You have accessJournal of UrologyStone Disease: New Technology/SWL, Ureteroscopic or Percutaneous Stone Removal III1 Apr 20121833 UNINTERRUPTED ASPIRIN, WARFARIN, OR CLOPIDOGREL DURING URETEROSCOPY AND LASER LITHOTRIPSY DOES NOT INCREASE COMPLICATIONS DUE TO BLEEDING Nicholas Toepfer, Kelly Baylor, and Jennifer Simmons Nicholas ToepferNicholas Toepfer Danville, PA More articles by this author , Kelly BaylorKelly Baylor Danville, PA More articles by this author , and Jennifer SimmonsJennifer Simmons Danville, PA More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2012.02.1921AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Antithrombotic medications (ATMs) are sometimes discontinued prior to endoscopic treatment of urolithiaisis to decrease the risk of bleeding. Consequently, discontinuation of aspirin, warfarin and clopidogrel increases the risk of thromboembolic events in these comorbid patients. It is our practice to have patients remain on these medications perioperatively to decrease the risk of serious adverse events. We compared patients undergoing ureteroscopy with or without ATMs to determine if there was any difference in outcomes. METHODS We retrospectively reviewed the charts of patients at least 18 years of age who underwent ureteroscopy for urolithaisis from July 1, 2005 to October 1, 2010 by two surgeons at our institution. If patients continued aspirin, warfarin or clopidogrel within 48 hours of surgery they were considered to be on ATMs. Patients not on ATMs surgery made up the control group. A total of 646 cases met our criteria including 137 on aspirin, 24 on Coumadin, 17 on clopidogrel and 470 in the control group. RESULTS Patients on ATMs were older (63.1 years vs 46.9, p<0.001) and were more likely to have a history of pulmonary embolism, myocardial infarction (MI), limb ischemia, cerebral vascular accident (CVA), atrial fibrillation or deep vein thrombosis. There was no statistical difference in the number, total size or location of the stone, estimated blood loss, pre- or postoperative stent placement, ureteral access sheath use, ureteral dilatation or intraoperative complications. There was no difference in bleeding complications including need for blood transfusion, urinary clot retention or an unplanned repeat procedure for any of the 3 ATM groups. There was also no difference in postoperative fever, UTI, CVA, MI, death and emergency department or unplanned clinic visits. Patients on aspirin did have an increase in rehospitalization within 30 days of surgery (7.3% vs 2.7%, p<.014). CONCLUSIONS While patients on ATMs are significantly older and have multiple comorbidities, there is no increase in bleeding complications for patients who remain on aspirin, warfarin or clopidogrel during ureteroscopy and laser lithotripsy for urolithiasis and this protects them from serious thromboembolic events. © 2012 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 187Issue 4SApril 2012Page: e741 Advertisement Copyright & Permissions© 2012 by American Urological Association Education and Research, Inc.MetricsAuthor Information Nicholas Toepfer Danville, PA More articles by this author Kelly Baylor Danville, PA More articles by this author Jennifer Simmons Danville, PA More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...