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Review
. 2022;75(2):128-134.
doi: 10.5173/ceju.2022.0047. Epub 2022 Apr 14.

Current thromboprophylaxis in urological cancer patients during COVID-19 pandemic

Adam Ostrowski  1 , Piotr Skrudlik  2 , Filip Kowalski  1 , Paweł Lipowski  1 , Magdalena Ostrowska  1 , Przemysław Adamczyk  3 , Jan Adamowicz  1 , Tomasz Drewa  1 , Kajetan Juszczak  1   4
Affiliations
Review

Current thromboprophylaxis in urological cancer patients during COVID-19 pandemic

Adam Ostrowski et al. Cent European J Urol. 2022.

Abstract

Introduction: Venous thrombosis is a well-known complication of cancer disease, especially in Urology. However, even though proper antithrombotic prophylaxis is crucial in most urological procedures, we have insufficient high-quality studies on this topic. The European Association of Urology (EAU) Guidelines are outdated and lack data on COVID-19 increased risk of thrombosis. This review aimed to summarize data on thromboprophylaxis after radical prostatectomy, cystectomy, and nephrectomy during COVID-19 pandemic.

Material and methods: A thorough analysis of the EAU Guidelines of Thromboprophylaxis was performed and compared to PubMed search, considering updated literature on thromboprophylaxis of radical prostatectomy, cystectomy, nephrectomy, as well as COVID-19 influence on venous thrombosis and urological practice.

Results: Each patient should be evaluated individually to balance bleeding and venous thromboembolism (VTE) risk. There is still much uncertainty in low and medium-risk patients and all endoscopic procedures, where thromboprophylaxis could be omitted. Patients with COVID infection bear a significantly higher risk of VTE. All patients should be tested for COVID infection prior to a planned surgery during bursts of infections, undependably of vaccination status. Efforts to maintain early cancer diagnosis and treatment during the pandemic should be maintained.

Conclusions: The quality of evidence is inadequate, and when deciding on thromboprophylaxis, we need to base it on individual risk, cancer advancement, procedure type, and our own experience.

Keywords: COVID-19; thromboprophylaxis; thrombosis; urologic neoplasms; venous thromboembolism.

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Conflict of interest statement

The authors declare no conflicts of interest.

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