141 Continuation of Antiplatelet and/or Anticoagulation in Patients Undergoing Rezūm Prostate Ablation

Abstract

Rezūm is a minimally invasive technique to treat benign prostatic hyperplasia (BPH). Major advantages include no de novo erectile dysfunction and a low rate of retrograde ejaculation. Discontinuation of peri-operative antiplatelet and/or anticoagulation (APAC) is often preferred in practice to avoid bleeding complications. The objective of this study is to present our experience using Rezūm in patients continuing APAC in the perioperative setting. We retrospectively reviewed 179 patients that underwent Rezūm therapy at our institution since 7/2017. When deemed medically necessary, APAC was continued in the perioperative setting. Post-procedure catheterization regimen included a minimum of 3 days and a maximum of 4 weeks in men with preoperative catheter dependence. Outcomes included pre- and post-operative AUA symptoms score, peak flow, and postvoid residual. Bleeding-related complications and urinary tract infection rate were recorded. Fifty five patients were treated on APAC. Outcomes are reported in the Table. Briefly, the average prostate gland size was 81 grams. Significant improvements were seen in AUA symptom score, peak flow, and post void residual. Bleeding complications requiring intervention occurred in 5 (10.4%) patients, with all 5 undergoing catheter irrigation, 2 undergoing blood transfusion, and 1 undergoing cystoscopic clot evacuation. Of the five, 2 were on aspirin, 1 on apixaban, 1 on rivaraxoban, and 1 on dabigatran. Interestingly, 9/92 (9.8%) patients who were not on APAC had hematuria requiring intervention (9 catheter irrigation, 0 transfusion, and 2 cystoscopic clot evacuation).