| Objective:To assess the bleeding risk after transurethral therapy of BPH in patients with antithrombotic agent.Methods:We searched the databases of PubMed,Embase,The Cochrane Library,CNKI,and Wanfang Data for controlled clinical trials about the effect of perioperative anticoagulant therapy on postoperative bleeding in BPH published up to May 2018.The studies were screened according to the inclusion and exclusion criteria,the data extracted,and their quality evaluated by 2 reviewers independently,followed by a Meta-analysis using the RevMan 5.3 software.Results:A total of 26 studies were included and 4314 cases were involved in this Meta-analysis.Analysis of these studies found that compared with interrupted antithrombotic agents,continuous use of antithrombotic drugs lead to more frequent post-TURP bleeding[OR=4.34,95% CI(2.29 ~ 8.23),P<0.00001],and higher transfusion rate[OR=2.96,95% CI(1.19 ~ 7.36),P=0.02].Compared with those who never used antithrombotic agents,Continuous group also causes more postoperative bleeding complications[OR=5.52,95% CI(1.64 ~ 18.66),P=0.006].For laser treatment of BPH,continuous of antithrombotic agents has a higher transfusion rate than Interruption antithrombotic agents[OR=5.39,95% CI(1.49 ~ 19.53),P=0.01],showed no significant difference in Clot retention,blood transfusion rate,intraoperative hemoglobin decrease and postoperative catheter-indwelling time compared with those who never used antithrombotic agents(P>0.05),and showed less intraoperative hemoglobin decrease[WMD=-0.46,95% CI(-0.58 ~-0.35),P<0.00001]than the patients who underwent low molecular weight heparin(LMWH)substitution.Conclusion:Interruption of antithrombotic agents during TURP can prevent the risk of postoperative bleeding;continuous use of antithrombotic agents is safe and feasible during laser treatment of BPH;and whether LMWH substitution is necessary during the discontinuation of antithrombotic agents is controversial. |
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