Therapeutics and Clinical Risk Management (Sep 2024)
Thromboelastography in Long-Term Antiplatelet Therapy for Patients Diagnosed with Benign Prostate Hyperplasia Undergoing Holmium Laser Enucleation of the Prostate: A Retrospective Study
Abstract
Zhi-Bo Gu, Lei Qiu, Hua Zhu, Ming Lu, Jian-Gang Chen Department of Urology, Affiliated Hospital 2 of Nantong University, Nantong, Jiangsu Province, 226200, People’s Republic of ChinaCorrespondence: Jian-Gang Chen, Department of Urology, Affiliated Hospital 2 of Nantong University, No. 666 Victory Road, Chongchuan District, Nantong, Jiangsu Province, 226200, People’s Republic of China, 226200, Tel +862115996558081, Email [email protected]: To compare low- vs high-power HoLEP effects on coagulation in patients on antiplatelet (AP) therapy via thromboelastography (TEG).Methods: 210 patients was retrospectively analyzed and stratificated into three discrete groups, specifically: Group A (AP therapy, high-power HoLEP, n = 72); Group B (AP therapy, low-power HoLEP, n=73); Group C (no AP therapy, low-power HoLEP, n = 65). Baseline characteristics and coagulation profiles via TEG were compared. Univariate and multivariate analyses were conducted to identify independent risk factors associated with hematuria. Furthermore, parameters such as IPSS, Qmax, post-void residual volume V2 and PSA levels were recorded during 1year follow-up.Results: No differences in terms of baseline characteristics across all groups. Significant differences were observed in the duration of enucleation, morcellation, bladder irrigation, post-operative catheterization, length of hospital stay and the extent of hemoglobin reduction (F = 54.06, 8.54, 6.68, 9.24, 17.06, 5.97, p 0.05). Univariate and multivariate analyses revealed that prostate volume emerged as an independent risk factor for hematuria (OR 1.080, 95% CI: 1.007– 1.158, p = 0.031). Clinical outcomes including Qmax, IPSS, V2, and PSA demonstrated significant enhancement during 1 year follow-up.Conclusion: Compared to HP-HoLEP, LP-HoLEP effectively reduces surgical and subsequent processing times, decreases hospital stay duration, and diminishes hemoglobin decline, offering a viable option without discontinuing AP therapy.Keywords: anti-platelet therapy, BPH, high power, HoLEP, low power
