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Published in: BMC Urology 1/2017

Open Access 01-12-2017 | Research article

Risks and complications of transurethral resection of bladder tumors in patients receiving antiplatelet and/or anticoagulant therapy: a retrospective cohort study

Authors: Tsuzumi Konishi, Satoshi Washino, Yuhki Nakamura, Masashi Ohshima, Kimitoshi Saito, Yoshiaki Arai, Tomoaki Miyagawa

Published in: BMC Urology | Issue 1/2017

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Abstract

Background

Information on the safety of transurethral resection of bladder tumors (TURBT) in patients receiving anti-thromboembolic drugs is currently lacking. This study aimed to evaluate the clinical safety of TURBT in patients receiving anti-thromboembolic agents compared with patients not taking these agents and patients who interrupted their use perioperatively.

Methods

We retrospectively analyzed data for patients who underwent TURBT at Jichi Medical University Saitama Medical Center from September 2013 to August 2016.Patients who underwent surgery while receiving antiplatelet and/or anticoagulant drugs were allocated to the continuation group, those who interrupted these drugs comprised the interruption group, and those who did not use these agents were designated as the control group. We compared the patient characteristics, hemoglobin levels, and complications among the three groups.

Results

A total of 174 patients were analyzed including 19, 18, and 137 in the continuation, interruption, and control groups, respectively. There were no significant differences in patient and tumor characteristics, apart from age, among the three groups. Decreases in hemoglobin levels were similar in the continuation, interruption, and control groups (−0.50 g/dl, −0.40 g/dl, and −0.50 g/dl, respectively).Significantly more patients in the continuation group experienced clot retention compared with the control group (21% vs 5%, p = 0.03). Large tumor size tended to be a risk factor for clot retention in the continuation group (p = 0.07). No patient in the continuation or interruption group required blood transfusion, compared with two patients (1%) in the control group. No patients in any of the groups experienced cardiovascular events during their hospital stay or required rehospitalization for hematuria after discharge.

Conclusions

TURBT can be performed safely in patients who continue to take antiplatelet and/or anticoagulant agents, without increasing the risks of severe hemorrhage and blood transfusion. However, the risk of postoperative clot retention may be increased in these patients.
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Metadata
Title
Risks and complications of transurethral resection of bladder tumors in patients receiving antiplatelet and/or anticoagulant therapy: a retrospective cohort study
Authors
Tsuzumi Konishi
Satoshi Washino
Yuhki Nakamura
Masashi Ohshima
Kimitoshi Saito
Yoshiaki Arai
Tomoaki Miyagawa
Publication date
01-12-2017
Publisher
BioMed Central
Published in
BMC Urology / Issue 1/2017
Electronic ISSN: 1471-2490
DOI
https://doi.org/10.1186/s12894-017-0309-0

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