Thulium laser vaporesection of the prostate: Can we operate without interrupting oral antiplatelet/anticoagulant therapy?
Purpose: Thulium vaporesection of the prostate (ThuVARP) is a new and safe approach for patients receiving anticoagulant therapy in whom transurethral resection of the prostate (TURP) may possess a high bleeding risk. We aimed to demonstrate the efficacy and safety of ThuVARP in patients receiving...
Main Authors: | , , , , , , , |
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Format: | Article |
Language: | English |
Published: |
Korean Urological Association
2017-05-01
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Series: | Investigative and Clinical Urology |
Subjects: | |
Online Access: | https://www.icurology.org/Synapse/Data/PDFData/2020ICU/icu-58-192.pdf |
Summary: | Purpose: Thulium vaporesection of the prostate (ThuVARP) is a new and safe approach for patients receiving anticoagulant therapy
in whom transurethral resection of the prostate (TURP) may possess a high bleeding risk. We aimed to demonstrate the efficacy
and safety of ThuVARP in patients receiving oral antiplatelet/anticoagulant (OAP/OAC) therapy.
Materials and Methods: A total of 103 patients who underwent ThuVARP between 2011 and 2013 were enrolled in the study. Patients
were divided into 2 groups. Group A consisted of 47 patients who underwent low molecular weight heparin (LMWH) bridging
and group B consisted of 56 patients who were operated on while receiving OAP/OAC therapy.
Results: The drop in hemoglobin levels in the pre- and postoperative periods was significantly higher in group A than in group B.
When subgroups were analyzed, the mean drop in hemoglobin was significantly lower in the warfarin and ticlopidine subgroups
of group B than in group A. International Prostate Symptom Scores were significantly lower 3, 12, 18, and 24 months after surgery
in group A than in group B. Quality of life scores, maximal flow rate values, and postmicturition residual urine volumes (mL) were
similar between the 2 groups. A total of 38 and 41 patients in groups A and B, respectively, had no complications.
Conclusions: Our study showed the safety profile of continuing different OAP/OAC therapies in terms of bleeding problems in patients
undergoing ThuVARP. We strongly recommend abandoning LMWH bridging and maintaining the OAP/OAC regimen patients
are already receiving. |
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ISSN: | 2466-0493 2466-054X |