Management of patients treated with aspirin or warfarin and evaluation of haemostasis prior to prostatic biopsy: A survey of current practice amongstradiologists and urologists
Sej. Connor et Jp. Wingate, Management of patients treated with aspirin or warfarin and evaluation of haemostasis prior to prostatic biopsy: A survey of current practice amongstradiologists and urologists, CLIN RADIOL, 54(9), 1999, pp. 598-603
AIM: To document current practice concerning the management of patients tak
ing aspirin or warfarin and the evaluation of haemostatic function prior to
prostatic biopsy.
METHOD: A postal survey was performed with typed questionnaires being sent
to 275 urology and 275 radiology centres,
RESULTS: A high proportion of radiology departments in particular (83%) had
protocols in place concerning the management of aspirin or warfarin prior
to prostatic biopsy. A significant proportion of both radiologists and urol
ogists have postponed biopsies due to patients unexpectedly taking these me
dications. Few of the respondents reported the use of pre-biopsy screening
blood tests. Fifty-two percent of radiologists and 27% of urologists termin
ated aspirin prior to prostatic biopsy, although the urologists stopped asp
irin for a long time period. Ninety-five percent of radiologists and 84% of
urologists terminated warfarin prior to prostatic biopsy, although again t
he urologists stopped warfarin at an earlier stage. Most of those responden
ts who stopped warfarin prior to biopsy, also checked the INR, The urologis
ts generally stated a higher threshold (INR) which would be considered too
high to proceed.
CONCLUSION: There are wide variations in practice both within and between t
he radiology and urology groups. This is unsurprising, since there is confl
icting advice in the relevant literature.