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Urology: Study Finds PVP Safe for Men Taking Coumadin

Men in this group had low perioperative morbidity and good early functional outcomes

Treating prostatic obstruction with photoselective vaporization of the prostate (PVP) appears to be safe in men taking warfarin (Coumadin), according to the results of a small study published recently on the Journal of Urology website.

With increasing numbers of men taking anticoagulant medications, urologists performing surgery must balance bleeding risk with the potential complications of not taking the medications during the preoperative period. Most research regarding the effects of prostate surgery on men taking anticoagulants has included a range of medications such as aspirin, clopidogrel, and warfarin. With the current study, the authors focused only on men who took warfarin and who continued to do so at therapeutic levels while undergoing PVP.

The authors drew on a prospective database of 43 men who were taking warfarin when they underwent treatment with a 120-W lithium triborate laser between November 2006 and July 2010. Mean age was 73.4 years and mean prostate size was 75.3 mL. No men required blood transfusion, although two had prolonged catheterization for bleeding. No patient required discontinuation of warfarin during the preoperative period. Urinary tract infection occurred in four men and recatheterization was required in six men. Apart from three outliers, the mean postoperative stay was 21.6 hours. At three months, improvement in International Prostate Symptom Score, peak urinary flow rate, and post-void residual were similar to previously reported series of men not taking an anticoagulant.

The authors conclude that men taking warfarin “represent a challenging group of patients. Not only are there issues with their anticoagulation therapy, but this group of men also tend to have significant comorbidity. The treatment of prostatic obstruction with PVP appears to be safe in men taking Coumadin, with good early outcomes.“

Source: Woo HH, Hossack TA. 2011. Photoselective vaporization of the prostate with the 120-W lithium triborate laser in men taking Coumadin. Published on April 4, 2011 on the Journal of Urology website.