 1-1.73 units and group 2-1.21 units (p less than 0.0002). Intraoperative blood loss was not significantly different between subgroups 2a and 2b but the mean amount of blood transfused intraoperatively was lower in group 2a than in group 2b (0.99 and 1.39 units, respectively p less than 0.02). The greatest amounts of blood lost and transfused were in group 1 (no ligation) and the least amounts were in group 2a (ligation and nerve-sparing), representing highly statistically significant differences (p less than 0.0001).