Login to Access Video or Poster Abstract: MP27-11
Sources of Funding: none

Introduction

According to AUA guidelines Greenlight PVP 532-nm laser vaporization of the prostate should be considered in patients receiving anticoagulant medication or with a high cardiovascular risk. We sought to examine the functional and complications outcomes of high risk patients with cardiovascular disease necessitating maintenance of anticoagulation therapy (ACO).

Methods

Retrospective analysis of prospectively maintained institutional database was performed. Men were stratified according to ACO treatment status defined as the usage of anti-vitamin K, Heparin, direct thrombin inhibitor or and anti-Xa. Complications at 30 and 90 days according to Clavien classification and functional outcomes (IPSS, Qmax and PVR) were analyzed up to 5-years follow-up.

Results

A total of 39 (10%) patients were on ACO including 8 patients with prosthetic cardiac valve, 26 patients with malignant arrhythmias and 27 with coronary cardiac disease._x000D_ _x000D_ ACO patients were older (75 vs 67 years, p<0.01) and with more systemic disease defined by ASA score. Men with ACO were more likely to fail first trial of void, had significant longer catheterization time 1.7 vs 1 days and longer hospitalization 2.5 vs 0.5 days respectively (p<0.01 for all). ACO men had also higher 30 days readmission rate of 16% and higher rate of hematuria observed in almost 1/3 of the cases. Functional outcomes were significantly improved and equivalent to non ACO patients at all endpoints including at 5-year._x000D_

Conclusions

This is the first study to look at safety and functional outcomes of patients with cardiovascular disease requiring ACO with 5 years follow-up. PVP provide significant and durable treatment for symptomatic BPH in these high-risk ACO patient. However treatment comes with an increased risk of bleeding related complication implying longer catheterization and hospitalization that should be discussed during pre-operative patient counseling.

Funding

none