Thrombotic risk factors associated with transurethral prostatectomy

Abstract

TURP is associated with a hypercoagulable prothrombotic state; aspirin withdrawal perioperatively may be hazardous, and low-dose heparin prophylaxis for venous thrombosis should be considered.

High Power (80 W) Potassium-Titanyl-Phosphate Laser Vaporization of the Prostate in 66 High Risk Patients

“…Although prospective studies are scarce and the hazards of altering chronic anticoagulation for surgery are vastly underestimated, simple withdrawal of anticoagulants without any substitution has been demonstrated to pose a definite thromboembolic risk to the patient, particularly in elderly men with prostatic surgery due to the release of tissue thromboplastins. [12][13][14] The opposite approach of performing prostatectomy while on continuing anticoagulation with coumarin derivatives has been described for several techniques. Albeit in a small study population, conventional TURP failed to provide acceptable safety in these patients since there was a blood transfusion rate of more than 30%.…”

Holmium Laser Enucleation of the Prostate: Comparison of Immediate Postoperative Outcomes in Patients with and without Antithrombotic Therapy

“…This is particularly so in high-risk patients such as those with drug-eluting coronary stents, mechanical cardiac valves, recent pulmonary embolism or atrial fibrillation with prior cerebral ischemia. In addition, TURP is also associated with a hypercoagulable state postoperatively, therefore, further increasing the risk of thrombosis in these patients [9]. Currently, treating these high-risk patients with symptomatic BPH refractory to medical therapy remains a great challenge to the urological surgeon.…”

Venous Thromboembolic Prophylaxis for Transurethral Prostatectomy: Practice among British Urologists

“…Transurethral prostatectomy is associated with a perioperative hypercoagulable state 3 and is classi®ed as being of Although some epidemiological data suggest that the incidence of VTE in men after this operation 2 is comparable to that in the general population 5,6 , the recorded ®gures may be misleadingly low: whereas most patients stay in hospital for 5 days 2 , the usual time for postoperative VTE is 7±10 days. Some thromboembolic events may thus go unrecognized or come to the attention of another specialty.…”