MP23-11 DO NO HARM: THE ROLE OF PERIOPERATIVE HEPARIN IN ANTERIOR URETHROPLASTY

Abstract

You have accessJournal of UrologyHealth Services Research: Practice Patterns, Quality of Life and Shared Decision Making III (MP23)1 Sep 2021MP23-11 DO NO HARM: THE ROLE OF PERIOPERATIVE HEPARIN IN ANTERIOR URETHROPLASTY Harry Lee, Nathan Shaw, Erin Hays, and Krishnan Venkatesan Harry LeeHarry Lee More articles by this author , Nathan ShawNathan Shaw More articles by this author , Erin HaysErin Hays More articles by this author , and Krishnan VenkatesanKrishnan Venkatesan More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002014.11AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Venous thromboembolism (VTE) is a perioperative complication with significant morbidity. Routine use of peri-operative VTE prophylaxis is common guideline-driven practice across multiple surgical specialties. There is a discrepancy between guideline recommendations and clinical practice in the administration of peri-operative heparin for anterior urethroplasty. The purpose of this study was to examine the necessity of peri-operative heparin in patients undergoing anterior urethroplasty. METHODS: Patients were identified from an IRB-approved, prospectively maintained database of patients undergoing anterior urethral reconstruction by a single surgeon at MedStar Washington Hospital Center (MWHC) from 2012-2020. All patients had sequential compression devices (SCDs) prior to anesthesia induction. Patients received heparin based on hospital policy as dual prophylaxis. Primary endpoint was perioperative VTE within 30 days with secondary outcomes of peri-operative complications and stricture recurrence. RESULTS: We identified 342 patients who met inclusion criteria. 68 patients received peri-operative heparin. One patient had a DVT in the SCD only group. There were statistically significant increases in hospital length of stay, stricture recurrence, and post-operative complications in the group that received heparin. CONCLUSIONS: Routine heparin administration likely overtreats men undergoing anterior urethroplasty. There may be a subset of men in whom dual prophylaxis with heparin and SCD is beneficial for prevention of VTE. Currently guidelines do not offer adequate criteria to identify these men. We offer an algorithm to help guide further study to identify these patients. Source of Funding: None © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e405-e406 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Harry Lee More articles by this author Nathan Shaw More articles by this author Erin Hays More articles by this author Krishnan Venkatesan More articles by this author Expand All Advertisement Loading ...