Prostatectomy in an 85-year-old hemophiliac

R. Wylin and J. Schneider

Improved factor VIII preparations have made major surgery feasible for hemophiliac patients, as well as increasing their survival. In a hemphoiliac undergoing prostatectomy, the effects of local or systemic fibrinolysis and possible disseminated intravascular coagulation must be considered, in addition to the factor VIII deficiency. We successfully treated an octogenarian with benign prostatic hypertrophy and mild hemophilia during and after suprapubic prostatectomy by infusions of antihemophilic factor (factor VIII) concentrate. Cessation of infusion on the 15th day resulted in bleeding two days later. This ceased after resumption of antihemophilic factor infusion. Tests for abnormal fibrinolysis and fibrin split products gave negative results.