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Transperineal ultrasound-guided prostate biopsy is safe even when patients are on combination antiplatelet and/or anticoagulation therapy
To assess whether hemorrhagic complications associated with transperineal prostate biopsy increased in patients on antiplatelet and/or anticoagulant therapy. In total, 598 consecutive patients underwent transperineal prostate biopsy. The medication group comprised patients who took anti-thromboembol...
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| Published in: | BMC urology 2017-07, Vol.17 (1), p.53-53, Article 53 |
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| creator | Saito, Kimitoshi Washino, Satoshi Nakamura, Yuhki Konishi, Tsuzumi Ohshima, Masashi Arai, Yoshiaki Miyagawa, Tomoaki |
| description | To assess whether hemorrhagic complications associated with transperineal prostate biopsy increased in patients on antiplatelet and/or anticoagulant therapy.
In total, 598 consecutive patients underwent transperineal prostate biopsy. The medication group comprised patients who took anti-thromboembolic agents, and the control group comprised those who did not take these agents. No anti-thromboembolic agent was stopped before, during, or after prostate biopsy in the medication group. Complications developing in both groups were compared and classified using the modified Clavien classification system. Subgroup analyses to compare complications in patients taking single antiplatelet, single anticoagulant, and dual antiplatelet and/or anticoagulant agents, and multivariate analyses to predict bleeding risk were also performed.
Of the 598 eligible patients, 149 comprised the medication group and 449 comprised the control group. Hematuria (Grade I) developed in 88 (59.1%) and 236 (52.5%) patients in the medication and control group, respectively (p = 0.18). Clot retention (Grade I) was more frequently observed in the medication group than the controls (2.0% versus 0.2%, respectively, p |
| doi_str_mv | 10.1186/s12894-017-0245-z |
| format | article |
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In total, 598 consecutive patients underwent transperineal prostate biopsy. The medication group comprised patients who took anti-thromboembolic agents, and the control group comprised those who did not take these agents. No anti-thromboembolic agent was stopped before, during, or after prostate biopsy in the medication group. Complications developing in both groups were compared and classified using the modified Clavien classification system. Subgroup analyses to compare complications in patients taking single antiplatelet, single anticoagulant, and dual antiplatelet and/or anticoagulant agents, and multivariate analyses to predict bleeding risk were also performed.
Of the 598 eligible patients, 149 comprised the medication group and 449 comprised the control group. Hematuria (Grade I) developed in 88 (59.1%) and 236 (52.5%) patients in the medication and control group, respectively (p = 0.18). Clot retention (Grade I) was more frequently observed in the medication group than the controls (2.0% versus 0.2%, respectively, p < 0.05). Hospitalization was more frequently prolonged in the medication than the control group (4.0% versus 0.4% of patients, respectively). No complication of Grade III or higher developed in either group. Hematuria was more frequent in patients taking a single anticoagulant (p = 0.007) or two anti-thromboembolic agents (p = 0.04) compared with those taking a single antiplatelet agent. Other complications were generally similar among the groups. In the multivariate analysis, taking more than two anti-thromboembolic agents was the only significant risk factor for bleeding events.
No severe complication developed after the transperineal biopsies in either group, although minor bleeding was somewhat more frequent in the medication group. It may not be necessary to discontinue anticoagulant and/or antiplatelet agents when transperineal prostate biopsy is contemplated.