Thrombotic risk factors associated with transurethral prostatectomy

Objective To ascertain the potential thrombotic risk associated with transu rethral prostatectomy (TURP). Patients and methods The changes in coagulation variables were assessed in a prospective study of 40 patients undergoing TURF. Results There was a significant increase in thrombin-antithrombin complexes 6 h after TURF (ANOVA. P = 0.01) combined with a significant decrease in a ctivated partial thromboplastin time (ANOVA, P = 0.006), suggesting a posto perative hypercoagulable state. The significant increase in D-dimer 24 h af ter TURF (ANOVA. P = 0.015) in the absence of any significant rise in tissu e plasminogen activator antigen levels perioperatively (ANOVA, P = 0.737) s uggests a physiological fibrinolytic response to the developing procoagulan t state. The absence of any significant increase in plasminogen activator i nhibitor-1 antigen perioperatively (ANOVA, P = 0.348) suggests the observed hypercoagulability is not due to a fibrinolytic shutdown' reported in othe r forms of surgery. Conclusion TURF is associated with a hypercoagulable prothrombotic state; a spirin withdrawal perioperatively may be hazardous, and low-dose heparin pr ophylaxis for venous thrombosis should be considered.