An Automatic Bleeding-Rank System for Transurethral Resection of the Prostate Surgery Videos Using Machine Learning.

Benign prostatic hyperplasia (BPH) is the main cause of lower urinary tract symptoms (LUTS) in aging males. Transurethral resection of the prostate (TURP) surgery is performed by a cystoscope passing through the urethra and scraping off the prostrate piece by piece through a cutting loop. Although TURP is a minimally invasive procedure, bleeding is still the most common complication. Therefore, the evaluation, monitoring, and prevention of interop bleeding during TURP are very important issues. The main idea of this study is to rank bleeding levels during TURP surgery from videos. Generally, to judge bleeding level by human eyes from surgery videos is a difficult task, which requires sufficient experienced urologists. In this study, machine learning-based ranking algorithms are proposed to efficiently evaluate the ranking of blood levels. Based on the visual clarity of the surgical field, the four ranking of blood levels, including score 0: excellent; score 1: acceptable; score 2: slightly bad; and 3: bad, were identified by urologists who have sufficient experience in TURP surgery. The results of extensive experiments show that the revised accuracy can achieve 90, 89, 90, and 91%, respectively. Particularly, the results reveal that the proposed methods were capable of classifying the ranking of bleeding level accurately and efficiently reducing the burden of urologists.