Management of patients treated with aspirin or warfarin and evaluation of haemostasis prior to prostatic biopsy: A survey of current practice amongstradiologists and urologists

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.