Laser treatment of benign prostatic hyperplasia in patients on oral anticoagulant therapy

Because the number of patients requiring oral anticoagulation (OA) is steadily growing, more and more patients requiring surgical treatment of benign prostatic hyperplasia (BPH) are on OA. Laser treatment of BPH was said to offer a higher quality of hemostasis than transurethral resection of the prostate (TURP). Thus, laser was considered an interesting tool for BPH surgery in patients on OA therapy. To date, no randomized studies focusing on laser treatment in patients on OA are available. Compared to TURP, laser seems to decrease the risk of hemorrhage in patients on OA. Therefore, the laser could be considered a useful tool for managing patients on OA, and could be proposed as a first-line therapy for those patients requiring surgery. Continuing platelet aggregation inhibitors during the procedure is feasible. A switch to low molecular weight heparine medication prior to surgery is preferable to the continued use of OA during TURP. No conclusion can be reached regarding the preferred laser technique to treat these patients.