Urological surgery in patients with hemorrhagic bleeding disorders Hemophilia A, Hemophilia B, von Willebrand disease: a retrospective study with matched pairs analysis

Abstract

Urological interventions in hemophiliac patients with factor supply have the same risk for postoperative complications as in non-hemophiliacs. The only significant difference between hemophiliacs and non-hemophiliacs was the length of hospital stay.

Management of severe perioperative bleeding

“…508 Despite higher perioperative bleeding complications in patients with IBDs, 509 postoperative outcomes similar to matched pairs without IBDs was also reported. 504,[510][511][512][513] During recent decades, total knee replacement has been the most common surgical intervention performed in adult patients with haemophilia. The medium and longterm results of primary TKA in 74 patients with haemophilia showed good prosthetic survival at 5 and 10 years, with an excellent relief of pain.…”

“…514 However, an analysis of a US database for postoperative complications up to 8 years after TKA in patients with haemophilia (n ¼ 3396) and VWD (n ¼ 1379), compared with a matched cohort of patients without bleeding disorders (n ¼ 427 132 and n ¼ 384 657, respectively), found significantly higher rates of infection, transfusion of blood products, medical complications and revision after TKA in patients with IBDs. 515 Outcomes in general and abdominal surgery, 516,517 pseudo-tumour 518,519 and cancer surgery, 520 urological interventions, 511 laparoscopic surgery, 504 cardiac interventions, [521][522][523] and colonoscopies 524 have also been reported. Different types of surgery are performed successfully in patients with inhibitors, too.…”

Perioperative management and outcome of fracture treatment in patients with haemophilia without inhibitors

“…According to similar studies in general surgery and urology, the severity of haemophilia had no influence on the length of hospital stay. This underlines the effectiveness of individual factor replacement therapy for PWH undergoing minor and major surgical procedures .…”

Perioperative management of haemophilia B: A critical appraisal of the evidence and current practices

“…Surgical procedures in patients with haemophilia can be conducted in general hospitals or expert HTCs, but the settings have not been formally compared for differences in outcomes . The expert panel believed that management of haemophilia treatment during surgery is best handled at HTCs (eg as in the United Kingdom); however, they acknowledged that surgical care of haemophilia patients is moving beyond the HTC to ambulatory and outpatient surgical settings.…”

“…The literature search revealed successful multidisciplinary collaboration among surgeons, haematologists and other healthcare team members as one of the key items for improving surgery outcomes in patients with haemophilia.The expert panel acknowledged that, in practice, decisions on the surgical haemostatic plan are often made by the haematologist prior to surgery, with recommendations made to the surgical team by other healthcare professionals (eg dentist) as needed. This is due in part to logistical limitations on convening a regular MDT meeting, particularly where there are multiple medical professionals involved.Surgical procedures in patients with haemophilia can be conducted in general hospitals or expert HTCs, but the settings have not been formally compared for differences in outcomes 20. The expert panel believed that management of haemophilia treatment during surgery is best handled at HTCs (eg as in the United Kingdom); however, they acknowledged that surgical care of haemophilia patients is moving beyond the HTC to ambulatory and outpatient surgical settings.Patient preference for surgical site has been emphasized in recent publications 21,22.…”