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Aspirin, a silent risk factor in urology

J P Zhu1, M B Davidsen, H H Meyhoff

  • 1Department of Surgery A, Hillerød Hospital, Denmark.

Scandinavian Journal of Urology and Nephrology
|December 1, 1995
PubMed

Insights

Aspirin use may increase bleeding risks during urologic procedures like prostatectomy and biopsy. Stopping aspirin a week prior and using specific treatments can manage these aspirin-induced hemorrhagic complications.

Area of Science:

  • Urology
  • Pharmacology
  • Hemostasis

Background:

  • Aspirin is widely used for pain, inflammation, fever, and cardiovascular prophylaxis.
  • Aspirin use is associated with increased operative hemorrhagic complications, particularly relevant in urology.
  • Understanding aspirin's pharmacological effects on hemostasis is crucial for managing surgical risks.

Purpose of the Study:

  • To review the normal hemostatic mechanism and aspirin's effect on hemostasis.
  • To examine literature on aspirin-induced hemorrhagic complications in urologic procedures.
  • To describe strategies for managing bleeding complications in patients on aspirin.

Main Methods:

  • Literature review of aspirin's pharmacological effects on hemostasis.
  • Systematic review of reported hemorrhagic complications in urologic surgery.
  • Analysis of management strategies for bleeding complications.

Main Results:

  • Aspirin increases bleeding and transfusion needs after prostatectomy, though large trials are lacking.
  • Hemorrhagic complications are reported following prostate biopsy and extracorporeal shock wave lithotripsy.
  • Cessation of aspirin one week prior to procedures is suggested.

Conclusions:

  • Aspirin poses a bleeding risk in urologic procedures.
  • Pre-operative aspirin cessation and specific interventions can manage bleeding.
  • Further placebo-controlled trials are needed to confirm risks and optimal management.

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