Prostatic Diseases and Male Voiding DysfunctionStopping Anticoagulation Before TURP Does Not Appear to Increase Perioperative Cardiovascular Complications
Section snippets
Material and Methods
A list of all patients who underwent TURP from 2006-2010 were retrieved from the hospital's audit database. The medical records of all patients were obtained from off-site storage facilities. Each patient record was individually hand searched and the data stored in a database.
Inclusion criteria included bladder outlet obstruction secondary to benign prostatic hyperplasia or prostate cancer and those who previously underwent TURP, with a minimum of 6 weeks postoperative follow-up.
A total of 308
Results
The baseline demographics for the patient cohort (n = 305) are shown in Table 1.
In this series, 64% of patients (n = 194, group B) were not routinely receiving any anticoagulation preoperatively; 35% (n = 108, group A) were receiving anticoagulation, which was stopped before TURP; and in 0.98% (n = 3, group C), TURP was performed while patients were taking aspirin.
The indications for anticoagulation are shown in Table 2.
The postoperative complications for this cohort are summarized in Table 3.
Comment
The optimal management of the anticoagulated patient requiring TURP has continued to stimulate debate in recent years. As the proportions of these patients in our population steadily increases, there is an urgent need to provide clarification and evidence-based clinical guidelines that can assist in managing these individuals.1, 2, 3, 4
In our study population, 35% of patients were on anticoagulation therapy, comparable with the proportion found in other studies.1, 5 Antiplatelet drugs (eg,
Conclusions
Men who have anticoagulation therapy stopped before TURP do not appear to have a higher incidence of cardiovascular or cerebrovascular events, or bleeding-related morbidity when compared with anticoagulant-naïve patients in this retrospective study. Further clinical research is warranted to reexamine this issue and permit the development of evidence-based guidelines to manage the anticoagulated patient requiring TURP.
Acknowledgments
The authors wish to thank Ms. M. Roure from the Department of Urology, Westmead Hospital, for her assistance in data collection for this study.
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Financial Disclosure: Henry Woo is a paid consultant to American Medical Systems Inc.
Funding Support: Funding for the data collection & retrieval for this study was obtained from Australian Clinical Trials, Pty. Ltd.