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Article History

Received: 16 March 2026

Accepted: 24 April 2026

First Online: 11 May 2026

Declarations

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: This study was conducted with ethical exemption from the Allied Hospital/Faisalabad Medical University Ethical Review Committee. All research activities were performed in strict compliance with international ethical standards and institutional guidelines. To ensure complete patient privacy and data protection, all personally identifiable information was removed from the dataset prior to analysis. A rigorous anonymization protocol was implemented; whereby patient names were systematically replaced with unique alphanumeric codes. This coding system was securely maintained with restricted access to protect participant confidentiality throughout all stages of data collection, analysis, and reporting. The study was conducted in accordance with the 1964 Helsinki Declaration and its later amendments. Allied Hospital/Faisalabad Medical University Ethical Review Committee’s approval letter is attached with approval No 48.ERC/FMU/2020-21/171.

: The primary limitation of this study is the quasi-randomized allocation method, which may introduce selection bias. It was a single-center design with a small sample size (n=60). Our findings are from a resource-limited Pakistan's tertiary care hospital and may not be generalizable to other populations or healthcare systems. Tosukhowong method reduce measurement error compared to conventional techniques; error such as dilution variability and incomplete fluid collection cannot be entirely excluded. Transfusion rates, postoperative PSA levels and histopathology results were not assessed in this study as our primary focus was on intra-operative blood loss. Future large-scale studies with longer follow-up in geriatric patients are recommended to validate these findings.

: Informed consent was obtained from all participants, individually who were included in the study. No personal identifying information, clinical photographs or other identifiable data are presented in this manuscript.

: The authors declare no competing interests.