Successful prostatectomy in patients with inherited abnormalities of the factor VIII molecule.

Urological procedures pose specific medical and surgical problems in the patient with a hemorrhagic disorder. Three men, each with a different inherited deficiency involving the factor VIII molecule, underwent prostatectomy. Prolonged postoperative genitourinary hemorrhage was encountered and treated with replacement therapy and the use of inhibitors of fibrinolysis. Successful management of these patients with inherited coagulopathies depends on a thorough understanding of the hemostatic defect, adequate laboratory support and sufficient supplies of blood products.