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MINERVA UROLOGICA E NEFROLOGICA
A Journal on Nephrology and Urology
Indexed/Abstracted in: EMBASE, PubMed/MEDLINE, Science Citation Index Expanded (SciSearch), Scopus
Impact Factor 0,536
Minerva Urologica e Nefrologica 2013 September;65(3):189-95
Safety and efficacy of photoselective vaporization of prostate in patients receiving anticoagulants
Pawan V., Anup K., Niraj K., Biswajit N., Punita R., Rajendra A., Nayan M. ✉
Department of Urology V.M. Medical College and Safdarjang Hospital New Delhi, India
Aim: Objective of the present study was to evaluate the safety and efficacy of photoselective vaporization of the prostate (PVP) using a 80W potassium titanyl phosphate (KTP) laser, in benign prostatic enlargement (BPE) patients who were on ongoing anticoagulant therapy during the perioperative period.
Methods: Prospectively collected laser prostatectomy patient database of our hospital for the period between July 2009-Jan 2012 was retrospectively reviewed. Data on perioperative safety, functional outcome and complications up to follow-up at 6 months of 45 eligible patients who underwent PVP-KTP and were on perioperative anticoagulant therapy (study group) was compared with 47 eligible patients who underwent PVP-KTP and were not on perioperative anticoagulant therapy (control group). P<0.05 was considered statistically significant.
Results: The baseline characteristics of the two groups were similar except for ASA score which was significantly higher in the study group.(2.64±0.60 vs. 1.53±0.50). Though the need (15.55% vs. 4.25% patients) and duration of postoperative irrigation (243.33±49.66 vs. 52.5±10.60 min) was significantly higher in the study group, the postoperative hemoglobin drop 24 hours postoperatively did not differ significantly between the two groups (8.54% vs. 6.48%). No patient required a blood transfusion. The overall complication rate was similar in the two groups. In both groups, significant improvement was recorded in the IPSS, QOL, Q max, PVRU and prostate volume data upto 6 months follow up with no significant differences noted.
Conclusion: KTP-PVP can be performed safely and effectively in BPE patients on ongoing anticoagulation, without increasing the risk of perioperative bleeding or the need for blood transfusion.