Turp and turbt

It si quite debatable: A dose of 150 mg will certainly have some impact although I personally did not operate on such a patient. A dose of 75 mg is query. Bottom line: if you have within normal bleeding and clotting times, you can proceed and operate.

Some time you get normal coagulation profile with platelet dysfunction with open surgery you can manage but in endoscopic surgery some time difficult to manage bleeding

Some years ago we didn t any endoscop surgery

In the last few years in the most of German hospitals attitude changed.

We do uretersocopy, cystoscopy and if necessary suprapubic catheter insertion.

To all procedures we inform the patients about a probale risk

We do not TUR B and TUR P or Nephrostomy , nephrostomy only in emergency cases

we do normally not prostate biopsies

Sincerel yours

Fritz moll

platelet function can hardly be clinically assessed, normal bleeding and clotting times will probably denote that there is no substantial risk of bleeding. talking about 75 mg dose ( which is less than the standard dose of 100 mg used for prevention of CV and myocardial accidents) I 'd certainly operate and do most of the endoscopic procedures short of PCNL

I agree with Dr Wadie, barring PCNL where options of control of bleeding are limited every endoscopic or open procedure can be done with Aspirin 75mg. It is indeed safer to continue with Aspirin than discontinue and risk thrombo emblic event in a prone patient.

I do not require discontinuance of low dose aspirin prior to any procedures that I do, including kidney transplantation.

In general I do any surgery regardless of the Aspirin dose if bleeding and clotting times are normal. If you want to be on the secure side in TURP cases with borderline findings, you may use vaporisation or thulium laser which are also nice alternatives in fully anticoagulized patients.

None, because I believe that if we compared 2 groups discontinuing aspirin before and after surgery, there would be no difference

There is good evidence that it is ok to operate on and perform almost all urologic procedures if a patient is on Aspirin. In my practice, I like to take patients off of aspirin if possible and I routinely discuss this with the patient's cardiologist. If the procedure is necessary in a certain amount of time (Cystectomy) and the patient cannot come off of aspirin, I will proceed with the operation. Hope that helps.

In general no need to stop if patient is on low dose aspirin. High risk patients for bleeding can be considered Bleeding time, Clotting time or even Thromboelastogram (TEG) pre-operatively.

I am willing to perform prostate brachytherapy on patients taking 75mg Aspirin

I will check the Platelets count if it is in normal limit I will not do EndoscopicUrology surgery due to I cannot performe a good hemostasis

Platelet count would not be affected by aspirin nor PT and INR. It is the binding capacity of platelets that is affected. There is a platelet aggrevation test in our hospital, but that also is bound to be affected. All in all you know that your patient has an slightly increased danger of bleeding.

We have performed robotic assisted prostatectomies in 2 cases, and robotic assisted nephroureterectomy in 1 case under low dose aspirin and low molecular weight heparin simultaneously. All patients recoverd fine. Although nothing more than case report, and low low level of evidence, we offer this modality to patients under continuous low dose aspirin

The risk of stopping Aspirin and a resultant cardiac or CVA event, is far greater than the realistic risk of bleeding.

I would not stop Aspirin for any of the urological procedures.

If platlet function ( platlet ggregation test is normal ,INR ,may i do operations specially if it is simple or if a simple endoscopic pocedures like cystoscopy ,stone disintegration, Uretroscopies.

We have performed laparoscopic partial nephrectomies, open radical cystectomies, TUR-T and TUR-P 'ies without stopping aspirin. PNL is the operation that we would not perform with 75mg aspirin.

If that patients should definitely use the Aspirin (for example coronary stand), So I would not stop Aspirin for any of the urological procedures. Because cardiac risk is greater than the risk of bleeding.

No urologic procedure should be not done due to aspirin intake only. The bleeding observed in urologic procedures in patients treated with low dose of aspirin were never compared to bleeding in patient not in aspirin intake. The current level of evidence to avoid any procedure in this situation is too low (level 5).

La dosis es de la Aspirina de 75 MG es relativamente baja y no se debe suspender las pruebas diagnosticas,el riesgo de sangrado realmente es minimo