Recent evidence for anatomic endoscopic enucleation of the prostate (AEEP) in patients with benign prostatic obstruction on antiplatelet or anticoagulant therapy

Netsch, Christopher; Herrmann, Thomas; Bozzini, Giorgio; Berti, Lorenzo; Gross, Andreas J.; Becker, Benedikt

doi:10.1007/s00345-021-03647-z

Cited by 6 publications

(1 citation statement)

References 57 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Tm:YAG laser seems to provide better haemostasis, lower overall morbidity, shorter catheterization time, and shorter hospital stay compared with TURP [4,5,11]. Haemostatic properties have also been shown in patients with an increased haemorrhage risk (anticoagulation/ antiplatelets therapy, bleeding disorders) [20,21]; however, the retrospective nature of many studies and the inclusion of prostate sizes only between 50 mL and 110 mL make it difficult to come to strong conclusions [22]. Some studies have investigated factors potentially linked to postoperative bleeding, showing a higher rate in patients with larger prostate size [17], and those on anticoagulation [23] or who underwent multiple manual irrigations shortly after operation [24].…”

Section: Discussionmentioning

confidence: 99%

Prognostic Factors Predicting Bleeding After Discharge Requiring Readmission After Thulium Laser Enucleation of the Prostate (ThuLEP)

Perri,

Pacchetti,

Morini

et al. 2023

Soc Int Urol J

View full text Add to dashboard Cite

ObjectivesPostoperative haematuria is a feared complication following prostate enucleation, and it may occur even weeks after discharge. We evaluated the risk of bleeding after discharge and its predictive factors in patients who underwent Thulium laser enucleation of the prostate (ThuLEP).MethodsBetween January 2015 and December 2018, patients with surgical indication for benign prostatic hyperplasia underwent ThuLEP in 4 urology departments. All procedures were performed by experienced urologists. Postoperative haematuria was defined as macroscopic haematuria occurring 7 days after discharge. Readmission rate due to macroscopic haematuria was assessed. Logistic regression models tested for predictors of postoperative bleeding requiring readmission.ResultsOverall, 748 patients were included, and 52 (6.9%) of them were readmitted after discharge because of macroscopic haematuria. No cases of deep venous thrombosis or pulmonary embolism were diagnosed. Mean length of stay for surgical treatment was 2.1 days, and mean hospitalization for readmission was 5.6 days. None of the readmitted patients required reintervention, while 46.1% of them required blood transfusions. Diabetes mellitus (P < 0.05), a long bridge of oral anticoagulant drugs with low molecular weight heparin (LMWH) (P < 0.05) and history of constipation (P < 0.05) were significant predictors of readmission after discharge due to macroscopic haematuria.ConclusionsPatients with a clinical history of diabetes mellitus or constipation and patients who undergo a long bridge of oral anticoagulant therapy with LMWH are at higher risk of bleeding requiring readmission after ThuLEP.

show abstract