ArticleInternational journal of urology : official journal of the Japanese Urological Association2026
Bleeding Events Associated With Continuing Antithrombotic Therapy During Transrectal Ultrasound-Guided Prostate Biopsy: A Propensity Score-Matched Analysis.
Article in International journal of urology : official journal of the Japanese Urological Association, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
objectivesTo evaluate the association between antithrombotic continuation and the frequency and severity of bleeding events during transrectal ultrasound-guided prostate biopsies.
methodsThis retrospective cohort study involved 1248 patients who underwent transrectal ultrasound-guided prostate biopsy between April 2018 and December 2024. Patients were grouped into antithrombotic(+) (continued therapy) or antithrombotic(-) (no therapy). The groups were matched 1:1 using propensity scores based on patient demographics.
resultsPropensity score matching yielded 162 patients per group. Mild and severe hematuria rates were comparable between the antithrombotic(+) and antithrombotic(-) groups (80.9% and 1.9% vs. 72.8% and 2.5%), with overall rectal bleeding occurring in 29.6% and 29.0%, respectively. Hematospermia rates did not differ significantly. In the unmatched direct-acting oral anticoagulant cohort, severe rectal bleeding occurred in three patients (5.7%). Multivariate analysis identified diabetes mellitus (odds ratio, 3.47, 95% confidence interval, 1.10-10.96; p = 0.034) and biopsy core number (odds ratio, 0.39, 95% confidence interval, 0.21-0.74; p = 0.004) as independent predictors of severe bleeding events.
conclusionsTransrectal ultrasound-guided prostate biopsy was generally safe without antithrombotic discontinuation, with no significant increase in bleeding events. Caution is warranted when continuing direct-acting oral anticoagulants, particularly in patients with risk factors for bleeding, such as diabetes mellitus.
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