Impact of statin use on perioperative bleeding in patients with benign prostatic hyperplasia who underwent monopolar TURP
Öz
Objective: We aimed to evaluate the effect of statin use on bleeding complications in benign prostate hyperplasia (BPH) patients who underwent transurethral resection of the prostate (TURP).
Material and Methods: This prospective case-control study included patients with benign prostatic hyperplasia (BPH) who underwent TURP surgery. Seventy-six patients were included (30 statin users and 74 statin non-users). Data including patient age, preoperative laboratory values(complete blood count, prostate-specific antigen (PSA) levels, prostate volume, international normalized ratio (INR), activated partial thromboplastin time (aPTT)), intraoperative characteristics(amount of resected prostate tissue, blood transfusion, duration of surgery, duration of urinary catheterization) and postoperative features(serum complete blood count, and length of hospital stay)were collected. Patients who underwent TURP with or without statin use were compared with hematocrit and bleeding complications.
Results: There was no difference between the groups regarding the degree of reduction in hematocrit and platelet count. In both groups, postoperative hematocrit and platelet counts were significantly lower than preoperative values. There was no significant difference between the groups regarding age, PSA, prostate volume, histopathological diagnosis, transurethral resection (TUR) volume, INR, PT, aPTT, number of red blood cell (RBC) units transfused, duration of surgery, irrigation time, hematocrit, and platelet count. TUR volume, frequency of anticoagulant use, duration, and length of hospital stay were statistically higher in the statin user group
Conclusion: Our results showed that statin use did not impact bleeding in patients with BPH who underwent TURP. Considering the widespread use of statins, during surgery the effects of bleeding, we need more information on further studies to light.
Anahtar Kelimeler
benign prostatic hyperplasia bleeding statin transurethral resection of the prostate
Kaynakça
- 1. Lim KB. Epidemiology of clinical benign prostatic hyperplasia. Asian J Urol. 2017;4(3):148-51.
- 2. Langan RC. Benign Prostatic Hyperplasia. Prim Care. 2019;46(2):223-32.
- 3. Foster HE, Barry MJ, Dahm P, et al. Surgical Management of Lower Urinary Tract Symptoms Attributed to Benign Prostatic Hyperplasia: AUA Guideline. J Urol. 2018;200(3):612-9.
- 4. Suarez-Ibarrola R, Bach T, Hein S, et al. Efficacy and safety of aquablation of the prostate for patients with symptomatic benign prostatic enlargement: a systematic review. World J Urol. 2019.
- 5. Reich O, Gratzke C, Bachmann A, et al. Morbidity, mortality and early outcome of transurethral resection of the prostate: a prospective multicenter evaluation of 10,654 patients. J Urol. 2008;180(1):246-9.
- 6. Edwards JE, Moore RA. Statins in hypercholesterolaemia: a dose-specific meta-analysis of lipid changes in randomised, double blind trials. BMC Fam Pract. 2003;4:18.
- 7. Adams SP, Tsang M, Wright JM. Lipid-lowering efficacy of atorvastatin. Cochrane Database Syst Rev. 2015(3):CD008226.
- 8. Undas A, Brummel-Ziedins KE, Mann KG. Statins and blood coagulation. Arterioscler Thromb Vasc Biol. 2005;25(2):287-94.
- 9. Rodriguez AL, Wojcik BM, Wrobleski SK, Myers DD, Jr., Wakefield TW, Diaz JA. Statins, inflammation and deep vein thrombosis: a systematic review. J Thromb Thrombolysis. 2012;33(4):371-82.
- 10. Wiesbauer F, Kaun C, Zorn G, Maurer G, Huber K, Wojta J. HMG CoA reductase inhibitors affect the fibrinolytic system of human vascular cells in vitro: a comparative study using different statins. Br J Pharmacol. 2002;135(1):284-92.
