SynthesisProstate cancer and prostatic diseases2026
Perioperative outcomes of ongoing antithrombotic therapy during endoscopic surgery for benign prostatic hyperplasia: a systematic review and meta-analysis of observational studies.
Synthesis in Prostate cancer and prostatic diseases, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper, 1 of them a synthesis that pooled it.
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Who cites it
1 citing paper in PubMed, 1 synthesis or guideline pooled it.
- Ejaculation-sparing endoscopic surgery for benign prostatic hyperplasia: a systematic review and meta-analysis of randomized controlled trials.World journal of urology · 2026Pooled it
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Authors and funding
13 authors.
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No grant is acknowledged in the PubMed record.
Abstract
backgroundThe management of antithrombotic therapy in patients undergoing endoscopic surgery for benign prostatic hyperplasia (BPH) remains challenging due to competing risks of thromboembolism and perioperative bleeding. This meta-analysis evaluated perioperative outcomes among patients undergoing endoscopic prostate procedures while continuing antiplatelet (APT) or anticoagulant (AC) therapy compared with patients not receiving antithrombotic treatment.
methodsLiterature search was conducted on 17th September 2025 including PubMed, Medline, Embase, and Scopus database, to identify comparative studies evaluating perioperative outcomes of endoscopic prostate procedures in patients on versus off APT/AC therapy were identified. Data were pooled using random-effects models to estimate mean differences (MD) or odds ratios (OR) with 95% confidence intervals (CI).
resultsFifteen studies comprising 6091 patients (1900 on APT/AC, 4191 controls) were included. Operative time, postoperative hemoglobin decrease, catheterization duration, and continuous bladder irrigation time were comparable between groups across all surgical modalities. However, bleeding-related complications were significantly more frequent among APT/AC users undergoing transurethral resection of the prostate (TURP) (OR 1.90, 95% CI 1.05-3.41, p = 0.03) and enucleation (OR 2.91, 95% CI 1.71-4.93, p < 0.0001), particularly in the AC subgroup (OR 4.80, p = 0.0002). Enucleation also carried higher odds of bleeding requiring surgical hemostasis (OR 3.69, 95% CI 1.73-7.84, p = 0.0007) and acute urinary retention (OR 1.36, 95% CI 1.04-1.77, p = 0.02) among antithrombotic users. Conversely, photoselective vaporization (PVP) demonstrated comparable rates of transfusion, hemostasis, and urinary complications regardless of APT/AC therapy. Hospital stay was marginally longer after TURP and PVP among APT/AC users (p < 0.05).
conclusionsContinuation of antithrombotic therapy during PVP appears safe, with perioperative outcomes comparable to those of non-antithrombotic patients. Conversely, its ongoing use-especially AC-significantly increases bleeding risks following TURP and enucleation. PVP may therefore represent the preferred modality for high-risk patients requiring uninterrupted antithrombotic therapy. Clinical decision-making should balance individual thromboembolic risk against anticipated bleeding risk, with multidisciplinary input when appropriate.
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