Christopher Netsch1,2, Christina Moritz3, Andreas J Gross3,4. 1. Asklepios Klinik Barmbek, Abteilung für Urologie, Rübenkamp 220, 22291, Hamburg, Deutschland. c.netsch@asklepios.com. 2. Arbeitskreis Endourologie, Akademie der Deutschen Urologen, Düsseldorf, Deutschland. c.netsch@asklepios.com. 3. Asklepios Klinik Barmbek, Abteilung für Urologie, Rübenkamp 220, 22291, Hamburg, Deutschland. 4. Arbeitskreis Endourologie, Akademie der Deutschen Urologen, Düsseldorf, Deutschland.
Abstract
BACKROUND: Only few studies have assessed the safety and efficacy of transurethral surgery (TS) for the treatment of benign prostatic obstruction (BPO) in patients on oral anticoagulants. The aim of our study was to evaluate current treatment strategies and complication rates of TS for the treatment of BPO in patients on OA using an online survey. MATERIALS AND METHODS: A total of 300 German departments of urology received an e‑mail with a link for the online survey. The items of the questionnaire assessed the present practice of TS for BPO in patients on OA and the occurrence of complications. RESULTS: Seventy-five (23.4 %) departments responded to the online questionnaire. Of the respondents, 94.7 % performed TS in patients with BPO on OA and 42.7 % answered that they perform more than 30 prostate surgeries per year under OA. The respondents indicated that surgeries were carried out under aspirin (96 %), clopidogrel (46.7 %) or phenprocoumon (26.7 %). Indications for surgeries under OA were made by cardiologist recommendation (82.7 %), the surgeon (37.3 %), a need for emergency surgery (52 %), or the patient's will (10.7 %). Sixty-two (82.7 %) of the respondents perform bipolar or monopolar transurethral resection of the prostate (TUR-P) in patients on OA. In addition, 69.3 % of the respondents indicated that they use laser prostatectomy in patients on OA (thulium 24 %, Greenlight 24 %, holmium 16 %, and diode laser 5.3 %). Cardiovascular complications occurred in 12 % of the respondents. CONCLUSIONS: Despite the poor evidence for performing TS of BPO under OA, our survey showed surprising results: TS of BPO under OA is frequently performed, especially bipolar and monopolar TUR-P. Although our data were obtained using an online survey, the complication rates appear to be lower than previously thought.
BACKROUND: Only few studies have assessed the safety and efficacy of transurethral surgery (TS) for the treatment of benign prostatic obstruction (BPO) in patients on oral anticoagulants. The aim of our study was to evaluate current treatment strategies and complication rates of TS for the treatment of BPO in patients on OA using an online survey. MATERIALS AND METHODS: A total of 300 German departments of urology received an e‑mail with a link for the online survey. The items of the questionnaire assessed the present practice of TS for BPO in patients on OA and the occurrence of complications. RESULTS: Seventy-five (23.4 %) departments responded to the online questionnaire. Of the respondents, 94.7 % performed TS in patients with BPO on OA and 42.7 % answered that they perform more than 30 prostate surgeries per year under OA. The respondents indicated that surgeries were carried out under aspirin (96 %), clopidogrel (46.7 %) or phenprocoumon (26.7 %). Indications for surgeries under OA were made by cardiologist recommendation (82.7 %), the surgeon (37.3 %), a need for emergency surgery (52 %), or the patient's will (10.7 %). Sixty-two (82.7 %) of the respondents perform bipolar or monopolar transurethral resection of the prostate (TUR-P) in patients on OA. In addition, 69.3 % of the respondents indicated that they use laser prostatectomy in patients on OA (thulium 24 %, Greenlight 24 %, holmium 16 %, and diode laser 5.3 %). Cardiovascular complications occurred in 12 % of the respondents. CONCLUSIONS: Despite the poor evidence for performing TS of BPO under OA, our survey showed surprising results: TS of BPO under OA is frequently performed, especially bipolar and monopolar TUR-P. Although our data were obtained using an online survey, the complication rates appear to be lower than previously thought.
Authors: Thorsten Bach; Rolf Muschter; Roland Sroka; Stavros Gravas; Andreas Skolarikos; Thomas R W Herrmann; Thomas Bayer; Thomas Knoll; Claude-Clément Abbou; Guenter Janetschek; Alexander Bachmann; Jens J Rassweiler Journal: Eur Urol Date: 2011-10-21 Impact factor: 20.096
Authors: James D Douketis; Alex C Spyropoulos; Frederick A Spencer; Michael Mayr; Amir K Jaffer; Mark H Eckman; Andrew S Dunn; Regina Kunz Journal: Chest Date: 2012-02 Impact factor: 9.410
Authors: Luciano Macchione; Giuseppe Mucciardi; Alessandro Gali'; Antonina Di Benedetto; Salvatore Butticè; Carlo Magno Journal: Int Urol Nephrol Date: 2013-07-27 Impact factor: 2.370
Authors: Aurélien Descazeaud; Gregoire Robert; Souhil Lebdai; Alain Bougault; Abdel Rahmene Azzousi; Olivier Haillot; Marian Devonec; Marc Fourmarier; Christian Saussine; Nicolas Barry-Delongchamps; Alexandre de la Taille Journal: World J Urol Date: 2010-06-25 Impact factor: 4.226
Authors: Zohar A Dotan; Yoram Mor; Ilan Leibovitch; David Varon; Jacob Golomb; Mordechai Duvdevani; Jacob Ramon Journal: J Urol Date: 2002-08 Impact factor: 7.450