MP13-15 DO ANTIPLATELET AND ANTICOAGULANT INCREASE RISK OF HAEMORRHAGIC COMPLICATIONS IN PHOTOVAPORIZATION OF PROSTATE BY GREENLIGHT® LASER

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You have accessJournal of UrologyBenign Prostatic Hyperplasia: Surgical Therapy & New Technology III1 Apr 2015MP13-15 DO ANTIPLATELET AND ANTICOAGULANT INCREASE RISK OF HAEMORRHAGIC COMPLICATIONS IN PHOTOVAPORIZATION OF PROSTATE BY GREENLIGHT® LASER Pradère Benjamin, Peyronnet Benoit, Brichart Nicolas, and Bruyère Franck Pradère BenjaminPradère Benjamin More articles by this author , Peyronnet BenoitPeyronnet Benoit More articles by this author , Brichart NicolasBrichart Nicolas More articles by this author , and Bruyère FranckBruyère Franck More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2015.02.355AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Photoselective vaporization of prostate (PVP) is an alternative to transurethral resection of the prostate (TURP) particularly in patients with high risk of bleeding. The objective was to assess whether anticoagulants or antiplatelet intake in patients treated by PVP was associated with an increased risk of complications and to find risk factors for bleeding complications. METHODS All patients treated for benign prostate hyperplasia by PVP between November 2005 and January 2014 were included in a prospective study. According to the risk associated with the cessation of anticoagulant or antiplatelet for each patient, these treatments were stopped 5 days before surgery or continued. The frequency of haemorrhagic complications per and postoperative (bleeding requiring conversion to TURP, transfusion, clot removal, prolonged hematuria) in each group was compared by the Chi-2 test. Risk factors for bleeding complications per and postoperative were investigated by multivariate binary logistic regression. RESULTS Of 446 patients, 370 treated with PVP were analyzed, 17 (4.6%) had warfarin, 108 (29.2%) had aspirin and 16 (4.3%) clopidogrel. There were 39 hemorrhagic complications (10.5%). In univariate analysis, no significant differences were found on the incidence of bleeding complications between the groups anticoagulants continued, anticoagulants stopped and no anticoagulants (17.6% vs 10.5% vs 9.8%, p= 0.49); the results were similar with antiplatelet agents, respectively (14.8% vs 6.5% vs 9.1%, p = 0.21) for aspirin and (6.3% vs 14.8% vs 10%, p= 0.48) for clopidogrel. The use of anticoagulants or antiplatelet agents was not a factor in bleeding risk in multivariate analysis, the only risk factor was the low energy applied in joules/grams of prostate (OR= 0.95, IC95= [0.91 -0.98], p= 0.004). Four vascular complications occurred: three acute coronary syndromes including two patients for whom aspirin was stopped, and one phlebitis in a patient for whom a relay warfarin to low molecule weight heparin was performed. CONCLUSIONS The pursuit of anticoagulants or antiplatelet agents do not appear to increase the risk of bleeding complications in PVP. Their stopping for the intervention increases the risk of serious vascular accidents. We must therefore continue to perform these treatments during PVP procedure. © 2015 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 193Issue 4SApril 2015Page: e142 Advertisement Copyright & Permissions© 2015 by American Urological Association Education and Research, Inc.MetricsAuthor Information Pradère Benjamin More articles by this author Peyronnet Benoit More articles by this author Brichart Nicolas More articles by this author Bruyère Franck More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...