AUA 2017: Continuing Aspirin Does Not Increase Blood Loss from Percutaneous Nephrolithotommy

Boston, MA ( Patients with vascular or cardiac disease may benefit from continuing antiplatelet therapy during surgery. However, given the perceived increased risk of bleeding, urologists are often faced with a difficult clinical scenario prior to percutaneous nephrolithotomy (PCNL) surgery. In this moderated poster session, Dr. Timothy Tran presented data on 218 patients who underwent PCNL during the last three years at Mount Sinai Hospital.

Of their patient cohort, 20 patients continued Aspirin 81mg through surgery and an additional 20 patients stopped aspirin one week prior to their procedure. The remainder of the patients did not have a history of taking aspirin. The authors recorded hematocrit levels preoperatively, one hour after surgery and on postoperative day one. They found that there was no mean hematocrit difference between the three groups of patients at any of their time points. Additionally, there was no difference in preoperative platelet count, operating room time, and estimated blood loss. Of note, all patients did have a 16fr nephrostomy tube placed at the conclusion of the procedure.

The moderators polled the audience and at least half in attendance routinely perform PCNL while patients are on aspirin. Another consideration in patients who continue aspirin is to utilize a smaller sheath. In this study, continuing aspirin through PCNL did not appear to increase the risk of bleeding and it should be considered in patients with severe cardiac or vascular disease.

Presented By: Timothy Tran, MD

Author(s): Timothy Tran, Egor Parkhomenko, Julie Thai, Kyle Blum, Mantu Gupta

Affiliation: Department of Urology, Mount Sinai, New York, NY

Written By: Roshan M. Patel for

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