TY - JOUR
T1 - Photoselective laser vaporization prostatectomy in men receiving anticoagulants
AU - Sandhu, Jaspreet S.
AU - Ng, Casey K.
AU - Gonzalez, Ricardo R.
AU - Kaplan, Steven A.
AU - Te, Alexis E.
N1 - Copyright:
Copyright 2008 Elsevier B.V., All rights reserved.
PY - 2005/12
Y1 - 2005/12
N2 - Background and Purpose: Photoselective laser vaporization prostatectomy (PVP) with a high-power KTP laser is a hemostatic procedure for men with symptomatic benign prostatic hyperplasia (BPH). This study demonstrates the feasibility of PVP in men who are receiving anticoagulants. Patients and Methods: Men treated with PVP for symptomatic BPH between July 2002 and September 2003 who were receiving anticoagulants (N = 24) were reviewed retrospectively. Their mean age was 75 years, and the mean prostate volume was 82 cc (range 34-164 cc). Nine men (38%) were in retention, eight (33%) had had a myocardial infarction, seven (29%) had had a cerebrovascular accident, and seven had peripheral vascular disease. Of these men, 8 were on warfarin, 2 on clopidogrel, and 14 on aspirin. Men on warfarin discontinued the drug 2 days prior to surgery and restarted it the day after. The other two drugs were not discontinued. The PVP was performed with an 80 W KTP side-firing laser (Laserscope Greenlight PV) through a 23F continuous-flow cystoscope with normal saline as the irrigant. Results: The mean operative time was 101 minutes. No transfusions were required. Most (22; 92%) of the men were discharged without a catheter. The serum hematocrit did not change significantly (40.0% to 38.3%). The International Prostate Symptom Score decreased to 13.6, 10.9, 9.7, and 9.5 at 1, 3, 6, and 12 months from a mean of 18.7 preoperatively. The Q max increased from 9.0 mL/sec preoperatively to 15.1, 16.3, 20.9, and 20.1 mL/sec at 1, 3, 6, and 12 months. No patients had clinically significant hematuria postoperatively, and none suffered clot retention. Conclusions: Photoselective laser vaporization prostatectomy is a suitable treatment option in men being treated with anticoagulants, who are at high risk for clinically significant bleeding.
AB - Background and Purpose: Photoselective laser vaporization prostatectomy (PVP) with a high-power KTP laser is a hemostatic procedure for men with symptomatic benign prostatic hyperplasia (BPH). This study demonstrates the feasibility of PVP in men who are receiving anticoagulants. Patients and Methods: Men treated with PVP for symptomatic BPH between July 2002 and September 2003 who were receiving anticoagulants (N = 24) were reviewed retrospectively. Their mean age was 75 years, and the mean prostate volume was 82 cc (range 34-164 cc). Nine men (38%) were in retention, eight (33%) had had a myocardial infarction, seven (29%) had had a cerebrovascular accident, and seven had peripheral vascular disease. Of these men, 8 were on warfarin, 2 on clopidogrel, and 14 on aspirin. Men on warfarin discontinued the drug 2 days prior to surgery and restarted it the day after. The other two drugs were not discontinued. The PVP was performed with an 80 W KTP side-firing laser (Laserscope Greenlight PV) through a 23F continuous-flow cystoscope with normal saline as the irrigant. Results: The mean operative time was 101 minutes. No transfusions were required. Most (22; 92%) of the men were discharged without a catheter. The serum hematocrit did not change significantly (40.0% to 38.3%). The International Prostate Symptom Score decreased to 13.6, 10.9, 9.7, and 9.5 at 1, 3, 6, and 12 months from a mean of 18.7 preoperatively. The Q max increased from 9.0 mL/sec preoperatively to 15.1, 16.3, 20.9, and 20.1 mL/sec at 1, 3, 6, and 12 months. No patients had clinically significant hematuria postoperatively, and none suffered clot retention. Conclusions: Photoselective laser vaporization prostatectomy is a suitable treatment option in men being treated with anticoagulants, who are at high risk for clinically significant bleeding.
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U2 - 10.1089/end.2005.19.1196
DO - 10.1089/end.2005.19.1196
M3 - Article
C2 - 16359214
AN - SCOPUS:30544437076
VL - 19
SP - 1196
EP - 1198
JO - Journal of Endourology
JF - Journal of Endourology
SN - 0892-7790
IS - 10
ER -