2 BPH surgical options are safe for patients at high bleeding risk

  • Boeri L & al.
  • Eur Urol Focus
  • 11 Mar 2019

  • International Clinical Digest
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Takeaway

  • Both holmium laser enucleation of the prostate (HoLEP) and bipolar transurethral enucleation of the prostate (B-TUEP) are safe, minimally invasive surgical options for treating benign prostatic hyperplasia (BPH) in patients at high risk of bleeding because of anticoagulation (AC) or antiplatelet (AP) therapy.

Why this matters

  • A significant number of patients who require surgery for BPH are receiving either AC or AP therapy.

Study design

  • Researchers analyzed the health records of patients who underwent HoLEP and B-TUEP and were receiving AC or AP therapy or neither therapy (N=438; 100% white; HoLEP, 67.6%; B-TUEP, 32.4%).
  • Funding: None.

Key results

  • Patients in the HoLEP group with either AC or AP therapy required longer catheter maintenance and hospital stays (all P≤.01).
  • Patients in the B-TUEP group with either AC or AP therapy had longer hospital stays (P=.03) and more complications (P=.001).
  • Operative times and rates of postoperative complications were similar regardless of AC or AP therapy.
  • Postoperative hemoglobin drop and 2-month International Prostate Symptoms Scores were similar regardless of therapy or surgical technique.

Limitations

  • The study was retrospective and did not assess complications or functional outcomes >60 days after surgery.

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