Urological prosthetic surgery: Which men are at risk of postoperative thromboembolism?

Some men who undergo artificial urinary sphincter (AUS) and inflatable penile prosthesis (IPP) surgery encounter a venous thromboembolism (VTE) event within 90 days of their operation, reports a study.

“[A] history of varicose veins, deep vein thrombosis (DVT), and pulmonary embolism (PE) was associated with an increased likelihood of developing a postoperative DVT or PE,” the authors said.

Patients undergoing AUS and IPP surgery were identified using the Current Procedural Terminology and the International Classification of Diseases (ICD)-10 procedure codes between 2008 and 2017. ICD-9 and -10 codes were then used to identify healthcare visits related to lower extremity DVT and PE within 90 days of surgery.

Finally, the authors used a multivariable model to evaluate covariates and determine the association with outcomes of DVT or PE.

Of the 21,413 men who underwent surgery between 2008 and 2017, 4,870 (median age 62 years) were AUS and 16,543 (median age 68 years) IPP. DVT and PE events following AUS and IPP surgery occurred in 1.54 percent and 1.04 percent of patients, respectively.

In men undergoing AUS surgery, the following factors were associated with development of postoperative VTE: a history of varicose veins (hazard ratio [HR], 2.76, 95 percent confidence interval [CI], 1.11‒6.79), DVT (HR, 13.65, 95 percent CI, 7.4‒25.19), or PE (HR, 7.65, 95 percent CI, 4.01‒14.6)

Similarly, men in the IPP surgery group who had a history of DVT (HR, 12.6, 95 percent CI, 7.99‒19.93) and PE (HR, 8.9, 95 percent CI, 5.6‒14.13) were at higher risk of a VTE event following the procedure.