</description><identifier>ISSN: 1471-2490</identifier><identifier>EISSN: 1471-2490</identifier><identifier>DOI: 10.1186/s12894-017-0245-z</identifier><identifier>PMID: 28679384</identifier><language>eng</language><publisher>England: BioMed Central Ltd</publisher><subject>Aged ; Anticoagulant ; Anticoagulants ; Anticoagulants - therapeutic use ; Antiplatelet ; Antiplatelet therapy ; Biopsy ; Bleeding ; Cardiovascular Diseases - complications ; Cardiovascular Diseases - drug therapy ; Care and treatment ; Classification ; Comparative analysis ; Complication ; Complications and side effects ; Dosage and administration ; Drug Therapy, Combination ; Dual antiplatelet therapy ; Hematuria ; Hemorrhage ; Humans ; Image-Guided Biopsy - methods ; Male ; Multivariate analysis ; NMR ; Nuclear magnetic resonance ; Patient Safety ; Perineum ; Platelet Aggregation Inhibitors - therapeutic use ; Prevention ; Prostate ; Prostate - pathology ; Prostate biopsy ; Prostate cancer ; Prostatic Neoplasms - complications ; Prostatic Neoplasms - pathology ; Retrospective Studies ; Risk factors ; Thromboembolism ; Transperineal prostate biopsy ; Ultrasonography, Interventional ; Ultrasound ; Urology</subject><ispartof>BMC urology, 2017-07, Vol.17 (1), p.53-53, Article 53</ispartof><rights>COPYRIGHT 2017 BioMed Central Ltd.</rights><rights>Copyright BioMed Central 2017</rights><rights>The Author(s). 2017</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c560t-53a49eabf7b930ceb52e8c1e24973869d1514c93521fd6f6e574bb9841dca07a3</citedby><cites>FETCH-LOGICAL-c560t-53a49eabf7b930ceb52e8c1e24973869d1514c93521fd6f6e574bb9841dca07a3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC5499054/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.proquest.com/docview/1925368040?pq-origsite=primo$$EHTML$$P50$$Gproquest$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,885,25753,27924,27925,37012,37013,44590,53791,53793</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/28679384$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Saito, Kimitoshi</creatorcontrib><creatorcontrib>Washino, Satoshi</creatorcontrib><creatorcontrib>Nakamura, Yuhki</creatorcontrib><creatorcontrib>Konishi, Tsuzumi</creatorcontrib><creatorcontrib>Ohshima, Masashi</creatorcontrib><creatorcontrib>Arai, Yoshiaki</creatorcontrib><creatorcontrib>Miyagawa, Tomoaki</creatorcontrib><title>Transperineal ultrasound-guided prostate biopsy is safe even when patients are on combination antiplatelet and/or anticoagulation therapy</title><title>BMC urology</title><addtitle>BMC Urol</addtitle><description>To assess whether hemorrhagic complications associated with transperineal prostate biopsy increased in patients on antiplatelet and/or anticoagulant therapy.
In total, 598 consecutive patients underwent transperineal prostate biopsy. The medication group comprised patients who took anti-thromboembolic agents, and the control group comprised those who did not take these agents. No anti-thromboembolic agent was stopped before, during, or after prostate biopsy in the medication group. Complications developing in both groups were compared and classified using the modified Clavien classification system. Subgroup analyses to compare complications in patients taking single antiplatelet, single anticoagulant, and dual antiplatelet and/or anticoagulant agents, and multivariate analyses to predict bleeding risk were also performed.
Of the 598 eligible patients, 149 comprised the medication group and 449 comprised the control group. Hematuria (Grade I) developed in 88 (59.1%) and 236 (52.5%) patients in the medication and control group, respectively (p = 0.18). Clot retention (Grade I) was more frequently observed in the medication group than the controls (2.0% versus 0.2%, respectively, p < 0.05). Hospitalization was more frequently prolonged in the medication than the control group (4.0% versus 0.4% of patients, respectively). No complication of Grade III or higher developed in either group. Hematuria was more frequent in patients taking a single anticoagulant (p = 0.007) or two anti-thromboembolic agents (p = 0.04) compared with those taking a single antiplatelet agent. Other complications were generally similar among the groups. In the multivariate analysis, taking more than two anti-thromboembolic agents was the only significant risk factor for bleeding events.
No severe complication developed after the transperineal biopsies in either group, although minor bleeding was somewhat more frequent in the medication group. It may not be necessary to discontinue anticoagulant and/or antiplatelet agents when transperineal prostate biopsy is contemplated.