In vitro investigation of the optimal hydrogen peroxide dosage for bladder clots evacuation

In vitro investigation of the optimal hydrogen peroxide dosage for bladder clots evacuation

Albert Ciam 1 , Tjahjodjati Romdan 1 , Zola Wijayanti 1

1 Department of Surgery, Division of Urology, Universitas Padjadjaran; Department of Surgery, Division of Urology, Hasan Sadikin Hospital. Bandung, West Java Indonesia

*Correspondence: Albert Ciam. Email: albert12002@mail.unpad.ac.id

Abstract

Objective: Bladder clot retention after hematuria is a urological emergency. Traditional washout often fails, requiring endoscopic evacuation under general anesthesia – often inaccessible in remote or critical care settings. This study aimed to determine the optimal dose and dwell time of hydrogen peroxide (H2O2) for enhancing clot evacuation. Method: In this in vitro study, 24 bladder clot models using 100 g of human blood were randomized into six groups and treated with 0.15%, 0.30%, or 0.60% H2O2 or saline. Each model used a 750-mL transparent urinary bag with an 18 Fr Foley catheter. Instillations lasted 30 or 60 s and were repeated until clot clearance. Parameters measured included procedure difficulty, attempts, duration, and fluid volume. Results: All H2O2 concentrations improved clot removal. The 0.30% group significantly reduced time and difficulty versus 0.15% (p < 0.05). Extending dwell time to 60 s did not enhance outcomes and prolonged the procedure. Although 0.60% was effective, it offered no significant advantage over 0.30%. Conclusions: Instilling 0.30% H2O2 for 30 s appears most effective for clot evacuation. Further in vivo studies are recommended.

Keywords: Bladder clot. Bladder instillation. Hydrogen peroxide.

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⇄ Versión en Español
DOI: 10.24875/RUC.25000019
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    English versión
    DOI: 10.24875/RUC.25000019

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