1966 BIPOLAR TRANSURETHRAL RESECTION OF THE PROSTATE UNDER CONTINUOUS ORAL ANTICOAGULATION OR THROMBOCYT ANTIAGGREGATION THERAPY COMPARED TO A SERIES OF PATIENTS WITHOUT ORAL ANTICOAGULATION OR THROMBOCYT ANTIAGGREGATION THERAPY

Abstract

INTRODUCTION AND OBJECTIVES: More and more patients are under anticoagulation (OAC) or thrombocyt antiaggregation therapy (TAT) and the perioperative substitution of OAC/TAT carries risks. We therefore evaluated bleeding complications as well as functional outcome in patients undergoing bipolar TURP with ongoing OAC/TAT and compared these data to a series of patients without OAC/TAT. METHODS: 93 patients on OAC or TAT with BPH and 70 patients without OAC/TAT with BPH were treated by bipolar TUR-P. Exclusion criteria were patients with prostate cancer. The following parameters were assessed: Preand perioperative blood samples were used to assess perioperative blood loss and TUR syndrome. IPSS/IPSL, uroflow, residual urine were assessed preoperatively, 3 and 12 months postoperatively. Furthermore length of surgery, indwelling catheter and hospital stay, postoperative bleeding necessary to be evacuated by catheter or in anaesthesia, rate of bladder neck sclerosis or urethral stricture were analysed. Regular follow-up controls took place at 3 and 12 months postoperatively RESULTS: Cf Table. 3 month postoperative IPSS, IPSL, uroflow and residual urine improved in both groups significantly (p 0.001) compared to preoperatively and were stable in the 12 month follow up. There was no significant difference between the bipolar groups with or without OAC/TAT in improvement of IPSS (16 versus -15 points;p 0.18) IPSL score (4 versus -5 points; p 0.13) Qmax (10,3 versus 17,5 ml/s ; p 0.35) and residual urine (-143 versus -180ml; p 0.22) at 3 months of follow-up. CONCLUSIONS: Patients with ongoing OAC or TAT can undergo TUR-P in bipolar technique without any major risk. They have a slightly longer hospitalisation time and a trend to have more postoperative clot retention. However these data do not justify stopping OAC or TAT, which means a certain risk for the patient.