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DVT Prevention to Be Considered for All Urologic Surgeries

Patient risk factors, procedure risk determine type of deep vein thrombosis prophylaxis

MONDAY, Feb. 23 (HealthDay News) -- Consideration of deep vein thrombosis (DVT) prophylaxis is recommended for all patients undergoing a urological surgical procedure, according to a best practice statement from the American Urological Association published in the March issue of the Journal of Urology.

John B. Forrest, M.D., chairman of the American Urological Association in Linthicum, Md., and colleagues identified four categories of urologic surgeries deemed to be candidate procedures for DVT prophylaxis: transurethral surgery, anti-incontinence and pelvic reconstructive surgery, laparoscopic urologic surgeries (with or without robotic assistance), and open urologic surgery. Therapeutic options for DVT prophylaxis included mechanical (early ambulation, graduated compression stockings, and intermittent pneumatic compression), and pharmacologic (low-dose unfractionated heparin or low molecular weight heparin) methods.

The authors identified several factors that predisposed patients to DVT, including immobility, trauma, malignancy, prior DVT, age, estrogen therapy and smoking, among others. These factors are used to identify a patient's risk profile. However, when assessing an individual patient's risk for DVT, the inherent risk of the procedure should be considered together with the patient's risk profile.

"In many patients undergoing low-risk procedures, early ambulation may be the only DVT prophylactic measure that is indicated," the authors state. "However, in patients with a high-risk profile undergoing a high-risk procedure, an assessment of all risk factors inherent to the patient and planned procedure should dictate the appropriate DVT prophylaxis."

Several study authors report financial relationships with the pharmaceutical industry.

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