- 11. Undas A, Brummel-Ziedins KE, Mann KG. Anticoagulant effects of statins and their clinical implications. Thromb Haemost. 2014;111(3):392-400.
- 12. Hauer-Jensen M, Fort C, Mehta JL, Fink LM. Influence of statins on postoperative wound complications after inguinal or ventral herniorrhaphy. Hernia. 2006;10(1):48-52.
- 13. Truesdale MD, Polland AR, Graversen JA, et al. Impact of HMG-CoA reductase inhibitor (statin) use on blood loss during robot-assisted and open radical prostatectomy. J Endourol. 2011;25(9):1427-33.
- 14. Gratzke C, Bachmann A, Descazeaud A, et al. EAU Guidelines on the Assessment of Non-neurogenic Male Lower Urinary Tract Symptoms including Benign Prostatic Obstruction. Eur Urol. 2015;67(6):1099-109.
- 15. Murciano-Goroff YR, Wolfsberger LD, Parekh A, et al. Variability in MRI vs. ultrasound measures of prostate volume and its impact on treatment recommendations for favorable-risk prostate cancer patients: a case series. Radiat Oncol. 2014;9:200.
- 16. Mc Namara K, Alzubaidi H, Jackson JK. Cardiovascular disease as a leading cause of death: how are pharmacists getting involved? Integr Pharm Res Pract. 2019;8:1-11.
- 17. Banfi C, Brioschi M, Lento S, et al. Statins prevent tissue factor induction by protease-activated receptors 1 and 2 in human umbilical vein endothelial cells in vitro. J Thromb Haemost. 2011;9(8):1608-19.
- 18. Owens AP, Passam FH, Antoniak S, et al. Monocyte tissue factor-dependent activation of coagulation in hypercholesterolemic mice and monkeys is inhibited by simvastatin. J Clin Invest. 2012;122(2):558-68.
- 19. Momi S, Impagnatiello F, Guzzetta M, et al. NCX 6560, a nitric oxide-releasing derivative of atorvastatin, inhibits cholesterol biosynthesis and shows anti-inflammatory and anti-thrombotic properties. Eur J Pharmacol. 2007;570(1-3):115-24.
- 20. Sahebkar A, Serban C, Ursoniu S, et al. The impact of statin therapy on plasma levels of von Willebrand factor antigen. Systematic review and meta-analysis of randomised placebo-controlled trials. Thromb Haemost. 2016;115(3):520-32.
- 21. Glynn RJ, Danielson E, Fonseca FA, et al. A randomized trial of rosuvastatin in the prevention of venous thromboembolism. N Engl J Med. 2009;360(18):1851-61.
- 22. Khemasuwan D, Divietro ML, Tangdhanakanond K, Pomerantz SC, Eiger G. Statins decrease the occurrence of venous thromboembolism in patients with cancer. Am J Med. 2010;123(1):60-5.
- 23. Resh M, Mahmoodi BK, Navis GJ, Veeger NJ, Lijfering WM. Statin use in patients with nephrotic syndrome is associated with a lower risk of venous thromboembolism. Thromb Res. 2011;127(5):395-9.
- 24. Biedermann JS, Kruip M, van der Meer FJ, Rosendaal FR, Leebeek FWG, Cannegieter SC, et al. Rosuvastatin use improves measures of coagulation in patients with venous thrombosis. Eur Heart J. 2018;39(19):1740-7.
Benign prostat hiperplazi nedeniyle transüretral prostat rezeksiyonu uygulanan hastalarda statin kullanımının perioperatif kanamaya etkisi
Öz
Amaç: Transüretral prostat rezeksiyonu (TURP) uygulanan benign prostat hiperplazisi (BPH) hastalarında statin kullanımının kanama komplikasyonu üzerine etkisini değerlendirmeyi amaçladık.
