ArticleInternational urogynecology journal2026
Impact of Pharmacologic Thromboprophylaxis on Venous Thromboembolism and Bleeding Complications Following Pelvic Organ Prolapse Procedures.
Article in International urogynecology journal, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
introduction and hypothesisCurrent literature provides conflicting evidence regarding venous thromboembolism (VTE) pharmacologic thromboprophylaxis benefits in the context of postoperative bleeding complications in the setting of pelvic organ prolapse (POP) surgery. We hypothesized that patients receiving VTE pharmacologic thromboprophylaxis, compared to those who did not, would have a similar rate of VTE but higher bleeding complication rates.
methodsThis was a retrospective cohort study utilizing the Premier Healthcare Database. Patients who underwent POP surgery between January 2000 and March 2020 were identified and grouped by those who received a single dose of pharmacologic thromboprophylaxis and those who did not. Data were analyzed using Kruskal-Wallis, chi-squared tests, and inverse probability of treatment weighted analysis, as appropriate. The primary outcome was rate of composite bleeding complications within 3 months, and secondary outcomes were rate of VTE, emergency department visits, and readmissions.
resultsThe cohort included 214,427 patients, of which 13.7% received pharmacologic thromboprophylaxis. In the unweighted analysis, those who received pharmacologic thromboprophylaxis had higher rates of composite bleeding complications (1.1% vs 0.7%, p < 0.001). The rate of VTE was higher in those with pharmacologic thromboprophylaxis (0.23% vs 0.16%, p = 0.007). These findings persisted after using inverse probability of treatment weighted analysis to adjust for confounding factors, with an increased probability of developing bleeding complications (OR 1.51 [1.32, 1.71]) and VTE (OR 1.42 [1.08, 1.87]).
conclusionsWhen weighted on preoperative and operative characteristics, patients who received a single dose of thromboprophylaxis had increased risks of bleeding complications and VTE.
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