</description><subject>Aged</subject><subject>Anticoagulant</subject><subject>Anticoagulants</subject><subject>Anticoagulants - therapeutic use</subject><subject>Antiplatelet</subject><subject>Antiplatelet therapy</subject><subject>Biopsy</subject><subject>Bleeding</subject><subject>Cardiovascular Diseases - complications</subject><subject>Cardiovascular Diseases - drug therapy</subject><subject>Care and treatment</subject><subject>Classification</subject><subject>Comparative analysis</subject><subject>Complication</subject><subject>Complications and side effects</subject><subject>Dosage and administration</subject><subject>Drug Therapy, Combination</subject><subject>Dual antiplatelet therapy</subject><subject>Hematuria</subject><subject>Hemorrhage</subject><subject>Humans</subject><subject>Image-Guided Biopsy - methods</subject><subject>Male</subject><subject>Multivariate analysis</subject><subject>NMR</subject><subject>Nuclear magnetic resonance</subject><subject>Patient Safety</subject><subject>Perineum</subject><subject>Platelet Aggregation Inhibitors - therapeutic use</subject><subject>Prevention</subject><subject>Prostate</subject><subject>Prostate - pathology</subject><subject>Prostate biopsy</subject><subject>Prostate cancer</subject><subject>Prostatic Neoplasms - complications</subject><subject>Prostatic Neoplasms - pathology</subject><subject>Retrospective Studies</subject><subject>Risk factors</subject><subject>Thromboembolism</subject><subject>Transperineal prostate biopsy</subject><subject>Ultrasonography, Interventional</subject><subject>Ultrasound</subject><subject>Urology</subject><issn>1471-2490</issn><issn>1471-2490</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><sourceid>PIMPY</sourceid><sourceid>DOA</sourceid><recordid>eNptUk1v3CAQtapWTZr2B_RSWeqlFyeAAcOlUhT1I1KkXtIzGuPxLisvuGAn2vyD_uuycRrtVhUSDMN7D2Z4RfGeknNKlbxIlCnNK0KbijAuqocXxSnlDa0Y1-TlQXxSvElpQzJQCfm6OGFKNrpW_LT4fRvBpxGj8whDOQ9ThBRm31Wr2XXYlWMMaYIJy9aFMe1Kl8oEPZZ4h768X-dphMmhn1IJEcvgSxu2rfM5mWPwkxuHTB9wypvuIsTHnA2wmocFM60xwrh7W7zqYUj47mk9K35-_XJ79b26-fHt-uryprJCkqkSNXCN0PZNq2tisRUMlaWYy2xqJXVHBeVW14LRvpO9RNHwttWK084CaaA-K64X3S7AxozRbSHuTABnHhMhrgzE_MIBTY2KNRalxEZxQRBEi6rvQGstkGmVtT4vWuPcbrGzuQ0RhiPR4xPv1mYV7ozgWhPBs8CnJ4EYfs2YJrN1yeIwgMcwJ0M1lQ3RlJMM_fgPdBPm6HOrMoqJWipyiFpBLsD5PuR77V7UXApKa8qY3F97_h9UHh1u89947F3OHxHoQrDZDili_1wjJWbvRbN40WSLmb0XzUPmfDhszjPjr_nqP5TQ3N0</recordid><startdate>20170705</startdate><enddate>20170705</enddate><creator>Saito, Kimitoshi</creator><creator>Washino, Satoshi</creator><creator>Nakamura, Yuhki</creator><creator>Konishi, Tsuzumi</creator><creator>Ohshima, Masashi</creator><creator>Arai, Yoshiaki</creator><creator>Miyagawa, Tomoaki</creator><general>BioMed Central Ltd</general><general>BioMed Central</general><general>BMC</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QP</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><scope>5PM</scope><scope>DOA</scope></search><sort><creationdate>20170705</creationdate><title>Transperineal ultrasound-guided prostate biopsy is safe even when patients are on combination antiplatelet and/or anticoagulation therapy</title><author>Saito, Kimitoshi ; Washino, Satoshi ; Nakamura, Yuhki ; Konishi, Tsuzumi ; Ohshima, Masashi ; Arai, Yoshiaki ; Miyagawa, Tomoaki</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c560t-53a49eabf7b930ceb52e8c1e24973869d1514c93521fd6f6e574bb9841dca07a3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Aged</topic><topic>Anticoagulant</topic><topic>Anticoagulants</topic><topic>Anticoagulants - therapeutic use</topic><topic>Antiplatelet</topic><topic>Antiplatelet therapy</topic><topic>Biopsy</topic><topic>Bleeding</topic><topic>Cardiovascular Diseases - complications</topic><topic>Cardiovascular Diseases - drug therapy</topic><topic>Care and treatment</topic><topic>Classification</topic><topic>Comparative analysis</topic><topic>Complication</topic><topic>Complications and side effects</topic><topic>Dosage and administration</topic><topic>Drug Therapy, Combination</topic><topic>Dual antiplatelet therapy</topic><topic>Hematuria</topic><topic>Hemorrhage</topic><topic>Humans</topic><topic>Image-Guided Biopsy - methods</topic><topic>Male</topic><topic>Multivariate analysis</topic><topic>NMR</topic><topic>Nuclear magnetic resonance</topic><topic>Patient Safety</topic><topic>Perineum</topic><topic>Platelet Aggregation Inhibitors - therapeutic use</topic><topic>Prevention</topic><topic>Prostate</topic><topic>Prostate - pathology</topic><topic>Prostate biopsy</topic><topic>Prostate cancer</topic><topic>Prostatic Neoplasms - complications</topic><topic>Prostatic Neoplasms - pathology</topic><topic>Retrospective Studies</topic><topic>Risk factors</topic><topic>Thromboembolism</topic><topic>Transperineal prostate biopsy</topic><topic>Ultrasonography, Interventional</topic><topic>Ultrasound</topic><topic>Urology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Saito, Kimitoshi</creatorcontrib><creatorcontrib>Washino, Satoshi</creatorcontrib><creatorcontrib>Nakamura, Yuhki</creatorcontrib><creatorcontrib>Konishi, Tsuzumi</creatorcontrib><creatorcontrib>Ohshima, Masashi</creatorcontrib><creatorcontrib>Arai, Yoshiaki</creatorcontrib><creatorcontrib>Miyagawa, Tomoaki</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Calcium & Calcified Tissue Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest Central</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Publicly Available Content Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>BMC urology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Saito, Kimitoshi</au><au>Washino, Satoshi</au><au>Nakamura, Yuhki</au><au>Konishi, Tsuzumi</au><au>Ohshima, Masashi</au><au>Arai, Yoshiaki</au><au>Miyagawa, Tomoaki</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Transperineal ultrasound-guided prostate biopsy is safe even when patients are on combination antiplatelet and/or anticoagulation therapy</atitle><jtitle>BMC urology</jtitle><addtitle>BMC Urol</addtitle><date>2017-07-05</date><risdate>2017</risdate><volume>17</volume><issue>1</issue><spage>53</spage><epage>53</epage><pages>53-53</pages><artnum>53</artnum><issn>1471-2490</issn><eissn>1471-2490</eissn><abstract>To assess whether hemorrhagic complications associated with transperineal prostate biopsy increased in patients on antiplatelet and/or anticoagulant therapy.
In total, 598 consecutive patients underwent transperineal prostate biopsy. The medication group comprised patients who took anti-thromboembolic agents, and the control group comprised those who did not take these agents. No anti-thromboembolic agent was stopped before, during, or after prostate biopsy in the medication group. Complications developing in both groups were compared and classified using the modified Clavien classification system. Subgroup analyses to compare complications in patients taking single antiplatelet, single anticoagulant, and dual antiplatelet and/or anticoagulant agents, and multivariate analyses to predict bleeding risk were also performed.
Of the 598 eligible patients, 149 comprised the medication group and 449 comprised the control group. Hematuria (Grade I) developed in 88 (59.1%) and 236 (52.5%) patients in the medication and control group, respectively (p = 0.18). Clot retention (Grade I) was more frequently observed in the medication group than the controls (2.0% versus 0.2%, respectively, p < 0.05). Hospitalization was more frequently prolonged in the medication than the control group (4.0% versus 0.4% of patients, respectively). No complication of Grade III or higher developed in either group. Hematuria was more frequent in patients taking a single anticoagulant (p = 0.007) or two anti-thromboembolic agents (p = 0.04) compared with those taking a single antiplatelet agent. Other complications were generally similar among the groups. In the multivariate analysis, taking more than two anti-thromboembolic agents was the only significant risk factor for bleeding events.
No severe complication developed after the transperineal biopsies in either group, although minor bleeding was somewhat more frequent in the medication group. It may not be necessary to discontinue anticoagulant and/or antiplatelet agents when transperineal prostate biopsy is contemplated.</abstract><cop>England</cop><pub>BioMed Central Ltd</pub><pmid>28679384</pmid><doi>10.1186/s12894-017-0245-z</doi><tpages>1</tpages><oa>free_for_read</oa></addata></record> |
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| ispartof | BMC urology, 2017-07, Vol.17 (1), p.53-53, Article 53 |
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| source | Open Access: PubMed Central; Publicly Available Content Database |
| subjects | Aged Anticoagulant Anticoagulants Anticoagulants - therapeutic use Antiplatelet Antiplatelet therapy Biopsy Bleeding Cardiovascular Diseases - complications Cardiovascular Diseases - drug therapy Care and treatment Classification Comparative analysis Complication Complications and side effects Dosage and administration Drug Therapy, Combination Dual antiplatelet therapy Hematuria Hemorrhage Humans Image-Guided Biopsy - methods Male Multivariate analysis NMR Nuclear magnetic resonance Patient Safety Perineum Platelet Aggregation Inhibitors - therapeutic use Prevention Prostate Prostate - pathology Prostate biopsy Prostate cancer Prostatic Neoplasms - complications Prostatic Neoplasms - pathology Retrospective Studies Risk factors Thromboembolism Transperineal prostate biopsy Ultrasonography, Interventional Ultrasound Urology |
| title | Transperineal ultrasound-guided prostate biopsy is safe even when patients are on combination antiplatelet and/or anticoagulation therapy |
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