Anticoagulant but not antiplatelet use is associated with haematuria complications after bladder outflow surgery

Author:

Hilbert Rebecca1ORCID,Bibby Lisa2,Boxall Nicholas3,Srinivasan Luxna4,Aho Tev5,Lamb Benjamin W5

Affiliation:

1. Department of Urology, Lister Hospital, UK

2. Department of Urology, Doncaster Royal Infirmary, UK

3. Department of Urology, Peterborough and Stamford Hospitals NHS Foundation Trust, UK

4. Department of Paediatrics, Whipps Cross University Hospital NHS Trust, UK

5. Department of Urology, Cambridge University Hospitals NHS Foundation Trust, UK

Abstract

Objective: The evidence on the safety of peri-procedural management of more novel antithrombotic medication in the context of a wider option of bladder outflow obstruction (BOO) procedures is limited. We aimed to assess the risk of delayed discharge or readmission (specifically due to haematuria) for all patients undergoing BOO surgery. Patients and methods: Prospective identification of all patients undergoing any type of BOO procedure at a single centre between April and December 2019 was performed. Clinical information was obtained from electronic patient records to scrutinise medications, procedure, delayed discharge and readmission within 30 days of surgery due to haematuria. Results: Two hundred forty patients were identified. In all, 78.6% (22/28) of patients on anticoagulants were on novel agents. The delayed discharge rate due to haematuria was 0.58% (1/171) in the no antithrombotic group and 7.14% (2/28) in the anticoagulant-only group. Increased age and perioperative anticoagulant therapy predicated delayed discharge. Readmissions due to haematuria were statistically significant with 1.16% (2/171) readmitted with no antithombotics, compared with 14.3% (4/28) of those on anticoagulants ( p ⩽ 0.01). Conclusion: Perioperative anticoagulant use is associated with an increased risk of readmission following BOO surgery. Further work is required to help stratify and lower risk, especially with evolving surgical and medical technologies. Level of evidence: 3b

Publisher

SAGE Publications

Subject

Urology,Surgery

Reference16 articles.

1. Impact of oral anticoagulation on morbidity of transurethral resection of the prostate

2. Transurethral Prostatectomy (TURP) for Benign Disease. Information about your procedure from The British Association of Urological Surgeons (BAUS), http://www.baus.org.uk/_userfiles/pages/files/Patients/Leaflets/TURP for benign.pdf (2021, accessed December 2021).

3. BAUS Bladder Outflow Obstruction (BOO) audit November 2019 – National summary results, https://www.baus.org.uk/_userfiles/pages//files/professionals/research//BAUS%20Bladder%20Outflow%20Obstruction%20National%20Report%20November%202020.pdf (accessed February 2022).

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