Rare Complication after a Transrectal Ultrasound Guided Prostate Biopsy: A Giant Retroperitoneal Hematoma

Chiancone, Francesco; Mirone, Vincenzo; Fedelini, Maurizio; Meccariello, Clemente; Pucci, Luigi; Carrino, Maurizio; Fedelini, Paolo

doi:10.5301/uro.5000161

Cited by 2 publications

(3 citation statements)

References 9 publications

(11 reference statements)

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“…[25][26][27] The reported bleeding risk ranges from 0.1 to 10%, depending on needle size and target organ. [28][29][30][31] Risks of infection and/or peritonitis are <5%. 2…”

Section: Complicationsmentioning

confidence: 99%

Image-Guided Percutaneous Biopsy and Drainage of the Abdomen

Arellano

2018

Dig Dis Interv

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Image-guided percutaneous biopsy and abscess drainages are some of the most commonly performed procedures in interventional radiology. With advances in targeted immunotherapies for oncology patients, physicians increasingly depend on the experience and skill of the interventional radiologist to acquire tissue specimens from within the abdomen and pelvis. Furthermore, percutaneous drainage of abdominal and pelvic fluid collections has largely replaced the need for surgical interventions for infected abdominal collections. This review will discuss techniques of image-guided percutaneous abdominal biopsy and drainage.

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“…[25][26][27] The reported bleeding risk ranges from 0.1 to 10%, depending on needle size and target organ. [28][29][30][31] Risks of infection and/or peritonitis are <5%. 2…”

Section: Complicationsmentioning

confidence: 99%

Image-Guided Percutaneous Biopsy and Drainage of the Abdomen

Arellano

2018

Dig Dis Interv

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“…[10][11][12][13] A few cases of pelvic vessel puncture leading to giant retroperitoneal haematoma have also been reported. 14 The mechanism of action of NOACs is based on the inhibition of the transformation of fibrinogen to fibrin. This is achieved by direct inhibition of factor IIa (also called thrombin) for dabigatran, 1 or by direct inhibition of factor Xa for rivaroxaban, 15 edoxaban 16,17 and apixaban.…”

Section: Introductionmentioning

confidence: 99%

“…10–13 A few cases of pelvic vessel puncture leading to giant retroperitoneal haematoma have also been reported. 14…”

Section: Introductionmentioning

confidence: 99%

New oral anti-coagulation drugs and prostate biopsy: a call for guidelines

Coscarella

Motte

Dalati

et al. 2018

Therapeutic Advances in Urology

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Background:Prostate biopsy is a rather frequent procedure, mostly performed in outpatient settings. Bleeding complications following this procedure require precise and delicate management of pre-, peri- and post-procedure anti-coagulation treatments. New oral anti-coagulation drugs (NOACs) are increasingly used. However, the management of such treatments is feared and not yet well known to urologists. A protocol for prostate biopsy management of NOACs seems mandatory.Materials and methods:A review of the literature, using Pubmed and Cochrane databases, together with analysis of several medical associations’ recommendations in urology, anaesthesiology, cardiology, oncology and drug safety agency, was performed.Results:There are no recommendations about NOAC management for prostate biopsy available from scientific societies. There is also a lack of specific urological studies. However, several panels of expert recommendations could be helpful in establishing standardized protocols adapted from surgery to prostate biopsy. With the growing use of NOACs, recommendations have shifted to continue anti-coagulant treatment without bridging NOACs for low bleeding risk procedures such as prostate biopsy, in carefully selected groups of patients.Conclusion:Extensive indications coupled with the ease of use of NOACs contribute significantly to the widespread replacement of traditional vitamin K antagonist. Knowing that heparin bridging leads to more bleeding, and in the pursuit of more autonomy and safety, urologists should be able to propose dedicated anti-coagulant management using NOACs adapted to carefully selected patients before the prostate biopsy procedure. Further studies and guidelines specific to the concept of non-bridging for anti-coagulant-requiring patients are mandatory for this routine procedure.

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Rare Complication after a Transrectal Ultrasound Guided Prostate Biopsy: A Giant Retroperitoneal Hematoma

Cited by 2 publications

References 9 publications

Image-Guided Percutaneous Biopsy and Drainage of the Abdomen

Image-Guided Percutaneous Biopsy and Drainage of the Abdomen

New oral anti-coagulation drugs and prostate biopsy: a call for guidelines

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