[A multicenter study on the effect of continued antiplatelet therapy on postprocedural bleeding after transrectal ultrasound-guided prostate biopsy].

Abstract

To investigate the impact of continued antiplatelet therapy on bleeding complications following transrectal ultrasound-guided prostate biopsy (TRUS-PB). This multicenter retrospective study analyzed 296 patients undergoing TRUS-PB between April 2024 and January 2025 at eight centers affiliated with the National Clinical Research Center for Cardiovascular Diseases' Urology and Cardiovascular Comorbidity Consortium. Patients were categorized into an antiplatelet continuation group (those who continued antiplatelet therapy) and a control group (patients who did not use antiplatelet drugs). Clinical parameters, medication profiles, operative characteristics, postoperative complications, blood routine test and coagulation parameters were compared. A total of 64 patients were included in the treatment group, with an average age of (71.2±9.9) years; 232 patients were included in the control group, with an average age of (72.5±7.0) years. The rectal compression hemostasis time after biopsy was longer in the treatment group than in the control group[(8.1±1.8)min vs (3.7±1.4)min,P<0.05]. No statistically significant differences were observed in terms of age, ECOG score, PSA, prostate volume, number of biopsy needles, and tumor positivity rate (all P>0.05). No severe bleeding events requiring surgical intervention (Grade Ⅲ/Ⅳ) occurred in either group. There were no statistically significant differences between the two groups in terms of complications such as hematuria, rectal bleeding (Grade Ⅰ/Ⅱ), urinary retention (Grade Ⅰ/Ⅱ), and infection (all P>0.05). There were no statistically significant differences between the two groups in terms of blood routine test and coagulation parameters such as white blood cell count, hemoglobin, platelet count, prothrombin time, activated partial thromboplastin time, and fibrinogen (all P>0.05). Continuation of antiplatelet therapy in cardiovascular patients undergoing TRUS-PB did not increase severe complication risks but necessitated prolonged rectal compression time for hemostasis.