- Purpose: We evaluated efficacy and safety profile of patients with anticoagulation therapy (AT) undergoing holmium laser enucleation of the prostate (HoLEP).
Methods: Within our prospective institutional database (11/2017 to 11/2019), we analyzed functional outcomes and 30-day complication rates of HoLEP patients according to Clavien–Dindo classification (CLD), stratified according to specific AT vs. no AT. Further analyses consisted of uni- and multivariate logistic regression models (LRM) predicting complications.
Results: Of 268 patients undergoing HoLEP, 104 (38.8%) received AT: 25.7% were treated with platelet aggregation inhibitors (PAI), 8.2% with new oral anticoagulants (NOAC) and 4.9% with AT-combinations or coumarins bridged with low molecular weight heparins (LMWH/combination). Patients receiving AT were significantly more comorbid (p < 0.01). Pre- and postoperative maximal flow rates, residual void urine and IPSS at 3 months after surgery were invariably improved after HoLEP for patients with/ without AT. Overall complication rate was 19.5% in patients with no AT vs. 26.1% vs. 27.3 vs. 46.2%, respectively, in patients with PAI, NOAC and LMWH/combination (p < 0.01). Major complications (CLD ≥ 3b) occurred in 6.1% of no AT patients vs. 4.3% vs. 4.5 vs. 0% in patients with PAI, NOAC and LMWH/combination, respectively (p < 0.01). In multivariate LRM, AT was not significantly associated with higher complication rates, whereas high ASA status (OR 2.2, p = 0.04), age (OR 1.04, p = 0.02) and bioptical or incidental prostate cancer (OR 2.5, p = 0.01) represented independent risk factors.
Conclusion: Despite higher overall complication rates in AT patients, major complications were not more frequent in AT patients. HoLEP is safe and effective in anticoagulated patients.
MetadatenAuthor: | Marina DeukerORCiDGND, Jessica RührupGND, Pierre I. Karakiewicz, Maria-Noemi WelteGND, Luis KluthORCiDGND, Séverine BanekGND, Frederik RoosGND, Philipp MandelORCiDGND, Felix ChunORCiDGND, Andreas BeckerGND |
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URN: | urn:nbn:de:hebis:30:3-692235 |
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DOI: | https://doi.org/10.1007/s00345-020-03272-2 |
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ISSN: | 1433-8726 |
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Parent Title (English): | World journal of urology |
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Publisher: | Springer |
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Place of publication: | Berlin ; Heidelberg |
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Document Type: | Article |
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Language: | English |
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Date of Publication (online): | 2020/06/02 |
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Date of first Publication: | 2020/06/02 |
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Publishing Institution: | Universitätsbibliothek Johann Christian Senckenberg |
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Release Date: | 2022/12/12 |
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Tag: | Anticoagulation; Bleeding; Clavien–Dindo classification; Complications; HoLEP; Transfusion |
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Volume: | 39 |
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Issue: | 4 |
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Page Number: | 8 |
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First Page: | 1219 |
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Last Page: | 1226 |
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Note: | Open Access funding provided by Projekt DEAL. |
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Note: | Institut: Medizin |
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HeBIS-PPN: | 507188144 |
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Institutes: | Medizin |
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Dewey Decimal Classification: | 6 Technik, Medizin, angewandte Wissenschaften / 61 Medizin und Gesundheit / 610 Medizin und Gesundheit |
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Sammlungen: | Universitätspublikationen |
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Licence (German): | Creative Commons - Namensnennung 4.0 |
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