Controlled hypotension therapy with isosorbide dinitrate for postoperative bleeding of transurethral resection of the prostate.

Introduction: Postoperative bleeding is a well-known complication of transurethral resection of the prostate (TURP). This study aims to evaluate the efficacy and safety of controlled hypotension using isosorbide dinitrate (ISDN) as a treatment for refractory postoperative bleeding after TURP when conventional non-surgical treatments have failed. Methods: A retrospective analysis was conducted of eight patients who experienced postoperative bleeding following TURP and did not respond to standard non-surgical interventions. Patients were treated with an intravenous infusion of ISDN to induce controlled hypotension. The hemostatic effect was subsequently observed and evaluated once the mean arterial pressure was lowered to a target range of 66-73 mmHg. Outcomes: Hemostasis was achieved rapidly in all eight patients following the induction of controlled hypotension. The treatment demonstrated a highly satisfactory clinical effect, and no severe adverse events or complications were observed during or after the intervention. Conclusion: Controlled hypotension via intravenous ISDN is a safe, rapidly effective, and promising therapeutic alternative for managing refractory postoperative bleeding after TURP when conventional non-surgical measures fail.