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Safety of carbon bead injection for incontinence in patients taking warfarin
1Scott Department of Urology, Baylor College of Medicine, Houston, Texas 77030, USA.
Insights
Periurethral carbon bead injections using Durasphere can be safely administered to patients on warfarin anticoagulation. While minor complications like hematoma can occur, most patients tolerate the procedure without adverse events.
Area of Science:
- Urology
- Medical Device Safety
Background:
- Urinary incontinence affects many women, with intrinsic sphincteric deficiency being a common cause.
- Durasphere, a carbon-bead implant, is used for treating urinary incontinence.
- Warfarin is a common anticoagulant requiring careful management during procedures.
Purpose of the Study:
- To evaluate the safety and feasibility of Durasphere injections in patients on warfarin therapy.
- To assess the risk of complications in patients receiving anticoagulation during periurethral injections.
Main Methods:
- A case series of 20 patients with urinary incontinence undergoing periurethral carbon bead injections.
- All procedures were performed under local anesthesia while patients were on therapeutic warfarin doses.
- Complications related to anticoagulation were monitored and recorded.
Main Results:
- 36 injections were performed in 20 patients receiving therapeutic warfarin.
- Two complications occurred: a minor periurethral hematoma and a more severe case of urinary retention with intravesical hemorrhage.
- Most procedures were completed without significant bleeding or anticoagulation-related issues.
Conclusions:
- Periurethral carbon bead injections can be safely performed in most patients receiving therapeutic warfarin.
- Careful patient selection and monitoring are essential.
- Reversal of anticoagulation is generally not required for this procedure.
Objectives:
To determine the safety of the use of Durasphere in patients receiving warfarin anticoagulation.
Methods:
This case series included patients requiring long-term anticoagulation who also had intrinsic sphincteric deficiency or mixed urinary incontinence, and bladder outlets without hypermobility. All patients, with the exception of the 1 man in the study, were treated under local anesthesia with periurethral carbon bead injections, while receiving therapeutic doses of warfarin.
Results:
Between 1999 and 2004, 20 such patients received carbon bead injections, on 36 different occasions, during therapeutic warfarin administration. Two complications related to the anticoagulation were encountered, one minor complication of a small periurethral hematoma and the other more severe, with a patient developing urinary retention and intravesical hemorrhage.
Conclusions:
In most cases, the injection of carbon beads under local anesthesia in patients receiving therapeutic warfarin anticoagulation can be safely performed without reversal of the anticoagulation.
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