Gereç ve Yöntemler: Bu çalışma TURP ameliyatı geçirmiş BPH hastalarını içeren prospektif bir vaka-kontrol çalışmasıdır. Çalışmaya yetmiş altı hasta dahil edildi (30 statin kullanıcısı ve 74 statin kullanmayan). Hasta yaşı, ameliyat öncesi laboratuvar değerleri (tam kan sayımı, prostat spesifik antijen (PSA) seviyeleri, prostat hacmi, uluslararası normalleştirilmiş oran (INR), aktif parsiyel tromboplastin zamanı (aPTT)), intraoperatif özellikler (rezeke edilen prostat dokusu miktarı, kan transfüzyonu, ameliyat süresi, üriner kateterizasyon süresi) ve ameliyat sonrası özellikler (serum tam kan sayımı ve hastanede kalış süresi) değerlendirildi. Statin kullanan ve kullanmayan TURP yapılan hastalar hematokrit değerleri ve kanama komplikasyonları açısından karşılaştırıldı.
Bulgular: Hematokrit ve trombosit sayısındaki azalma düzeyi açısından gruplar arasında fark yoktu. Her iki grupta da ameliyat sonrası hematokrit ve trombosit sayıları ameliyat öncesi değerlere göre anlamlı derecede düşüktü. Gruplar arasında yaş, PSA, prostat hacmi, histopatolojik tanı, transüretral rezeksiyon (TUR) hacmi, INR, PT, aPTT, transfüze edilen kan miktarı, ameliyat süresi, irrigasyon süresi, hematokrit ve trombosit sayısı açısından anlamlı fark yoktu. Statin kullanan grupta TUR hacmi, antikoagülan kullanım sıklığı, kateterizasyon süresi ve hastanede kalış süresi istatistiksel olarak daha yüksekti.
Sonuç: Sonuçlarımız, TURP uygulanan BPH’lı hastalarda statin kullanımının kanamayı etkilemediğini gösterdi. Statinlerin yaygın kullanımı göz önüne alındığında, ameliyat sırasında kanama üzerindeki etkilerine ışık tutacak daha fazla çalışmaya ihtiyaç vardır.
Kaynakça
- 1. Lim KB. Epidemiology of clinical benign prostatic hyperplasia. Asian J Urol. 2017;4(3):148-51.
- 2. Langan RC. Benign Prostatic Hyperplasia. Prim Care. 2019;46(2):223-32.
- 3. Foster HE, Barry MJ, Dahm P, et al. Surgical Management of Lower Urinary Tract Symptoms Attributed to Benign Prostatic Hyperplasia: AUA Guideline. J Urol. 2018;200(3):612-9.
- 4. Suarez-Ibarrola R, Bach T, Hein S, et al. Efficacy and safety of aquablation of the prostate for patients with symptomatic benign prostatic enlargement: a systematic review. World J Urol. 2019.
- 5. Reich O, Gratzke C, Bachmann A, et al. Morbidity, mortality and early outcome of transurethral resection of the prostate: a prospective multicenter evaluation of 10,654 patients. J Urol. 2008;180(1):246-9.
- 6. Edwards JE, Moore RA. Statins in hypercholesterolaemia: a dose-specific meta-analysis of lipid changes in randomised, double blind trials. BMC Fam Pract. 2003;4:18.
- 7. Adams SP, Tsang M, Wright JM. Lipid-lowering efficacy of atorvastatin. Cochrane Database Syst Rev. 2015(3):CD008226.
- 8. Undas A, Brummel-Ziedins KE, Mann KG. Statins and blood coagulation. Arterioscler Thromb Vasc Biol. 2005;25(2):287-94.
- 9. Rodriguez AL, Wojcik BM, Wrobleski SK, Myers DD, Jr., Wakefield TW, Diaz JA. Statins, inflammation and deep vein thrombosis: a systematic review. J Thromb Thrombolysis. 2012;33(4):371-82.
