RESUMO
BACKGROUND: Whether antithrombotic agents should be stopped before prostate biopsy is unsettled. We investigated the impact of antithrombotic agents on bleeding complications after prostate biopsy. MATERIALS AND METHODS: Among the patients who underwent transrectal ultrasound-guided prostate biopsy from June 2006 to December 2013 at Ebina General Hospital, Kanagawa, Japan, 1817 cases were retrospectively assessed. Patients were divided into two groups: those not taking antithrombotic agents (control group) and those taking them (experimental group). The frequency and severity of bleeding complications after the procedure were compared. The severity of bleeding events was graded using the Common Terminology Criteria for Advanced Events vol. 4.0. RESULTS: Hemorrhagic complications were classified into grades 1 to 3. Patients with complications of Grade 2 and above needed treatment. As for the Grade 1 event, there were no differences between two groups. The frequency of more than Grade 2 bleeding events was 1.7% and 3.5% in the control and experimental group, respectively; the odds ratio was 2.18 (P = 0.039). Grade 3 events occurred in seven patients of the control group (0.5%) and four patients of the experimental group (1.2%). CONCLUSIONS: The present study showed that continuation of antithrombotic agents increased the frequency of hemorrhagic complications requiring intervention. It suggests that attention should be paid to the patients taking antithrombotic agents before prostate biopsy.
RESUMO
A 65 year-old man visited the outpatient clinic of internal medicine complaining of fever and upper abdominal pain. Bilateral adrenal tumors were detected by CT scan and ultrasonography without any hormonal abnormalities. The diagnosis was bilateral primary non-functioning adrenal tumors because there was no tumor except adrenals with the detailed examinations. Then we are informed about the patient and he was transferred for the surgery. Cortisol was administrated because adrenal insufficiency was observed before surgery. Right adrenalectomy was performed after the recovery of patient status with cortisol. The pathological diagnosis was malignant lymphoma (diffuse large, B cell type). The patient was getting worse and dead 15 days after the surgery.