Archivos espanoles de urologia · 2025
Bleeding Risks in Urologic Surgery: A Prospective Analysis of Anticoagulant and Antiaggregant Use in Transurethral Resection of Prostate, Transurethral Resection of Bladder Tumour and Open Prostatectomy.
СтатьяНаблюдательное исследованиеНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
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Ilktac Abdullah, Ersoz Cevper, Kalkan Senad, Dogan Bayram, Akbulut Habib, Akcay Muzaffer, Gevher Fatih, Ilbey Yusuf Ozlem
Аннотация
BACKGROUND: The use of anticoagulant (AC) and antiaggregant (AG) medications is increasingly common in elderly patients undergoing urologic surgeries. This prospective observational study aimed to evaluate the influence of AC/AG therapy on bleeding-related complications following transurethral resection of the prostate (TURP), transurethral resection of bladder tumour (TURBT) and open prostatectomy (OP).
METHODS: Patients who underwent TURP, TURBT or OP between March 2022 and January 2023 were included in this study. Patients were stratified according to AC/AG usage. Perioperative management details, including low-molecular-weight heparin (LMWH) bridging, were recorded. We evaluated parameters including duration of irrigation, length of stay, episodes of clot retention, transfusion rate and re-admission rate due to haematuria.
RESULTS: Among TURP patients, those using AC/AG therapy had significantly higher rates of transfusion (2.27% vs 0%, p = 0.038), postoperative clot retention (7.57% vs 0.53%, p = 0.008), re-catheterisation (9.09% vs 3.72%, p = 0.046) and re-admission due to haematuria (11.36% vs 3.72%, p = 0.008) compared with those not receiving AC/AG therapy. In the TURBT group, AC/AG use was associated with an elevated rate of rehospitalisation (p = 0.026). OP patients on AC/AG therapy experienced increased transfusion rates (p = 0.030), early postoperative clot retention (p = 0.034) and re-operations (p = 0.016). LMWH bridging was associated with further increases in irrigation volume, early clot retention and rehospitalisation, particularly in TURBT and OP patients.
CONCLUSIONS: AC/AG therapy significantly influences bleeding outcomes after TURP, TURBT and OP. LMWH bridging may further exacerbate these risks. This study emphasises the need for caution regarding bleeding-related complications in patients receiving AC/AG therapy.
METHODS: Patients who underwent TURP, TURBT or OP between March 2022 and January 2023 were included in this study. Patients were stratified according to AC/AG usage. Perioperative management details, including low-molecular-weight heparin (LMWH) bridging, were recorded. We evaluated parameters including duration of irrigation, length of stay, episodes of clot retention, transfusion rate and re-admission rate due to haematuria.
RESULTS: Among TURP patients, those using AC/AG therapy had significantly higher rates of transfusion (2.27% vs 0%, p = 0.038), postoperative clot retention (7.57% vs 0.53%, p = 0.008), re-catheterisation (9.09% vs 3.72%, p = 0.046) and re-admission due to haematuria (11.36% vs 3.72%, p = 0.008) compared with those not receiving AC/AG therapy. In the TURBT group, AC/AG use was associated with an elevated rate of rehospitalisation (p = 0.026). OP patients on AC/AG therapy experienced increased transfusion rates (p = 0.030), early postoperative clot retention (p = 0.034) and re-operations (p = 0.016). LMWH bridging was associated with further increases in irrigation volume, early clot retention and rehospitalisation, particularly in TURBT and OP patients.
CONCLUSIONS: AC/AG therapy significantly influences bleeding outcomes after TURP, TURBT and OP. LMWH bridging may further exacerbate these risks. This study emphasises the need for caution regarding bleeding-related complications in patients receiving AC/AG therapy.