title: Impact of oral anticoagulation on morbidity of transurethral resection of the prostate.
abstract: OBJECTIVE
  To assess the impact of oral anticoagulation (OA) on morbidity of transurethral resection of the prostate (TURP). OA included warfarin and platelet aggregation inhibitors (PAI).
  
  
  METHODS
  Multicenter analysis of patients operated for symptomatic benign prostatic hyperplasia (BPH) by TURP. Patients under OA were compared to those with no OA.
  
  
  RESULTS
  Out of 612 patients included in the analysis, 206 (33%) were on OA prior surgery (55 warfarin, 142 PAI, and 9 warfarin and PAI). No patient continued warfarin and clopidogrel during the operating period. Patients under OA were significantly older (75 vs. 71 yo, P < 0.001), had larger prostate volume (56 vs. 49 ml, P = 0.05), and had higher rate of bladder catheter prior surgery (26 vs. 17%, P = 0.02). At 3 months follow-up, patients in the OA group had a higher weight of resected tissue (24 vs. 21.7 g, P < 0.001), a longer duration of hospitalization (6.4 vs. 4.7 days P < 0.001), a higher rate of bladder clots (13 vs. 4.7%, P < 0.001), red cell transfusion (1.9 vs. 1.0%, P = 0.026), late hematuria (15.0 vs. 8.4%, P = 0.004), and thromboembolic events (2.4 vs. 0.7, P = 0.02). In multivariable analysis, OA status was the sole independent parameter associated with bladder clots (P = 0.004) and with late hematuria (P = 0.03).
  
  
  CONCLUSIONS
  OA had a significant and independent impact on TURP outcome in terms of bleeding complications. This data could be used for treatment decision and for patient's information prior BPH surgery.
authors.affiliation: Department of Urology, Service de chirurgie urologique, Hopital Dupuytren CHU de Limoges, 2 av Martin Luther King, 87042, Limoges, France. aureliendescazeaud@gmail.com
authors.forename: Aurélien
authors.initials: A
authors.lastname: Descazeaud
authors.forename: Gregoire
authors.initials: G
authors.lastname: Robert
authors.forename: Souhil
authors.initials: S
authors.lastname: Lebdai
authors.forename: Alain
authors.initials: A
authors.lastname: Bougault
authors.forename: Abdel Rahmene
authors.initials: AR
authors.lastname: Azzousi
authors.forename: Olivier
authors.initials: O
authors.lastname: Haillot
authors.forename: Marian
authors.initials: M
authors.lastname: Devonec
authors.forename: Marc
authors.initials: M
authors.lastname: Fourmarier
authors.forename: Christian
authors.initials: C
authors.lastname: Saussine
authors.forename: Nicolas
authors.initials: N
authors.lastname: Barry-Delongchamps
authors.forename: Alexandre
authors.initials: A
authors.lastname: de la Taille
mesh_terms: D000284:Administration, Oral; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000925:Anticoagulants / Q000008:administration & dosage*; D017707:Erythrocyte Transfusion; D006417:Hematuria / Q000453:epidemiology*; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D009017:Morbidity; D010975:Platelet Aggregation Inhibitors / Q000008:administration & dosage; D013923:Thromboembolism / Q000453:epidemiology*; D020728:Transurethral Resection of Prostate / Q000009:adverse effects*; D014859:Warfarin / Q000008:administration & dosage
chemical_list: D000925:Anticoagulants; D010975:Platelet Aggregation Inhibitors; D014859:Warfarin