AUA 2017: Venous thromboembolism rates following radical cystectomy stratified by method of prophylaxis

Boston, MA (UroToday.com) In this study, the authors set to assess whether the method of VTE prophylaxis was associated with the incidence of symptomatic VTE. At USC, the philosophy on VTE prophylaxis has been separated into two eras. In the first, prophylaxis was achieved using a 10mg loading dose of warfarin, followed by adjustments to achieve a goal INR of 2.0. No VTE prophylaxis was given after discharge. In the modern era, patients either received 5000 units of subcutaneous heparin thrice a day or were started on 5000 units of heparin, followed by TID heparin until discharge, and 40mg Lovenox for 30 days after discharge. No difference was found in the total incidence of symptomatic VTE, as well as PE’s or DVT’s individually. As such, the authors concluded that extended VTE prophylaxis is not indicated after radical cystectomy.

As pointed out by Dr. Eila Skinner after the presentation, although the incidences of symptomatic VTE may be similar, asymptomatic VTE’s may be more prevalent in the former as imaging modalities used to detect VTE’s have improved over the years. As morbidities and mortality can also result from asymptomatic VTE’s, it is also important to define the incidence of asympatomic VTE’s.

Presented by: Cory Hugen, MD

Written By: Roger Li MD Urologic Oncology Fellow, UT MD Anderson Cancer Center
Ashish M. Kamat MD Wayne B. Duddlesten Professor, UT MD Anderson Cancer Center

at the 2017 AUA Annual Meeting - May 12 - 16, 2017 – Boston, Massachusetts, USA
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