Thrombotic risk factors associated with transurethral prostatectomy
C R Bell1, P J Murdock, K J Pasi
1Department of Urology, The Katherine Dormandy Haemophilia Centre, London, UK.
BJU International
|June 15, 1999
Summary
Transurethral prostatectomy (TURP) can lead to a hypercoagulable, prothrombotic state. Aspirin withdrawal may increase risk, suggesting consideration of heparin prophylaxis for venous thrombosis prevention.
Area of Science:
- Urology
- Thrombosis Research
- Surgical Risk Assessment
Background:
- Transurethral prostatectomy (TURP) is a common surgical procedure.
- Understanding the thrombotic risk associated with TURP is crucial for patient safety.
Purpose of the Study:
- To investigate the potential thrombotic risk following transurethral prostatectomy (TURP).
Main Methods:
- A prospective study involving 40 patients undergoing TURP.
- Assessment of coagulation variables, including thrombin-antithrombin complexes, activated partial thromboplastin time, d-dimer, tissue plasminogen activator antigen, and plasminogen activator inhibitor-1.
Main Results:
- Significant increase in thrombin-antithrombin complexes and decrease in activated partial thromboplastin time post-TURP, indicating a hypercoagulable state.
- Elevated d-dimer levels suggest a physiological fibrinolytic response.
- Absence of significant changes in tissue plasminogen activator and plasminogen activator inhibitor-1 suggests the hypercoagulability is not due to 'fibrinolytic shutdown'.
Conclusions:
- Transurethral prostatectomy (TURP) is associated with a hypercoagulable, prothrombotic state.
- Perioperative aspirin withdrawal may pose a hazard.
- Consideration of low-dose heparin prophylaxis for venous thrombosis is recommended.
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