While the problem of hemorrhage has been a major consideration in prostatic surgery for as long as that field of endeavor has existed, the urological surgeon has devised a number of effective methods which almost always lead to its successful management. Apart from direct ligation of bleeding vessels in open operative approaches, electrocoagulation, inflatable bags serving as tampons, and direct packing have all been utilized and proved invaluable.
The medical literature, on the other hand, contains numerous accounts of the employment of more radical measures to control other types of pelvic hemorrhage. These have principally dealt with uterine hemorrhage due to neoplastic disease or operative trauma; however, such measures have also been applied in controlling the blood loss from extensive bladder neoplasms. In these situations bilateral internal iliac artery ligation has been performed after failure of all other measures.
One decisive consideration attends all procedures in any part of the