Transrectal ultrasound-guided prostate biopsy in patients long-term receiving aspirin in low doses

Sivkov A.V., Keshishev N.G., Kovchenko G.A.

Introduction & Objectives: There is a great number of patients who have an indications for transrectal ultrasound (TRUS)-guided prostate biopsy are on chronic treatment with low-dose aspirin for different cardiovascular disease. The aim is to determine safety of prostate biopsy performance in patients receiving low-dose aspirin (75-100mg) without interruption before and after prostate biopsy procedure.

Material & Methods: A total of 168 men were enrolled in trial. Patients were randomized in two groups. Group I included 83 patients on chronic low-dose aspirin medication for primary prevention of cardiovascular disease, group II included 85 patients who didn’t receive any anticoagulation/antiplatelet therapy at least during three month before biopsy. The TRUS-guide 12 cores multifocal prostate biopsy was performed in two groups according to single protocol. All consecutive men were asked to complete questionnaire over the 7 days following TRUS biopsy. The questionnaire contained information on presence and severity of hematuria, rectal bleeding, hematospermia, rectal pain and body temperature increase.

Results: the overall haematuria complication rate was 52/83 patients (43%) in group I (49 - Grade I, 3 - Grade II), 46/85 patients (39%)- in group II (Grade I) (p=0.02). No significant difference was found for the incidence of haemospermia and rectal bleeding between the two groups (4/83 (3%) and 6/85 (5%) in groups I and II respectively). There also wasn’t statistically difference between rectal pain. Non persistent acute fever were recognized in any patient.

Conclusions: Regular intake of low doses aspirin (75-100 mg) is not associated with significantly increase risk of bleeding in patients who undergo transrectal prostate biopsy. According to our data prostate biopsy can be performed without the interruption of chronic aspirin intake, but require inpatient care. 

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