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Updated: Jan 19, 2026
Vessel-sparing Excision and Primary Anastomosis
Published on: January 7, 2019
[Rate of thrombosis and bleeding after urological surgery under standardized anticoagulation]
S K Morische1, M W Kramer1, A S Merseburger1
1Klinik für Urologie, UKSH, Campus Lübeck, Ratzeburger Allee 160, 23538, Lübeck, Deutschland.
Insights
Urological surgery patients face a low risk of postoperative thromboembolism (0.8%) but a significant risk of bleeding (20.3%). This study analyzes complications to inform venous thromboembolism prevention guidelines.
Area of Science:
- Urology
- Vascular Surgery
- Thrombosis Prevention
Background:
- Urological surgery is associated with high-risk patients for venous thromboembolism (VTE) per German guidelines.
- Analysis of complications in urological surgery patients between 2012-2016.
Purpose of the Study:
- To evaluate the incidence of bleeding and thrombosis complications in patients undergoing urological surgery.
- To assess the current practices in VTE prophylaxis for urological surgery.
Main Methods:
- Retrospective, monocentric cohort study.
- Analysis of 3609 surgeries performed between 2012-2016.
- Data collected on anticoagulation, patient-specific, and surgery-specific risk factors, and complications.
Main Results:
- 77.8% of patients received no VTE prophylaxis; 10.2% received aggregation inhibitors; 8.5% received heparin.
- Postoperative thromboembolic events occurred in 0.8% of patients within 28 days.
- Bleeding complications occurred in 20.3% of patients (4.8% minor, 15.5% major).
Conclusions:
- Postoperative thromboembolism risk in urological surgery is low (0.8%).
- Postoperative bleeding risk is considerably higher (20.3%), with a substantial proportion of major bleeds (15.5%).
- Findings warrant discussion regarding current VTE prevention guidelines in urological surgery.
Background:
According to the current definition of the German guideline for prevention of venous thromboembolism, urological surgery includes a high number of high-risk patients. All patients undergoing urological surgery between 2012 and 2016 were analyzed with regard to complications (bleeding or thrombosis).
Materials And Methods:
This study is a retrospective and monocentric cohort study. Included were all patients who underwent surgery between 2012 and 2016 at the Urological Department at the University Hospital of Luebeck. Information was collected relating to anticoagulation, patient-specific and surgery-specific risk factors, and complications.
Results:
In all, 3609 surgeries were analyzed: 77.8% of patients received no medical prophylaxis, 10.2% received an aggregation inhibitor, and 8.5% synthetic, unfractionated or low molecular weight heparin. Heparin was administered to 80.4% of patients after surgery. During an average hospital stay of 4.5 days, 93.3% of the patients received no change in anticoagulation. Merely 0.8% of all patients suffered from clinical thomboembolic events within 28 days. In contrast the number of bleedings was higher with 20.3% (minor: 4.8%, major: 15.5%).
Conclusion:
We found a slight risk for postoperative thromboembolism (0.8%). The risk for postoperative bleeding in contrast was 20.3%, including 15.5% major bleedings. The results are discussed in relation to the current guidelines.
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