The following is a summary of “Aquablation in Patients on Antithrombotics: Assessment of Safety, Postoperative Bleeding Rates and Clinical Outcomes,” published in the November 2023 issue of Urology by Sadri, et al.

For a study, researchers sought to assess the impact of perioperative antithrombotic use on bleeding outcomes following Aquablation.

A total of 116 men who underwent Aquablation as part of the WATER prospective trial were categorized into two groups based on their perioperative antithrombotic status. The decision on antithrombotic cessation and restart timing was at the discretion of the surgeon. Intraoperative hemostasis was achieved using either no-cautery balloon tamponade or cautery. The primary endpoints included immediate postoperative hematuria rates and changes in hemoglobin. Secondary endpoints comprised bleeding complications at 90 days and non-bleeding postoperative adverse events.

Among the participants, 41 men were on perioperative antithrombotic medications, while 75 were not. Preoperative hemoglobin levels were similar in both groups. The change in postoperative hemoglobin from baseline did not differ significantly between the antithrombotic and antithrombotic-naïve groups (1.8 ± 1.5 g/dL vs. 1.8 ± 1.7 g/dL, respectively; P = .896). In the 3-month postoperative period, 9.8% of men in the antithrombotic group and 5.3% in the antithrombotic-naïve group experienced a Clavien-Dindo grade 1 complication (P = .451). Grade 2 complications were observed in 19.5% and 14.7% of patients in the antithrombotic and antithrombotic-naïve groups, respectively (P = .601), with none associated with bleeding. No cases of de novo erectile dysfunction were reported in either group. Blood product transfusion was required by one patient (2.4%) in the antithrombotic group and none in the antithrombotic-naïve group (P = .353).

Aquablation demonstrated comparable postoperative bleeding outcomes and other adverse effects for men with benign prostatic hypertrophy, irrespective of their use of antithrombotic therapy.

Reference: goldjournal.net/article/S0090-4295(23)00685-4/fulltext