Archivio Italiano di Urologia e Andrologia 2015; 87, 2 136 ORIGINAL PAPER Influence of antiplatelet-anticoagulant drugs on the need of blood components transfusion after vesical transurethral resection Alvaro Julio Virseda-Rodríguez 1 , Barbara Padilla-Fernández 2 , Mirian López-Parra 3 , Maria Tatiana Santos-Antunes 4 , Lauro Sebastian Valverde-Martínez 1 , Maria Jesus Nieto-González 3 , Jesus Fernando San Miguel-Izquierdo 5 , Anabel Lorenzo-Gómez 4 , Maria Begoña García-Cenador 4 , Patricia Antúnez-Plaza 6 , Maria Fernanda Lorenzo-Gómez 1,4 1 Department of Urology, University Hospital of Salamanca; 2 Department of Urology, University Hospital of the Canary Islands (Tenerife); 3 Department of Haematology, University Hospital of Salamanca; 4 Department of Surgery, University of Salamanca; 5 Clinical and Translational Medicine of the University of Navarra; 6 Department of Pathology, University Hospital of Salamanca; University Hospital of Salamanca. Surgery Department of the University of Salamanca. IBSAL (Instituto de Investigación Biomédica de Salamanca). Aims: The effect of the antithrombotic pre- ventive therapy on haemorrhage keeps uncertain. We investigate the influence of the antiplatelet and anticoagulant drugs (AP/AC drugs) on the transfusion require- ment after vesical transurethral resection (VTUR). We also describe the epidemiology of the blood components transfusion in our department. Materials and Methods: Retrospective observational study of a series of patients needing blood transfusion at the Urology Department between June 2010 and June 2013. Selection of 100 consecutive patients who were transfused after VTUR due to bladder transitional cell carcinoma (BTCC) (group A = GA). Control group: 100 consecutive patients who underwent VTUR due to BTCC and were not transfused (group B = GB). Transfusion criteria: Haemoglobin < 8 g/dl + anaemia symp- toms. Age, gender, associated AP/AC treatment, secondary diag- noses, toxics, tumour stage and grade were analysed. Results: 212 patients required transfusion of a blood component. 169 were men (79%) and 43 women (21%). Median age 77.59 years (SD 9.42, range 50-92). Secondary diagnoses: Diabetes Mellitus 64%, high blood pressure 77%, dyslipidemia 52%. 60% of patients were previously treated with AP/AC drugs. Average Haemoglobin pre-transfusion values: 7.4 g/dl (DE ± 0.7). Average Haemoglobin post-transfusion values: 8.9 g/Dl (DE ± 0.72). Most frequent transfusion indications were bladder can- cer (37%), kidney cancer (11%), prostate cancer (8%), benign prostatic hyperplasia (BHP) (8%), other urological diagnoses (36%). Intraoperative transfusions indicated by the anaesthesi- ologist: kidney cancer (33%), BPH (28%). Patients who underwent VTUR due to BTCC were older in GA (77.59 years SD 9.42) than in GB (68.98 years SD 11.78) (p = 0.0001). Similar gender distribution (15 women in GA and 24 in GB). Less patients were asked to keep their treatment with ASA 100mg (AcetylSalicylicAcid) in GA (25.64%) than in GB (50%) (p = 0.0330). More aggressive tumour grade in GA (p = 0.0003) and higher stage in GA (p = 0.0018) regardless of con- comitant treatment with AP/AC drugs. Conclusions: The pathologies which most needed blood compo- nents' transfusions in the Urology Department were (in order of frequency): bladder cancer, kidney cancer, prostate cancer, prostate adenoma. ASA100mg did not influence the transfu- Summary No conflict of interest declared. INTRODUCTION The urologic surgery is considered as having a high haemorrhagic risk. The development of several blood components in the last decades has changed the man- agement of multiple pathologies and has increased the survival of millions of patients. Haematuria with anaemia which requires blood transfu- sion is considered a surgical complication in the record- ing codes of the hospital processes. There are in the mar- ket several antiplatelet and anticoagulant drugs (AP/AC) which are frequently part of the regular treatment of many urological patients. Other specialists (Haema- tologists, Cardiologists, Anaesthesiologists,...) prescribe withdrawal and reintroduction standards when a vesical transurethral resection (VTUR) is required. We investi- gated the factors which could condition the transfusion requirement in patients taking AP/AC drugs. Aims of the study were: to describe the number of trans- fusions performed in a "standard" Urology department attending to 333,000 inhabitants and their indication and to investigate the risk factors related with the blood trans- fusion requirements in patients who underwent VTUR due to bladder transitional cell carcinoma (BTCC). DOI: 10.4081/aiua.2015.2.136 sion's requirements in VTUR due to BTCC. Tumour stage and higher grade have a greater influence in transfusion's require- ments than concomitant AP/AC treatment. The heterogeneity of AP/AC protocols does not allow to establish the benefit of stopping those drugs before surgery in terms of avoiding blood transfusions when performing a VTUR. KEY WORDS: Transurethral resection; Bladder transitional car- cinoma; Blood transfusion. Submitted 23 December 2014; Accepted 28 January 2015