Bleeding Events Associated With Continuing Antithrombotic Therapy During Transrectal Ultrasound-Guided Prostate
Kenichi Hata1,2,3, Yuma Goto2,3, Masaki Hashimoto2,3
1Department of Urology, Shonan Keiiku Hospital, Fujisawa, Kanagawa, Japan.
Summary
Continuing antithrombotic therapy during prostate biopsies is safe, showing no increased bleeding risk. However, caution is advised for direct-acting oral anticoagulants in patients with diabetes.
Area of Science:
- Urology
- Cardiology
- Oncology
Background:
- Prostate biopsies are common procedures.
- Antithrombotic therapy is frequently used in patients undergoing prostate biopsies.
- The safety of continuing antithrombotic therapy during these biopsies is a critical consideration.
Purpose of the Study:
- To assess the association between continuing antithrombotic therapy and bleeding events.
- To evaluate the frequency and severity of bleeding during transrectal ultrasound-guided prostate biopsies.
- To compare bleeding rates in patients who continued versus discontinued antithrombotic therapy.
Main Methods:
- Retrospective cohort study of 1248 patients undergoing prostate biopsy.
- Patients were grouped based on antithrombotic therapy continuation (antithrombotic(+) vs. antithrombotic(-)).
- Propensity score matching (1:1) was used to control for confounding factors.
Main Results:
- Matched analysis (162 patients/group) showed comparable rates of mild/severe hematuria and rectal bleeding.
- No significant difference in hematospermia rates was observed.
- Diabetes mellitus and biopsy core number were independent predictors of severe bleeding.
Conclusions:
- Transrectal ultrasound-guided prostate biopsy is safe without antithrombotic discontinuation.
- No significant increase in bleeding events was observed when antithrombotic therapy was continued.
- Caution is advised for direct-acting oral anticoagulants in patients with bleeding risk factors like diabetes.
