The effect of antiplatelet and anticoagulant therapy on the clinical outcome of patients undergoing ureteroscopy.

OBJECTIVE

To determine if there is any difference in the clinical outcome for patients receiving aspirin, clopidogrel, and warfarin undergoing ureteroscopy and laser lithotripsy for urolithiasis compared with patients on no antithrombotic medication.

METHODS

We retrospectively reviewed patients who underwent ureteroscopy for urolithaisis from July 1, 2005 to October 1, 2010. If patients continued aspirin, clopidogrel, or warfarin within 48 hours of surgery, they were considered to be on antithrombotic therapy. Patients not on these medications or those who discontinued the medications atleast 5 days before surgery comprised the control group. Six hundred forty-six patients met our inclusion criteria for analysis including 137 on aspirin alone, 17 on clopidogrel, 22 on warfarin, and 470 in the control group.

RESULTS

Patients on antiplatelet and anticoagulants were older and were more likely to have risk factors for thromboembolism. When comparing patients on aspirin, clopidogrel, or warfarin with patients not on these medications, there was no difference in bleeding complications or need for an unplanned repeat ureteroscopy. There was also no difference in complications within 30 days of surgery.

CONCLUSION

Among patients undergoing elective ureteroscopy and laser lithotripsy on the antithrombotic medications aspirin, clopidogrel, and warfarin, the procedure was as successful, and complications were not increased, compared with patients on no antithrombotic medications.