Safety of carbon bead injection for incontinence in patients taking warfarin.
OBJECTIVE
To determine the safety of the use of Durasphere in patients receiving warfarin anticoagulation.


METHODS
This case series included patients requiring long-term anticoagulation who also had intrinsic sphincteric deficiency or mixed urinary incontinence, and bladder outlets without hypermobility. All patients, with the exception of the 1 man in the study, were treated under local anesthesia with periurethral carbon bead injections, while receiving therapeutic doses of warfarin.


RESULTS
Between 1999 and 2004, 20 such patients received carbon bead injections, on 36 different occasions, during therapeutic warfarin administration. Two complications related to the anticoagulation were encountered, one minor complication of a small periurethral hematoma and the other more severe, with a patient developing urinary retention and intravesical hemorrhage.


CONCLUSIONS
In most cases, the injection of carbon beads under local anesthesia in patients receiving therapeutic warfarin anticoagulation can be safely performed without reversal of the anticoagulation.
McCrery
R J
RJ
Scott Department of Urology, Baylor College of Medicine, Houston, Texas 77030, USA.
Appell
R A
RA
D000368:Aged; D000369:Aged, 80 and over; D000925:Anticoagulants / Q000627:therapeutic use*; D001672:Biocompatible Materials / Q000008:administration & dosage*; D005260:Female; D005936:Glucans / Q000009:adverse effects*; D006801:Humans; D007267:Injections; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D014549:Urinary Incontinence / Q000188:drug therapy / Q000628:therapy*; D014859:Warfarin / Q000627:therapeutic use*; D015040:Zirconium / Q000009:adverse effects*
D000925:Anticoagulants; D001672:Biocompatible Materials; D005936:Glucans; C431745:durasphere; D014859:Warfarin; D015040:Zirconium