UroToday - Among 37 patients fully anticoagulated at the time of ureteroscopic lithotripsy, all successfully completed their procedure; none required a postoperative transfusion and there were no instances of clot retention or reoperation.

When compared to a matched cohort of nonanticoagulated urolithiasis ureteroscopy patients with similar size stones and stone location, the stone free rate 81% vs. 78% (e.g. presence of a > 2mm stone on CT scan at 1 month follow-up) and incidence of complications 11% vs. 8% were similar. Of interest, a ureteral access sheath was used in 22% of the anticoagulated patients without any apparent increase in bleeding; one might hypothesize that with an access sheath, it would be easier to keep the field clear should there be any minor bleeding.

Bottom line: This is good news; patients who are anticoagulated and a candidate for ureteroscopic holmium laser lithotripsy do NOT need to stop their anticoagulants.

Turna B, Stein RJ, Smaldone MC, Santos BR, Kefer JC, Jackman SV, Averch TD, Desai MM.
J Urol. 2008 Apr;179(4):1415-9.
doi:10.1016/j.juro.2007.11.076

Reported by UroToday Medical Editor Ralph V. Clayman, MD

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