- 10. Wiesbauer F, Kaun C, Zorn G, Maurer G, Huber K, Wojta J. HMG CoA reductase inhibitors affect the fibrinolytic system of human vascular cells in vitro: a comparative study using different statins. Br J Pharmacol. 2002;135(1):284-92.
- 11. Undas A, Brummel-Ziedins KE, Mann KG. Anticoagulant effects of statins and their clinical implications. Thromb Haemost. 2014;111(3):392-400.
- 12. Hauer-Jensen M, Fort C, Mehta JL, Fink LM. Influence of statins on postoperative wound complications after inguinal or ventral herniorrhaphy. Hernia. 2006;10(1):48-52.
- 13. Truesdale MD, Polland AR, Graversen JA, et al. Impact of HMG-CoA reductase inhibitor (statin) use on blood loss during robot-assisted and open radical prostatectomy. J Endourol. 2011;25(9):1427-33.
- 14. Gratzke C, Bachmann A, Descazeaud A, et al. EAU Guidelines on the Assessment of Non-neurogenic Male Lower Urinary Tract Symptoms including Benign Prostatic Obstruction. Eur Urol. 2015;67(6):1099-109.
- 15. Murciano-Goroff YR, Wolfsberger LD, Parekh A, et al. Variability in MRI vs. ultrasound measures of prostate volume and its impact on treatment recommendations for favorable-risk prostate cancer patients: a case series. Radiat Oncol. 2014;9:200.
- 16. Mc Namara K, Alzubaidi H, Jackson JK. Cardiovascular disease as a leading cause of death: how are pharmacists getting involved? Integr Pharm Res Pract. 2019;8:1-11.
- 17. Banfi C, Brioschi M, Lento S, et al. Statins prevent tissue factor induction by protease-activated receptors 1 and 2 in human umbilical vein endothelial cells in vitro. J Thromb Haemost. 2011;9(8):1608-19.
- 18. Owens AP, Passam FH, Antoniak S, et al. Monocyte tissue factor-dependent activation of coagulation in hypercholesterolemic mice and monkeys is inhibited by simvastatin. J Clin Invest. 2012;122(2):558-68.
- 19. Momi S, Impagnatiello F, Guzzetta M, et al. NCX 6560, a nitric oxide-releasing derivative of atorvastatin, inhibits cholesterol biosynthesis and shows anti-inflammatory and anti-thrombotic properties. Eur J Pharmacol. 2007;570(1-3):115-24.
- 20. Sahebkar A, Serban C, Ursoniu S, et al. The impact of statin therapy on plasma levels of von Willebrand factor antigen. Systematic review and meta-analysis of randomised placebo-controlled trials. Thromb Haemost. 2016;115(3):520-32.
- 21. Glynn RJ, Danielson E, Fonseca FA, et al. A randomized trial of rosuvastatin in the prevention of venous thromboembolism. N Engl J Med. 2009;360(18):1851-61.
- 22. Khemasuwan D, Divietro ML, Tangdhanakanond K, Pomerantz SC, Eiger G. Statins decrease the occurrence of venous thromboembolism in patients with cancer. Am J Med. 2010;123(1):60-5.
- 23. Resh M, Mahmoodi BK, Navis GJ, Veeger NJ, Lijfering WM. Statin use in patients with nephrotic syndrome is associated with a lower risk of venous thromboembolism. Thromb Res. 2011;127(5):395-9.
- 24. Biedermann JS, Kruip M, van der Meer FJ, Rosendaal FR, Leebeek FWG, Cannegieter SC, et al. Rosuvastatin use improves measures of coagulation in patients with venous thrombosis. Eur Heart J. 2018;39(19):1740-7.
Ayrıntılar
| Birincil Dil | İngilizce |
|---|---|
| Konular | Üroloji |
| Bölüm | Araştırma Makaleleri |
| Yazarlar | |
| Yayımlanma Tarihi | 29 Aralık 2021 |
| Yayımlandığı Sayı | Yıl 2021 Cilt: 13 Sayı: 3 |
