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Laser prostatectomy in patients on anticoagulant therapy or with bleeding disorders.
J Urol. 2003 Nov; 170(5):1851-5.JU

Abstract

PURPOSE

Bleeding disorders or the use of anticoagulant medication are contraindications to transurethral prostate resection in men with lower urinary tract symptoms (LUTS) suggestive of benign prostatic hyperplasia (BPH). Laser prostatectomy has proved to be adequate surgical therapy with less blood loss than transurethral prostate resection.

MATERIALS AND METHODS

A prospective, controlled study was done in patients at high risk (HR) with LUTS suggestive of BPH. They were treated with contact laser prostatectomy (CLP) or the combination of CLP with visual laser ablation prostatectomy (VLAP). HR was defined as bleeding disorders or anticoagulants use. As a control, men at normal risk with LUTS suggestive of BPH were treated with CLP. Patients completed validated questionnaires and underwent urodynamics at baseline and 6 months postoperatively.

RESULTS

A total of 75 patients were included, namely 19 in the HR-CLP group, 11 in the HR-CLP-VLAP group and 45 in the normal risk CLP group. Obstruction relief, and symptomatic and subjective improvement were equal in all 3 groups. Effective capacity (maximum cystometric capacity minus post-void residual volume) also improved significantly in all except the HR-CLP group. Maximum urine flow improved in all groups but not significantly in the HR-CLP group. Intraoperative and postoperative complications were slightly higher in HR cases. However, blood transfusion was never necessary and there was no mortality.

CONCLUSIONS

CLP and especially CLP-VLAP perform almost as well in HR cases compared with CLP in those at normal risk. These procedures are safe for men at HR with LUTS suggestive of BPH.

Authors+Show Affiliations

Department of Urology (HP G 05.201), University Medical Center Utrecht, PO Box 85500, 3508 GA Utrecht, The Netherlands. HvMelick@hotmail.comNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Comparative Study
Evaluation Study
Journal Article

Language

eng

PubMed ID

14532791

Citation

van Melick, Harm H E., et al. "Laser Prostatectomy in Patients On Anticoagulant Therapy or With Bleeding Disorders." The Journal of Urology, vol. 170, no. 5, 2003, pp. 1851-5.
van Melick HH, van Venrooij GE, Boon TA. Laser prostatectomy in patients on anticoagulant therapy or with bleeding disorders. J Urol. 2003;170(5):1851-5.
van Melick, H. H., van Venrooij, G. E., & Boon, T. A. (2003). Laser prostatectomy in patients on anticoagulant therapy or with bleeding disorders. The Journal of Urology, 170(5), 1851-5.
van Melick HH, van Venrooij GE, Boon TA. Laser Prostatectomy in Patients On Anticoagulant Therapy or With Bleeding Disorders. J Urol. 2003;170(5):1851-5. PubMed PMID: 14532791.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Laser prostatectomy in patients on anticoagulant therapy or with bleeding disorders. AU - van Melick,Harm H E, AU - van Venrooij,Ger E P M, AU - Boon,Tom A, PY - 2003/10/9/pubmed PY - 2003/12/3/medline PY - 2003/10/9/entrez SP - 1851 EP - 5 JF - The Journal of urology JO - J Urol VL - 170 IS - 5 N2 - PURPOSE: Bleeding disorders or the use of anticoagulant medication are contraindications to transurethral prostate resection in men with lower urinary tract symptoms (LUTS) suggestive of benign prostatic hyperplasia (BPH). Laser prostatectomy has proved to be adequate surgical therapy with less blood loss than transurethral prostate resection. MATERIALS AND METHODS: A prospective, controlled study was done in patients at high risk (HR) with LUTS suggestive of BPH. They were treated with contact laser prostatectomy (CLP) or the combination of CLP with visual laser ablation prostatectomy (VLAP). HR was defined as bleeding disorders or anticoagulants use. As a control, men at normal risk with LUTS suggestive of BPH were treated with CLP. Patients completed validated questionnaires and underwent urodynamics at baseline and 6 months postoperatively. RESULTS: A total of 75 patients were included, namely 19 in the HR-CLP group, 11 in the HR-CLP-VLAP group and 45 in the normal risk CLP group. Obstruction relief, and symptomatic and subjective improvement were equal in all 3 groups. Effective capacity (maximum cystometric capacity minus post-void residual volume) also improved significantly in all except the HR-CLP group. Maximum urine flow improved in all groups but not significantly in the HR-CLP group. Intraoperative and postoperative complications were slightly higher in HR cases. However, blood transfusion was never necessary and there was no mortality. CONCLUSIONS: CLP and especially CLP-VLAP perform almost as well in HR cases compared with CLP in those at normal risk. These procedures are safe for men at HR with LUTS suggestive of BPH. SN - 0022-5347 UR - https://www.unboundmedicine.com/medline/citation/14532791/Laser_prostatectomy_in_patients_on_anticoagulant_therapy_or_with_bleeding_disorders_ L2 - https://www.jurology.com/doi/10.1097/01.ju.0000092502.56901.f7?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -