SMSNA 31st Scientific Program at AUA - Considering the Pros and Cons for Operating on Anticoagulated Patients
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On Friday, May 15, during the SMSNA 31st Annual Scientific Program at AUA, a debate ensued involving Drs. Jeffrey Loh-Doyle and Niki Parikh, where they considered whether penile implants should be placed in anticoagulated patients.
Dr. Loh-Doyle, with the counterpoint of view, acknowledges that implants can still be placed in patients on anticoagulants with few adverse events, but states plainly that it should not be done. He says those who operate on anticoagulated patients are more aware of the potential adverse events that could happen, which may skew results. Dr. Loh-Doyle states the chance of a post-operative hematoma may be high, with one study suggesting anticoagulants should be restarted as soon as possible after penile surgery. Several other studies have instead proved this wrong, Dr. Loh-Doyle says. He states that a cardiologist appointment and diagnosis should take priority. He says penile implants are elective and should be treated as such if there is time for it.
Dr. Parikh, with the pro point of view, states there is a clear correlation between erectile dysfunction and cardiovascular disease. She says the risk of complications with stopping anticoagulants can be fatal. Several studies have looked into the potential negative effects of anticoagulants with inconclusive results. Dr. Parikh states that in her study, those with anti-coagulated systems and coagulated patients actually performed better than the control. She states part of what brought success was keeping the IPP partially inflated post-op and returning the patient to a high-volume physician.
Should anticoagulated patients be operated on?
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