title: Thrombotic risk factors associated with transurethral prostatectomy.
abstract: OBJECTIVE
  To ascertain the potential thrombotic risk associated with transurethral prostatectomy (TURP).
  
  
  METHODS
  The changes in coagulation variables were assessed in a prospective study of 40 patients undergoing TURP.
  
  
  RESULTS
  There was a significant increase in thrombin-antithrombin complexes 6 h after TURP (anova, P=0.01) combined with a significant decrease in activated partial thromboplastin time (anova, P=0.006), suggesting a postoperative hypercoagulable state. The significant increase in d-dimer 24 h after TURP (anova, P=0.015) in the absence of any significant rise in tissue plasminogen activator antigen levels perioperatively (anova, P=0.737) suggests a physiological fibrinolytic response to the developing procoagulant state. The absence of any significant increase in plasminogen activator inhibitor-1 antigen perioperatively (anova, P=0.348) suggests the observed hypercoagulability is not due to a 'fibrinolytic shutdown' reported in other forms of surgery.
  
  
  CONCLUSIONS
  TURP is associated with a hypercoagulable prothrombotic state; aspirin withdrawal perioperatively may be hazardous, and low-dose heparin prophylaxis for venous thrombosis should be considered.
authors.affiliation: Department of Urology, The Katherine Dormandy Haemophilia Centre, London, UK.
authors.forename: C R
authors.initials: CR
authors.lastname: Bell
authors.forename: P J
authors.initials: PJ
authors.lastname: Murdock
authors.forename: K J
authors.initials: KJ
authors.lastname: Pasi
authors.forename: R J
authors.initials: RJ
authors.lastname: Morgan
mesh_terms: D000925:Anticoagulants / Q000627:therapeutic use; D001779:Blood Coagulation Factors / Q000032:analysis; D016063:Blood Loss, Surgical; D006487:Hemostasis; D006801:Humans; D008297:Male; D011446:Prospective Studies; D011468:Prostatectomy / Q000009:adverse effects*; D012307:Risk Factors; D013927:Thrombosis / Q000209:etiology* / Q000517:prevention & control
chemical_list: D000925:Anticoagulants; D001779:Blood Coagulation Factors