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Laser treatment of benign prostatic hyperplasia in patients on oral anticoagulant therapy: a review
Author(s) -
Descazeaud Aurélien,
Robert Gregoire,
Azzousi Abdel Rahmene,
Ballereau Charles,
Lukacs Bertrand,
Haillot Olivier,
Dumonceau Olivier,
Devonec Marian,
Fourmarier Marc,
Saussine Christian,
De La Taille Alexandre
Publication year - 2009
Publication title -
bju international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.773
H-Index - 148
eISSN - 1464-410X
pISSN - 1464-4096
DOI - 10.1111/j.1464-410x.2008.08284.x
Subject(s) - medicine , enucleation , prostate , hyperplasia , prostatectomy , urology , transurethral resection of the prostate , oral anticoagulant , laser therapy , anticoagulant , surgery , laser , warfarin , cancer , optics , atrial fibrillation , physics
We assessed the therapeutic efficacy and safety of laser prostatectomy (LP) for treating benign prostatic hyperplasia (BPH) in patients on oral anticoagulation. We systematically reviewed previous reports, using the Pubmed database and bibliographies of retrieved articles and reviews. The oral anticoagulation included coumarin derivatives and platelet‐aggregation inhibitors (PAI). Previous studies do not allow the establishment of definitive conclusions for managing patients on oral anticoagulation and who require BPH surgery. No randomized studies are available. Nevertheless, compared to transurethral resection of the prostate (TURP), LP seems to decrease the risk of haemorrhage in patients taking PAI or coumarin derivatives. Therefore, LP is a useful alternative to TURP for managing patients on oral anticoagulation, and could be proposed as the first intention for those patients. Continuing PAI during the procedure is feasible. A replacement of coumarin derivatives by low molecular weight heparin is preferable. No conclusion can be reached on the preferred type of laser technique to treat these patients, but data on laser enucleation is much less abundant and conclusive than that on laser vaporization.