Ureteroscopic and flexible ureteroscopic lithotripsy: continuation or discontinuation of anticoagulant or antiplatelet drugs? A Chinese survey among urologists

Urolithiasis. 2023 Feb 21;51(1):39. doi: 10.1007/s00240-023-01413-x.

Abstract

Purpose: To evaluate the management of antithrombotic drugs made by different urologists before ureteroscopic lithotripsy and flexible ureteroscopy in stone patients undergoing active anticoagulant or antiplatelet therapy.

Methods: A survey was distributed to 613 urologists in China, which included personal work information and views on the management of anticoagulants (AC) or antiplatelet (AP) drugs during the perioperative period of ureteroscopic lithotripsy (URL) and flexible ureteroscopy (fURS).

Results: 20.5% of urologists believed that AP drugs could be continued and 14.7% believed that AC drugs could be continued. 26.1% of the urologists who participated in more than 100 ureteroscopic lithotripsy or flexible ureteroscopy surgeries each year believed that AP drugs could be continued and 19.1% believed that AC drugs could be continued, compared with 13.6% (P < 0.01) and 9.2% (P < 0.01) of the urologists who performed less than 100 surgeries. Among the urologists with more than 20 cases undergoing active AC or AP therapy per year, 25.9% thought that AP drugs could be continued and 19.7% thought that AC drugs could be continued, compared with 17.1% (P = 0.008) and 11.5% (P = 0.005) of the urologists with less than 20 cases.

Conclusion: The decision on the continuation of AC or AP drugs before ureteroscopic and flexible ureteroscopic lithotripsy should be individualized. The experience in URL and fURS surgeries and in dealing with patients under AC or AP therapy is the influencing factor.

Keywords: Anticoagulant drugs antiplatelet drugs; Flexible ureteroscopy; Ureteroscopic lithotripsy.

MeSH terms

  • Anticoagulants
  • China
  • Humans
  • Kidney Calculi* / surgery
  • Lithotripsy*
  • Platelet Aggregation Inhibitors
  • Treatment Outcome
  • Ureteral Calculi* / therapy
  • Ureteroscopy*
  • Urologists

Substances

  • Anticoagulants
  • Platelet Aggregation Inhibitors