title: [Current Practice in the Transurethral Treatment of Benign Prostatic Obstruction under Oral Anticoagulants : A Nation-wide Survey].
abstract: BACKGROUND
  Only few studies have assessed the safety and efficacy of transurethral surgery (TS) for the treatment of benign prostatic obstruction (BPO) in patients on oral anticoagulants. The aim of our study was to evaluate current treatment strategies and complication rates of TS for the treatment of BPO in patients on OA using an online survey.
  
  
  METHODS
  A total of 300 German departments of urology received an e‑mail with a link for the online survey. The items of the questionnaire assessed the present practice of TS for BPO in patients on OA and the occurrence of complications.
  
  
  RESULTS
  Seventy-five (23.4 %) departments responded to the online questionnaire. Of the respondents, 94.7 % performed TS in patients with BPO on OA and 42.7 % answered that they perform more than 30 prostate surgeries per year under OA. The respondents indicated that surgeries were carried out under aspirin (96 %), clopidogrel (46.7 %) or phenprocoumon (26.7 %). Indications for surgeries under OA were made by cardiologist recommendation (82.7 %), the surgeon (37.3 %), a need for emergency surgery (52 %), or the patient's will (10.7 %). Sixty-two (82.7 %) of the respondents perform bipolar or monopolar transurethral resection of the prostate (TUR-P) in patients on OA. In addition, 69.3 % of the respondents indicated that they use laser prostatectomy in patients on OA (thulium 24 %, Greenlight 24 %, holmium 16 %, and diode laser 5.3 %). Cardiovascular complications occurred in 12 % of the respondents.
  
  
  CONCLUSIONS
  Despite the poor evidence for performing TS of BPO under OA, our survey showed surprising results: TS of BPO under OA is frequently performed, especially bipolar and monopolar TUR-P. Although our data were obtained using an online survey, the complication rates appear to be lower than previously thought.
authors.affiliation: Asklepios Klinik Barmbek, Abteilung für Urologie, Rübenkamp 220, 22291, Hamburg, Deutschland. c.netsch@asklepios.com.|Arbeitskreis Endourologie, Akademie der Deutschen Urologen, Düsseldorf, Deutschland. c.netsch@asklepios.com.
authors.forename: Christopher
authors.initials: C
authors.lastname: Netsch
authors.affiliation: Asklepios Klinik Barmbek, Abteilung für Urologie, Rübenkamp 220, 22291, Hamburg, Deutschland.
authors.forename: Christina
authors.initials: C
authors.lastname: Moritz
authors.affiliation: Asklepios Klinik Barmbek, Abteilung für Urologie, Rübenkamp 220, 22291, Hamburg, Deutschland.|Arbeitskreis Endourologie, Akademie der Deutschen Urologen, Düsseldorf, Deutschland.
authors.forename: Andreas J
authors.initials: AJ
authors.lastname: Gross
mesh_terms: D000284:Administration, Oral; D000368:Aged; D000369:Aged, 80 and over; D000925:Anticoagulants / Q000627:therapeutic use*; D015984:Causality; D015897:Comorbidity; D019538:Health Care Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology* / Q000517:prevention & control; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D015995:Prevalence; D011470:Prostatic Hyperplasia / Q000453:epidemiology* / Q000601:surgery*; D012189:Retrospective Studies; D012307:Risk Factors; D020728:Transurethral Resection of Prostate / Q000706:statistics & numerical data*; D016896:Treatment Outcome
chemical_list: D000925:Anticoagulants
keywords: Anticoagulants; Laser therapy; Minimally invasive; Prostatic hyperplasia; Transurethral resection of prostate
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