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HOLEP SAFE IN CARDIAC PATIENT




IS HOLEP SAFE IN CARDIAC PATIENTS ?

Now a days, patients of heart disease, stroke, atrial fibrillation etc are on antiplatelet drugs (like aspirin, clopidogrel) or anti coagulant (like dabigatran) medications (for making the blood thin). Earlier TURP (electro cautery procedure) required stoppage of these medications 28 days before surgery, as they increase the risk of bleeding during operation and post operative period. But that in contrary increased the chances of a cardiac event or a neurological event.

 Now with advent of HOLEP (laser procedure),those drugs are stopped for less than 2-3 days before procedure or even holep can be performed while patients are still on those medications,as the risk of bleeding is very less or almost nil.

Therefore today these critical patients can also be safely treated while on blood thinners.

Also patients with poor cardiac function, could not be treated earlier due to tur syndrome. This is caused by absorbption of fluids during surgery causing increase in the cardiac pressure. However since the laser procedure is performed by saline irrigation therefore this problem does not occur during laser resection of prostate, therefore today these patients are more safely treated.