Risk of Post-operative Thromboembolism in Men Undergoing Urologic Prosthetic Surgery: An Assessment of 21,413 Men

• Published in: The Journal of urology p. 101097JU0000000000002801
• Main Authors: Hebert, Kevin J, Matta, Rano, Horns, Joshua J, Paudel, Niraj, Das, Rupam, Kohler, Tobias S, Pastuszak, Alexander W, McCormick, Benjamin J, Hotaling, James M, Myers, Jeremy B
• Format: Journal Article
• Language: English
• Published: United States 10.06.2022
• Subjects: MarketScan; artificial urinary sphincter; deep vein thrombosis; subcutaneous heparin; venous thromboembolism; inflatable penile prosthesis surgery; pulmonary embolism

To assess venous thromboembolism (VTE) and associated risk factors following artificial urinary sphincter (AUS) and inflatable penile prosthesis (IPP) surgery. Using IBM MarketScan, a commercial claims database, patients undergoing AUS and IPP surgery were identified using Current Procedural Terminology (CPT) and ICD-10 procedure codes between 2008 and 2017. ICD-9 and 10 codes were used to identify healthcare visits associated with lower extremity deep vein thrombosis (DVT) and pulmonary embolism (PE) within 90 days of surgery. Covariates were assessed using a multivariable model to determine association with outcome of DVT and/or PE. 21,413 men underwent AUS (4870) or IPP (16543) surgery between 2008 and 2017 with a median age of 62 years and 68 years, respectively. DVT or PE events following AUS and IPP surgery occurred in 1.54% and 1.04%, respectively. A history of varicose veins (Hazard Ratio 2.76; 95% CI [1.11-6.79]), prior history of DVT (HR 13.65; 95% CI [7.4-25.19]), or PE (HR 7.65; 95% CI [4.01-14.6]) were highly associated with development of postoperative VTE. Likewise, prior history of DVT (HR 12.6; 95% CI [7.99-19.93]) and PE (HR 8.9; 95% CI [5.6-14.13]) were strongly associated with a VTE event following IPP surgery. In a large cohort of men undergoing AUS and IPP surgery, 1.54% and 1.04% of men experienced a VTE event within 90 days of surgery, respectively. Prior history of varicose veins, DVT, and PE were associated with an increased likelihood of developing a postoperative DVT or PE.