Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
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 The European Association of Urology (EAU) Guidelines are outdated and lack data on COVID-19 increased risk of thrombosis.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.

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflicts of interest.

References

    1. Mirshahi S, Pocard LL, Mirshahi M, Soria J. Pathogenesis and Diagnosis of Venous Hypercoagulable States in Cancer. J Hematol Thrombo Dis. 2015;3:3–4.
    1. Violette PD, Vernooij RWM, Aoki Y, et al. An International Survey on the Use of Thromboprophylaxis in Urological Surgery. Eur Urol Focus. 2021;7:653–658. - PubMed
    1. Tikkinen RC, Gould MK, Naspro R, et al. Thromboprophylaxis; EAU Guidelines Edn presented at the EAU Annual Congress Amsterdam; 2020. ISBN 978-94-92671-07-3.
    1. Ribal MJ, Cornford P, Briganti A, et al. European Association of Urology Guidelines Office Rapid Reaction Group: An Organisation-wide Collaborative Effort to Adapt the European Association of Urology Guidelines Recommendations to the Coronavirus Disease 2019 Era. Eur Urol. 2020;78:21–28. - PMC - PubMed
    1. Falanga A, Rickles FR. Pathophysiology of the thrombophilic state in the cancer patient. Seminars in thrombosis and hemostasis. Semin Thromb Hemost. 1999;25:173–182. - PubMed

LinkOut - more resources