title: Thulium laser (Revolix) vapoenucleation of the prostate is a safe procedure in patients with an increased risk of hemorrhage.
abstract: OBJECTIVE
  To evaluate the feasibility and safety of thulium:yttrium-aluminium-garnet laser vapoenucleation of the prostate (ThuVEP) in patients with chronic anticoagulation and bleeding disorders.
  
  
  METHODS
  We retrospectively analyzed the clinical data (transfusion rate, hemoglobin changes, residual urine, bleeding complications, complications and residual urine) of patients with chronic anticoagulation and bleeding disorders treated with ThuVEP. Anticoagulation was not paused for surgery.
  
  
  RESULTS
  We identified 39 patients who fulfilled the inclusion criteria (32 with chronic anticoagulation, 3 with bleeding disorder, and 4 with both). Mean preoperative hemoglobin was 12.9 g/l; the postoperative hemoglobin was 11.7 g/l. One patient received a blood transfusion. Mean residual urine was 166 ml preoperatively and 47 ml postoperatively, respectively; spontaneous voiding postoperatively was feasible in 36 patients. During follow-up, 5 patients suffered from gross hematuria, which was treated conservatively.
  
  
  CONCLUSIONS
  ThuVEP is a safe procedure in patients with therapeutic anticoagulation, bleeding disorders and platelet aggregation inhibitor medication.
authors.affiliation: Klinik und Poliklinik für Urologie, Universitätsklinikum Bonn, Bonn, Germany. Stefan.Hauser@uni-bonn.de
authors.forename: Stefan
authors.initials: S
authors.lastname: Hauser
authors.forename: Sebastian
authors.initials: S
authors.lastname: Rogenhofer
authors.forename: Jörg
authors.initials: J
authors.lastname: Ellinger
authors.forename: Timo
authors.initials: T
authors.lastname: Strunk
authors.forename: Stefan C
authors.initials: SC
authors.lastname: Müller
authors.forename: Guido
authors.initials: G
authors.lastname: Fechner
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000925:Anticoagulants / Q000009:adverse effects*; D015415:Biomarkers / Q000097:blood; D001778:Blood Coagulation Disorders / Q000150:complications*; D016063:Blood Loss, Surgical / Q000517:prevention & control*; D001803:Blood Transfusion; D005240:Feasibility Studies; D005858:Germany; D006417:Hematuria / Q000209:etiology / Q000517:prevention & control; D006454:Hemoglobins / Q000378:metabolism; D006801:Humans; D053685:Laser Therapy / Q000009:adverse effects / Q000295:instrumentation*; D053844:Lasers, Solid-State; D008297:Male; D008875:Middle Aged; D010975:Platelet Aggregation Inhibitors / Q000009:adverse effects; D019106:Postoperative Hemorrhage / Q000097:blood / Q000209:etiology / Q000517:prevention & control*; D011468:Prostatectomy / Q000009:adverse effects / Q000295:instrumentation* / Q000379:methods; D011470:Prostatic Hyperplasia / Q000150:complications / Q000601:surgery*; D012189:Retrospective Studies; D013932:Thulium; D013997:Time Factors; D016896:Treatment Outcome; D014546:Urinary Catheterization; D014554:Urination
chemical_list: D000925:Anticoagulants; D015415:Biomarkers; D006454:Hemoglobins; D010975:Platelet Aggregation Inhibitors; D013932:Thulium