International Survey on Use of Thromboprophylaxis in Urological Surgery
Decisions regarding thromboprophylaxis in urologic surgery involve a trade-off between decreased risk of venous thromboembolism (VTE) and increased risk of bleeding. Both patient- and procedure-specific factors are critical in making an informed decision on the use of thromboprophylaxis. Our systematic review of the literature revealed that existing guidelines in urology are limited (BJUI 2016). Recommendations from national and international guidelines often conflict and are largely based on indirect as opposed to procedure-specific evidence. These issues have likely contributed to large variation in the use of VTE prophylaxis within and between countries. However the magnitude of this variation has been well characterized.
To address this gap we have conducted an international survey on use of thromboprophylaxis in urological surgery (ISTHMUS). The survey consisted of three case based scenarios which represented a spectrum of VTE risk. This Survey was pilot tested, then administered to representative sampling of urologists from Canada, Finland and Japan. Our primary goal was to characterize the within country and between country variation in use for common urological procedures. Additionally, the results of this project will also serve as a baseline measure of urological practice pattern from which impact of the upcoming EAU thromboprophylaxis guideline can be assessed in the future.