Korean J Urol.  2012 Apr;53(4):234-239.

Discontinuation of Anticoagulant or Antiplatelet Therapy for Transrectal Ultrasound-Guided Prostate Biopsies: A Single-Center Experience

• Raheem OA
• Casey RG
• Galvin DJ
• Manecksha
• Varadaraj
• McDermott
• Grainger R
• Lynch TH

Abstract

PURPOSE
Historically, it was thought that hemorrhagic complications were increased with transrectal ultrasound-guided prostate biopsies (TRUS biopsy) of patients receiving anticoagulation/antiplatelet therapy. However, the current literature supports the continuation of anticoagulation/antiplatelet therapy without additional morbidity. We assessed our experience regarding the continuation of anticoagulation/antiplatelet therapy during TRUS biopsy.
MATERIALS AND METHODS
A total of 91 and 98 patients were included in the anticoagulation/antiplatelet (group I) and control (group II) groups, respectively. Group I subgroups consisted of patients on monotherapy or dual therapy of aspirin, warfarin, clopidogrel, or low molecular weight heparin. The TRUS biopsy technique was standardized to 12 cores from the peripheral zones. Patients completed a questionnaire over the 7 days following TRUS biopsy. The questionnaire was designed to assess the presence of hematuria, rectal bleeding, and hematospermia. Development of rectal pain, fever, and emergency hospital admissions following TRUS biopsy were also recorded.
RESULTS
The patients' mean age was 65 years (range, 52 to 74 years) and 63.5 years (range, 54 to 74 years) in groups I and II, respectively. The overall incidence of hematuria was 46% in group I compared with 63% in group II (p=0.018). The incidence of hematospermia was 6% and 10% in groups I and II, respectively. The incidence of rectal bleeding was similar in group I (40%) and group II (39%). Statistical analysis was conducted by using Fisher exact test.
CONCLUSIONS
There were fewer hematuria episodes in anticoagulation/antiplatelet patients. This study suggests that it is not necessary to discontinue anticoagulation/antiplatelet treatment before TRUS biopsy.

Keyword

Anticoagulants; Antiplatelets; Transrectal ultrasound-guided prostate biopsy

MeSH Terms

Anticoagulants
Aspirin
Biopsy
Emergencies
Fever
Hematuria
Hemorrhage
Hemospermia
Heparin, Low-Molecular-Weight
Humans
Incidence
Prostate
Ticlopidine
Warfarin
Anticoagulants
Aspirin
Heparin, Low-Molecular-Weight
Ticlopidine
Warfarin

Figure

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  FIG. 1 Patients questionnaire of transrectal ultrasound prostate biopsy.

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