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. 2021 Nov;27(6):e659-e666.
doi: 10.1111/hae.14388. Epub 2021 Aug 3.

Prostate interventions in patients with mild haemophilia: Safe and feasible

Benoit Mesnard  1 , Nicolas Drillaud  2 , Marianne Sigaud  2 , Gabriella Hakim  3 , Samuel Chelly  4 , Catherine Ternisien  2 , Marc Fouassier  2 , Ismaël Chelghaf  1 , Stéphane De Vergie  1 , Marie-Aimée Perrouin Verbe  1 , Jérôme Rigaud  1 , Arthur David  5 , Marc Trossaërt  2 , Julien Branchereau  1   3   6
Affiliations

Prostate interventions in patients with mild haemophilia: Safe and feasible

Benoit Mesnard et al. Haemophilia. 2021 Nov.

Abstract

Introduction: To date, there is no specific recommendation or evaluation of the morbidity of prostate surgery in patients with haemophilia (PWH) although this surgery is common and at high risk of bleeding.

Aim: To assess the post-operative morbidity of benign prostate hyperplasia (BPH) surgeries and of oncological prostate interventions in patients with mild haemophilia A or B.

Methods: We performed a monocentre, epidemiological, in real life study. Data were collected between 1 January, 1997 and 1 September, 2020 and focused on prostate biopsy, radical prostatectomy, prostate radiotherapy, simple prostatectomy, transurethral resection of prostate (TURP) and laser-vaporisation in patients with mild haemophilia A or B.

Results: Between 1 January, 1997 and 1 September, 2020, 51 interventions were performed on 30 patients with mild haemophilia. Haemophilia A represented 93.33% of the population and haemophilia B 6.67%. For prostate biopsies (n = 24), median length of hospitalisation was 4 days and only one patient needed a blood transfusion. No patient needed re-admission. For prostatectomy (n = 10), one patient presented with intra-operative and post-operative bleeding. Two patients required re-admission. The other patients did not present any significant haemorrhagic symptoms. For radiotherapy (n = 4), two patients presented a grade II complication (radiocystitis and radiorectitis). For BPH surgeries, during hospitalisation, laser-vaporisation (n = 5) was less haemorrhagic than TURP (n = 5) but after hospital discharge, 60% of patients presented a haemorrhagic complication with two readmissions and one surgical re-explorations.

Conclusion: Performed in a specialised centre, prostate surgeries and interventions in patients with mild haemophilia is feasible with acceptable morbidity.

Keywords: biopsy; haemophilia A; haemophilia B; laser therapy; prostate; prostatectomy; transurethral resection of prostate.

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References

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