Blood loss in long-term aspirin users undergoing transurethral prostatectomy
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1Urological Division, University Hospital of Kuopio, Finland.
Insights
For men undergoing transurethral resection of the prostate (TURP), continuing long-term aspirin use (250 mg/day) did not significantly increase blood loss. Preoperative aspirin cessation is likely unnecessary for TURP patients.
Area of Science:
- Urology
- Cardiovascular Medicine
- Pharmacology
Background:
- Aspirin is commonly prescribed for cardiovascular and cerebrovascular disorder prevention.
- Many patients undergoing transurethral resection of the prostate (TURP) are long-term aspirin users.
- The routine preoperative use of aspirin as an antithrombotic agent is less common now.
Purpose of the Study:
- To investigate the impact of long-term aspirin use on blood loss during TURP.
- To determine if preoperative aspirin cessation is necessary for TURP patients.
Main Methods:
- A comparative study involving 40 long-term aspirin users (250 mg/day) and 42 control patients undergoing TURP.
- Measurement of intraoperative and postoperative blood loss.
- Correlation of blood loss with operating time and prostatic weight.
Main Results:
- Mean blood loss in aspirin users was 358 ml (range 50-1550 ml) versus 478 ml (range 40-2400 ml) in the control group.
- No significant difference in mean blood loss was observed between the groups when correlated with operating time and prostatic weight.
- Two aspirin-treated patients experienced late postoperative bleeding requiring bladder emptying.
Conclusions:
- Long-term aspirin use (250 mg/day) does not significantly enhance blood loss during TURP.
- Preoperative cessation of aspirin therapy appears unnecessary for patients undergoing TURP.
- The findings support the continuation of aspirin therapy for cardiovascular protection in TURP candidates.
Abstract:
As aspirin is now widely used for preventing recurrence of cardiovascular and cerebrovascular disorders, many men selected for transurethral resection of the prostate (TURP) are aspirin users. The previous indication for aspirin as a preoperatively administered antithrombotic agent is no longer common. In this study we investigated the blood loss in long-term aspirin users (250 mg/day) undergoing TURP. The mean blood loss in the 40 aspirin users was 358 (range 50-1550) ml, and in a control group of 42 men it was 478 (40-2400) ml. When mean blood loss was correlated to operating time and prostatic weight, the intergroup difference was not significant. In the late postoperative period two aspirin-treated men had bleeding with tamponade of the urinary bladder requiring emptying in the operating room. As blood loss was not enhanced by aspirin use, avoidance of aspirin before TURP appears to be unnecessary.
