Evidence map›Paper›PMID 41206372›Full record

ArticleWorld journal of urology2025

To stop or not to stop. Endoscopic enucleation of the prostate in patients on blood thinners: outcomes, a real-life prospective multicenter study of 932 cases.

Daniele Castellani, Steffi Kar-Kei Yuen, Carlo Giulioni, Khi Yung Fong, Steeve Doizi, Stefano Moretto, Marek Zawadzki, Yiloren Tanidir, Mehmet Ilker Gökce, Abhay Mahajan and 22 more

Abstract readMulticenter Study
PubMed Publisher
In one paragraph

Article in World journal of urology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

32 authors.

Daniele CastellaniUrology Unit, Azienda Ospedaliero-Universitaria delle Marche, via Conca 71, 60126, Ancona, Italy. castellanidaniele@gmail.com.
Steffi Kar-Kei YuenEndourology section of the European Association of Urology, Arnhem, The Netherlands.
Carlo GiulioniUrology Unit, Villa Igea Private Hospital, Ancona, Italy.
Khi Yung FongDepartment of Urology, Sengkang General Hospital, Singapore, Singapore.
Steeve DoiziUrology Unity, Sorbonne University, Tenon Hospital, Paris, France.
Stefano MorettoUrology Unity, Sorbonne University, Tenon Hospital, Paris, France.
Marek ZawadzkiUrology Unit, St. Anna Hospital, Piaseczno, Poland.
Yiloren TanidirDepartment of Urology, Medicana Atasehir Hospital, Istanbul, Turkey.
Mehmet Ilker GökceEndourology section of the European Association of Urology, Arnhem, The Netherlands.
Abhay MahajanSai Urology Hospital and MGM Medical College, Chhatrapati Sambhajinagar, Maharashtra, India.
Dmitriy SytnikUrology Unit, St.Luke's Clinical Hospital, Saint-Petersburg, Russian Federation.
Abdulrahman AlkandariUrology Department, Thunder Bay Regional Health Sciences Centre, Northern Ontario School of Medicine, Thunder Bay, ON, Canada.
Benedikt BeckerDepartment of Urology, Asklepios Hospital Barmbek, Hamburg, Germany.
Cemil AydinDepartment of Urology, School of Medicine, Hitit University, Çorum, Turkey.
Nebil AkdoganDepartment of Urology, Faculty of Medicine, Cukurova University, Adana, Turkey.
Ender Cem BulutDepartment of Urology, Faculty of Medicine, Gazi University, Ankara, Turkey.
Sumit MoreDepartment of Urology, Sarvodaya Hospital and Research Centre, Faridabad, India.
Vincent De ConinckEndourology section of the European Association of Urology, Arnhem, The Netherlands.
Abai XuDepartment of Urology, Zhujiang Hospital, Southern Medical University, Guangzhou, China.
Nariman GadzhievUrology Unit, Saint-Petersburg State University Hospital, Saint Petersburg, Russia.
Vigen MalkhasyanUrology Department, Russian University of Medicine, Botkin Hospital Moscow, Moscow, Russian Federation.
Karl TanDepartment of Urology, Veterans Memorial Medical Center, Quezon City, Philippines.
Yong Wei LimDepartment of Urology, Sengkang General Hospital, Singapore, Singapore.
Mahmoud Nabil Ismail LaymonUrology and Nephrology Center, Mansoura University, Mansoura, Egypt.
Giorgio MazzonDepartment of Urology, University College Hospital London, London, UK.
Biligere Priyadarshi SarvajitDepartment of Urology, Ng Teng Fong General Hospital, Singapore, Singapore.
Mallikarjuna ChiruvellaDepartment of Urology, Asian Institute of Nephrology and Urology, Hyderabad, India.
Dmitry EnikeevRabin Medical Center (Belenson, Hasharon), Petah Tikva, Israel.
Bhaskar SomaniEndourology section of the European Association of Urology, Arnhem, The Netherlands.
Omar AbdelAzizUrology Unit, Kasr AlAiny Medical School, Cairo University, Cairo, Egypt.
Thomas HerrmannEndourology section of the European Association of Urology, Arnhem, The Netherlands.
Vineet GauharEndourology section of the European Association of Urology, Arnhem, The Netherlands.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeTo evaluate the safety of endoscopic enucleation of the prostate (EEP) in benign prostatic hyperplasia (BPH) patients maintained on blood thinners compared to those who discontinued therapy, and to identify independent predictors of postoperative bleeding complications.

methodsBPH patients on blood thinners planned for EEP were prospectively enrolled from 30 centers (December 2024-June 2025). Patients were divided into Group 1 (continued blood thinners, n = 329) and Group 2 (discontinued blood thinners, n = 603). Outcomes included bleeding complications, hospital stay, and functional results. Multivariable logistic regression identified predictors of postoperative bleeding (blood transfusion, need for restarting of continuous bladder washout, clot retention, surgical control of post-operative bleeding).

resultsThe overall population had a median age of 70.0 years and prostate volume of 81.0 ml. Group 1 patients had higher comorbidity rates. Group 1 demonstrated significantly longer median operative times (87.0 vs. 70.0 min, p < 0.001) and increased bleeding-related complications, including continuous bladder washout restart (14.3% vs. 2.5%, p < 0.001), blood transfusion requirements (1.5% vs. 0.5%, p < 0.001), and hospital readmissions (10.0% vs. 4.1%, p < 0.001). Rates of surgical hemostasis intervention were similar (1.8% in Group 1 vs. 2.0% in Group 2, p = 0.92). No major thrombotic events occurred. Independent predictors of bleeding included longer operative time (OR 1.01, p < 0.001) and combination antiplatelet/anticoagulant therapy (OR 2.47, p = 0.04), while tranexamic acid was associated with lower odds (OR 0.18, p < 0.001).

conclusionEEP can be safely performed in patients on blood thinners with acceptable morbidity, though bleeding complications are higher. Combination therapy carries the highest risk, while tranexamic acid reduces bleeding complications.

Indexed as

EndoscopyPostoperative HemorrhageProstatectomyProstatic HyperplasiaAgedAged, 80 and overHumansMaleMiddle AgedProspective StudiesTreatment OutcomeAnticoagulantsBenign prostatic hyperplasiaEndoscopic enucleation of the prostatePlatelet aggregation inhibitors

Identifiers

PMID41206372

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.