To analyze the impact of perioperative antithrombotic use on the bleeding outcomes following Aquablation.
116 men with who underwent Aquablation as part of the WATER prospective trial (NCT02505919) were assigned to 2 groups based on perioperative antithrombotic status. Antithrombotic cessation and restart timing were based on the surgeon's discretion. Methods of achieving intraoperative hemostasis consisted of no-cautery balloon tamponade or cautery. Primary endpoints included immediate post-operative hematuria rates and changes in hemoglobin. Secondary endpoints included 90-day bleeding complications and non-bleeding post-operative adverse events.
41 men took antithrombotic medications in the perioperative period while 75 men had no antithrombotic medication. Preoperative hemoglobin levels were comparable between both groups. Post-operative hemoglobin change from baseline (drop of 1.8 ± 1.5g/dl among the antithrombotic group vs. 1.8 ± 1.7 g/dl among the antithrombotic-naïve group) did not differ between both groups (p=0.896). In total, 4 (9.8%) men in the antithrombotic group and 4 (5.3%) patients in the antithrombotic-naïve group experienced a Clavien-Dindo Grade 1 complication (p=0.451) in the 3-month postoperative period. Eight (19.5%) patients in the antithrombotic group and 11 (14.7%) patients in the antithrombotic-naïve group experienced a Clavien-Dindo Grade 2 complication (p=0.601), none of which is associated with bleeding in both groups. No men in either group demonstrated de novo erectile dysfunction. One patient (2.4%) in the antithrombotic group and none in the antithrombotic-naïve group required blood products (p=0.353).
Aquablation demonstrates comparable post-operative bleeding outcomes and other adverse effects for men with BPH who are on antithrombotic therapy.
Urology. 2023 Aug 11 [Epub ahead of print]
Iman Sadri, Anindyo Chakraborty, David-Dan Nguyen, Adel Arezki, Kussil Oumedjbeur, Naeem Bhojani, Dean Elterman, Bilal Chughtai, Peter Gilling, Neil Barber, Gopal Badlani, Mihir Desai, Leo Doumanian, Alexis E Te, Claus Roehrborn, Kevin C Zorn
Department of Urology, McGill University, Montreal, QC, Canada., Faculty of Medicine, McGill University, Montreal, QC, Canada., Division of Urology, University Health Network, University of Toronto, Toronto, ON, Canada., Division of Urology, Centre Hospitalier de L'Université de Montréal, Montreal, QC, Canada., Department of Urology, Weill Cornell Medical College-New York Presbyterian Hospital, New York, New York, USA., Department of Urology, Tauranga Hospital, Tauranga, New Zealand., Section of Urology, Department of Surgery, Frimley Health NHS Foundation Trust, Frimley, United Kingdom., Department of Urology, Wake Forest University, Winston-Salem, NC, USA., Catherine and Joseph Aresty Department of Urology, Keck School of Medicine, University of Southern California, Los Angeles, California., Institute of Urology, University of Southern California, Los Angeles, California, USA., Urology, The University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, Texas 75390., Division of Urology, Centre Hospitalier de L'Université de Montréal, Montreal, QC, Canada. Electronic address: .