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Anticoagulative Therapy is Not a Contraindication For Penile Prosthesis Implantation
Kai H. Hammerich, MD, PhD, John E. Humphrey, MD, Nelson E. Bennett, MD.
Lahey Clinic Medical Center, Burlington, MA, USA.

Introduction
Inflatable penile prostheses (IPP) represent the most effective treatment option for erectile dysfunction (ED) when conservative measures are unsuccessful or contraindicated. Many patients require anticoagulation therapy (AAT) for pre-existing conditions. Discontinuation of these medications may lead to life-threatening complications. Historically, these men were not candidates for IPP implantation. The objective of this study is to report perioperative outcomes in men undergoing IPP on AAT.
Material/Methods
Men undergoing IPP placement between 2009 and 2012 by a single surgeon were reviewed. Patient demographics, co-morbidities, and peri-operative parameters were evaluated. AAT included Aggrenox, Coumadin, Lovenox, Plavix, and/or Aspirin.
Results
91 patients constitute the study population. 11 patients continued AAT during surgery. There was no significant difference in age between men on anticoagulation and men who were not, 62.54vs. 59.18 years. Co-morbidities included diabetes (12%), HTN (60%), hyperlipidemia (45%), and CAD (55%). There were no significant differences analyzed in length of hospital stay [3.2 vs. 1.1 days; p=0.21], duration of ED [7.91 vs. 4.90 years; p=0.15], EBL [127.27 vs. 124.50 mL; p=0.90], operative time [155.9 vs. 168.7 min; p=0.08], INR [1.6 vs. 1.02; p=0.14], and PTT [30.3 vs. 30.28; p=0.98]. One patient on ASA had MI POD#1. No bleeding complications or transfusions occurred.
Conclusion
No significant differences in perioperative outcomes were observed in men undergoing IPP surgery on or off anticoagulant medication. IPP implantation may be safely completed in the setting of AAT without increased blood loss, hospital stay, or complication rate. Furthermore, this patient group might benefit from continuation of anticoagulation for pre-existing disease.


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