Thromboembolic disease in the patient undergoing urologic surgery.

There is no question that a substantial risk of venous thrombosis, pulmonary embolism, and lethal pulmonary embolism exist among patients undergoing urologic surgery. Available prophylactic strategies should sharply reduce this risk. Acceptable treatment options exist for patients who develop thromboembolism despite, or in the absence of, prophylaxis. Accurate diagnosis, however, is essential in order to select the most appropriate option. Finally, it should be noted that in making judgments, the comments provided can offer only general guidelines for patients undergoing urologic surgery. Individual patients may have a particular constellation of circumstances that dictates a rational deviation in decision-making from these general guidelines. However, one pivotal decision from which there should be not deviation without extraordinarily special justification is that some form of prophylaxis for deep venous thrombosis should be offered to all patients undergoing major urologic surgical procedures.