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The following is a summary of “Impact of oral antithrombotic agents on urinary continence recovery following robot-assisted radical prostatectomy: a retrospective cohort study,” published in the September 2024 issue of Urology by Oshima et al.
Robot-assisted radical prostatectomy (RARP) is widely used for prostate cancer, but the impact of antithrombotic agents on urinary recovery post-surgery is not well studied.
Researchers conducted a retrospective study to compare urinary continence recovery and oncological outcomes in patients with localized prostate cancer undergoing RARP, with and without antithrombotic therapy.
They analyzed 394 patients who underwent conventional anterior RARP between February 2015 and February 2021, dividing them into 2 groups: those taking oral antithrombotic agents (AT group) and those not (control group). Urinary continence recovery, complications, and oncological outcomes were assessed, with clinical factors influencing continence recovery identified through Cox proportional hazards analysis.
The results showed no significant difference in background data or bleeding complications between groups. However, continence recovery was significantly poorer in the AT group for both complete pad-free (HR: 0.53 [95% CI: 0.39–0.71]) and ≤1 safety pad use (HR: 0.74 [95% CI: 0.59–0.94]). The AT group had a higher rate of anastomotic leakage on cystography (20.9% vs. 6.7%). Univariate analysis revealed that antithrombotic use, higher PSA levels, and advanced clinical stage were linked to poor urinary continence recovery. Multivariate analysis identified antithrombotic use as an independent negative factor for continence recovery. There was no significant difference in positive surgical margin (19.0% vs. 23.8%) or biochemical-recurrence-free rates between groups.
Investigators concluded that taking oral antithrombotic agents was associated with poorer urinary continence recovery after RARP. They found no significant differences in oncological outcomes between groups.
Source: bmcurol.biomedcentral.com/articles/10.1186/s12894-024-01594-6
