A retrospective examination of transurethral resection of a bladder tumor with continuous antithrombotic therapy

An increasing elderly population has resulted in an increase in the number of patients receiving antithrombotic therapy who need to undergo urological surgery, and thus we are experiencing difficulty treating such patients in daily medical practice more frequently than in the past. In our department, transurethral resection of a bladder tumor (TURBT) has been performed in 333 patients during a period of 3 years and 9 months since April 2011. Among these patients, 110 (33%) had received some antithrombotic therapy prior to surgery. We retrospectively examined the cases of TURBT with continuous preoperative antithrombotic therapy. The preoperative antithrombotic therapy included anticoagulant therapy only in 10 patients (3%), antiplatelet therapy only in 85 patients (26%), and a combination of anticoagulant and antiplatelet therapy in 15 patients (5%). Compared to the 223 patients without antithrombotic therapy (control group), the 58 patients with continuous perioperative antithrombotic therapy showed no increase in the incidence of postoperative hemorrhage and experienced no perioperative cerebral-cardiovascular events. Postoperative hemorrhage developed in only 1 patient, with idiopathic thrombocytopenic purpura, and a transfusion was given. Thromboembolism, one of the perioperative complications, can be serious and may carry a poor prognosis in many cases. In cases of TURBT, on the other hand, appropriate management can decrease the risk for hemorrhagic complications. Even if such complications do develop, hemorrhagic complications are extremely unlikely to have a life-threatening effect. Thus, the results of our examination suggest that continuous antithrombotic therapy is very effective in cases of TURBT.