Related Experiment Video
Updated: May 17, 2026
09:17
In Vivo Luminal Measurement of Distension-Evoked Urothelial ATP Release in Rodents
Published on: September 7, 2022
Bladder outlet procedures in the setting of anticoagulation therapy
1Department of Urology, New York University School of Medicine, NYU Langone Medical Center, New York, New York, USA.
Current Opinion in Urology
|October 26, 2012
Summary
Men on chronic anticoagulation undergoing BPH procedures face increased bleeding risks. Bipolar and laser prostate procedures may offer better hemostasis, but further study is needed.
Area of Science:
- Urology
- Cardiology
- Geriatrics
Background:
- Benign prostatic hyperplasia (BPH) is common in older men.
- Chronic anticoagulation and antiplatelet therapies are frequently used for cardiovascular and cerebrovascular disease prevention.
- Managing BPH in patients on antithrombotic therapy presents unique challenges regarding surgical safety.
Purpose of the Study:
- To evaluate the safety and bleeding risks associated with bladder outlet procedures for BPH in men receiving chronic oral anticoagulation and antiplatelet therapies.
- To compare hemostatic outcomes of different surgical techniques in this patient population.
Main Methods:
- Review of recent series and studies assessing outcomes of BPH procedures in patients on anticoagulation.
- Analysis of hemorrhagic, cardiovascular, and cerebrovascular complications.
- Comparison of outcomes between monopolar transurethral resection of the prostate (TURP) and newer techniques like bipolar vaporization, laser vaporization, and enucleation.
Main Results:
- Conflicting findings exist, but recent data indicate an increased risk of bleeding complications in patients on chronic anticoagulation undergoing BPH procedures.
- Withdrawal of antithrombotic therapy perioperatively increases cardiovascular and cerebrovascular risks.
- Bipolar electrosurgical vaporization, laser vaporization, and enucleation of the prostate appear to offer superior hemostasis compared to monopolar TURP.
Conclusions:
- Patients on chronic anticoagulation require heightened caution during surgical procedures due to elevated bleeding and thromboembolic risks.
- Photoselective vaporization, Holmium laser enucleation, and bipolar vaporization may reduce bleeding complications in men with BPH undergoing bladder outlet procedures.
- Prospective randomized trials are necessary to definitively determine the optimal surgical methods for managing BPH in patients on antithrombotic therapy, especially when discontinuation is not feasible.
Related Concept Videos
01:29Venous Thrombosis III: Interprofessional Care
Venous thrombosis requires effective prevention and treatment strategies to improve patient outcomes and reduce potential complications.Prevention StrategiesHealthcare providers must prioritize preventing venous thromboembolism (VTE) for all adult patients upon admission. Interventions depend on bleeding and thrombosis risk, medical history, current medications, diagnoses, planned procedures, and patient preferences. Patients on bed rest should change positions every two hours and, if not...
01:26Cardiac Catheterization IV: Nursing Management
Nursing responsibilities before cardiac catheterization include:Assess for allergies and establish baseline health status.Before cardiac catheterization, assess the patient for allergies to contrast dye. Perform a comprehensive baseline assessment, including vital signs, heart and breath sounds, and a neurovascular assessment of the extremities, noting distal pulses, skin color, and temperature. Instruct the patient to fast for 8-12 hours before the procedure. Evaluate baseline laboratory...
01:22Imaging Studies VI: Voiding Cystourethrography and Cystography
Voiding Cystourethrography (VCUG) and Cystography are specialized radiographic procedures used to examine the structure and function of the bladder and urethra.Voiding Cystourethrography (VCUG)A Voiding Cystourethrogram (VCUG) is a diagnostic imaging procedure that assesses the anatomy and function of the lower urinary tract. It focuses on the bladder, bladder neck, and urethra, helping detect abnormalities such as vesicoureteral reflux (VUR)—the backward or reverse flow of urine into the...
01:22Imaging Studies V: Intravenous Urography and Retrograde Pyelography
IntroductionIntravenous Urography (IVU) and Retrograde Pyelography (RP) are important diagnostic imaging techniques used to evaluate the urinary system. These methods help identify structural abnormalities, obstructions, and functional issues in the kidneys, ureters, and bladder. Both procedures use iodine-based contrast media to enhance the visibility of urinary tract structures on X-ray images, though they differ in their methods and indications.1. Intravenous Urography (IVU)Intravenous...
01:19Imaging Studies VII: Vascular Imaging
DefinitionRenal angiography, also known as renal arteriography, is an imaging technique used to obtain a comprehensive view of blood flow and the vascular structure of blood vessels in the kidneys and surrounding areas.PurposeRenal angiography detects blood vessel abnormalities in the kidneys, such as aneurysms, stenosis, thrombosis, vascular tumors, and renal artery stenosis. It evaluates kidney function and guides interventional treatments like angioplasty or stent placement.Pre-Procedure...
01:30Venous Thrombosis IV: Nursing Management
Nursing management begins with a thorough assessment of the patient's health history. Key factors include trauma to veins, peripherally inserted central catheters, varicose veins, recent pregnancy or childbirth, surgery, bacteremia, prolonged bed rest, atrial fibrillation, COPD, heart failure, cancer, coagulation disorders, myocardial infarction, spinal cord injury, stroke, prolonged travel, recent bone fractures, and dehydration. Review medication intake, particularly oral contraceptives,...