Safety Study of Maintaining Oral Anticoagulant Therapy in Patients Undergoing Thulium Laser Enucleation of the Prostate for Benign Prostatic Hyperplasia
Year: 2026
Type: preprint
Study design: Observational Study
Abstract: Objective To explore the clinical safety of maintaining oral anticoagulant therapy in patients with benign prostatic hyperplasia (BPH) undergoing thulium laser enucleation of the prostate (ThuLEP), and to provide evidence-based basis for perioperative anticoagulant management in clinical practice. Methods A retrospective analysis was performed on the clinical data of 186 BPH patients who underwent ThuLEP in the Department of Urology of our hospital from July 2023 to December 2024. According to the perioperative anticoagulant use protocol, the patients were divided into three groups: the anticoagulant maintenance group (62 cases, continued oral administration of original anticoagulants), the anticoagulant withdrawal group (61 cases, discontinued anticoagulants 7–10 days before surgery and received low-molecular-weight heparin bridging therapy), and the non-medication control group (63 cases, no history of long-term oral anticoagulant/antiplatelet therapy). Perioperative related indicators (operation time, intraoperative blood loss, hemoglobin decrease value), incidence of postoperative complications (bleeding, hematuria, urinary tract infection, thromboembolic events, etc.), as well as postoperative indwelling catheter time, length of hospital stay, and International Prostate Symptom Score (IPSS) and Quality of Life Score (QoL) at 1 month and 3 months after surgery were compared among the three groups. Results There were no statistically significant differences in preoperative general data (age, prostate volume, coagulation function, underlying diseases, etc.) among the three groups ( P > 0.05). There were no statistically significant differences in operation time [(68.5 ± 12.3) min vs (65.8 ± 11.7) min vs (66.2 ± 12.1) min], intraoperative blood loss [(52.3 ± 15.6) mL vs (49.7 ± 14.9) mL vs (48.9 ± 14.5) mL], and hemoglobin decrease value [(1.2 ± 0.4) g/dL vs (1.1 ± 0.3) g/dL vs (1.0 ± 0.3) g/dL] among the anticoagulant maintenance group, anticoagulant withdrawal group, and non-medication control group (all P > 0.05). There were no statistically significant differences in the incidence of postoperative bleeding, hematuria, urinary tract infection, or urinary incontinence among the three groups ( P > 0.05); no severe bleeding or blood transfusion cases occurred in any of the three groups. The incidence of postoperative thromboembolic events in the anticoagulant maintenance group (1.61%) was significantly lower than that in the anticoagulant withdrawal group (8.20%), with a statistically significant difference ( P < 0.05); no thromboembolic events occurred in the non-medication control group, which showed no statistically significant difference compared with the anticoagulant maintenance group ( P > 0.05) but a statistically significant difference compared with the anticoagulant withdrawal group ( P < 0.05). There were no statistically significant differences in postoperative indwelling catheter time or length of hospital stay among the three groups ( P > 0.05). At 1 month and 3 months after surgery, the IPSS score and QoL score of the three groups were significantly improved compared with those before surgery (P < 0.05), but there were no statistically significant differences among the groups ( P > 0.05). Conclusion Maintaining oral anticoagulant therapy in BPH patients undergoing ThuLEP does not increase the perioperative bleeding risk, but can significantly reduce the incidence of thromboembolic events. Its safety is equivalent to that of non-medication patients, and it does not affect the surgical efficacy or postoperative recovery, which is safe and feasible in clinical application.
Source: Research Square
Authors: kang CHEN, Jueren ZHAO, Hua GONG, Weihua CHEN
Language: English
Subfield: Urology
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W7203841144