Dr. Pereira on perioperative subcutaneous heparin for IPP surgery

In this video, Thairo Pereira, MD, highlights notable findings from the study “Incidence of Venous Thromboembolism and Hematoma Following Placement of Inflatable Penile Prosthetic: Safety of Perioperative Subcutaneous Heparin,” which was presented at the 24th Annual Fall Scientific Meeting of the Sexual Medicine Society of North America in San Diego, California. Pereira is an andrology fellow at Indiana University School of Medicine in Indianapolis, Indiana.

Video Transcript:

We reviewed data from over 240 patients, and roughly 53% of them received perioperative subcutaneous heparin. Among the group that did not receive subcutaneous heparin, the incidence of VTE was 1.8%, compared with none in the group that received subcutaneous heparin. There was no statistically significant difference in hematoma formation between both groups, which is important because subcutaneous heparin can potentially increase the risk of hematoma formation. We didn't see any difference, which is great. The only difference between the 2 groups was the one without heparin had a higher hypertension prevalence, but there was no other significant difference between them.

Also, there was no significant difference regarding Caprini risk factors. And 94% of the patients in this study were considered at high or high risk for VTE based on their Caprini risk factor score, which is a risk factor that we use to screen the risk of VTE events. Patients can be categorized as low risk up to high risk. In conclusion, we found that the use of perioperative subcutaneous heparin in patients undergoing IPP surgery without the placement of a surgical drain is safe and effective, preventing VTE without increasing the chance of these patients to develop hematoma and also decreasing the chance of VTE. The VTE risk and Caprini scores in the IPP population is currently an unaddressed area for perioperative IPP surgical management. It is lacking in both the AUA and EAU guidelines. Therefore, the use of perioperative subcutaneous heparin should be considered in all patients that are undergoing IPP surgery.

This transcription has been edited for clarity.