Do no harm: the role of perioperative heparin in urethroplasty.

MedStar author(s):
Citation: International Urology & Nephrology. 54(9):2181-2186, 2022 Sep.PMID: 35759208Institution: MedStar Georgetown University Hospital/MedStar Washington Hospital Center | MedStar Washington Hospital CenterDepartment: Urology | Urology Residency-CategoricalForm of publication: Journal ArticleMedline article type(s): Journal ArticleSubject headings: IN PROCESS -- NOT YET INDEXEDYear: 2022ISSN:
  • 0301-1623
Name of journal: International urology and nephrologyAbstract: CONCLUSION: Routine LDUH administration likely overtreats men undergoing urethroplasty. There may be a subset of men in whom dual prophylaxis with LDUH and SCD is beneficial for prevention of VTE. Current guidelines do not offer adequate criteria to identify these men. We offer clinical considerations to help guide further study to identify these patients. Copyright © 2022. The Author(s), under exclusive licence to Springer Nature B.V.METHODS: Patients were identified from an IRB-approved database of patients undergoing urethral reconstruction by a single surgeon at MedStar Washington Hospital Center from 2012 to 2020. All patients had sequential compression devices (SCD) prior to anesthesia induction. Select patients received LDUH as dual prophylaxis. Primary endpoint was perioperative VTE within 30 days.OBJECTIVE: To examine the safety of single modality mechanical venous thromboembolism (VTE) prophylaxis in patients undergoing urethroplasty. VTE is a perioperative complication with significant morbidity. Routine use of peri-operative VTE prophylaxis is common guideline-driven practice across multiple surgical specialties. There is a discrepancy between guideline recommendations and clinical practice in the administration of peri-operative low-dose unfractionated heparin (LDUH) for urethroplasty.RESULTS: We identified 345 patients who met inclusion criteria. Sixty-nine patients received peri-operative LDUH. One patient had a deep vein thrombosis in the SCD only group.All authors: Hays E, Lee HH, Shaw NM, Venkatesan KFiscal year: FY2023Digital Object Identifier: Date added to catalog: 2022-09-26
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Item type Current library Collection Call number Status Date due Barcode
Journal Article MedStar Authors Catalog Article 35759208 Available 35759208

CONCLUSION: Routine LDUH administration likely overtreats men undergoing urethroplasty. There may be a subset of men in whom dual prophylaxis with LDUH and SCD is beneficial for prevention of VTE. Current guidelines do not offer adequate criteria to identify these men. We offer clinical considerations to help guide further study to identify these patients. Copyright © 2022. The Author(s), under exclusive licence to Springer Nature B.V.

METHODS: Patients were identified from an IRB-approved database of patients undergoing urethral reconstruction by a single surgeon at MedStar Washington Hospital Center from 2012 to 2020. All patients had sequential compression devices (SCD) prior to anesthesia induction. Select patients received LDUH as dual prophylaxis. Primary endpoint was perioperative VTE within 30 days.

OBJECTIVE: To examine the safety of single modality mechanical venous thromboembolism (VTE) prophylaxis in patients undergoing urethroplasty. VTE is a perioperative complication with significant morbidity. Routine use of peri-operative VTE prophylaxis is common guideline-driven practice across multiple surgical specialties. There is a discrepancy between guideline recommendations and clinical practice in the administration of peri-operative low-dose unfractionated heparin (LDUH) for urethroplasty.

RESULTS: We identified 345 patients who met inclusion criteria. Sixty-nine patients received peri-operative LDUH. One patient had a deep vein thrombosis in the SCD only group.

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