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首页> 外文期刊>Case Reports in Obstetrics and Gynecology >Intravesicular Onabotulinumtoxin A Hemorrhage on Rivaroxaban
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Intravesicular Onabotulinumtoxin A Hemorrhage on Rivaroxaban

机译：脊髓灰质胰岛素毒素在rivaroxaban上的出血

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摘要

Overactive bladder (OAB) is urgency, with or without urgency incontinence. For OAB, an injection of onabotulinumtoxin A (BOTOX?) can be a low-risk outpatient procedure. We present a patient on a novel anticoagulant that experienced excessive bleeding after this procedure. This 80-year-old G2P2002 Caucasian female had a history of urge urinary incontinence. She presented for intravesicular onabotulinumtoxin A injection (150 units) after recent initiation of rivaroxaban (Xarelto?) for her atrial fibrillation. Several hours after an uncomplicated procedure, she presented with anuria and pain after gross hematuria earlier in the day. Her pain was immediately alleviated with bladder irrigation. She was discharged home and remained asymptomatic. With the popularity of the novel anticoagulants, new guidance on management of these medications during procedures is limited. When managing a patient on a novel anticoagulant before any procedure, even a low risk procedure, several factors should be considered to determine if the medication should be held, bridged, or continued. In sum, each patient on anticoagulation undergoing any procedure should be assessed individually for thrombotic risk, bleeding risk, and the procedural risk to best avoid postprocedural hemorrhage.
机译：过度活性膀胱（OAB）是紧急性的，有或没有紧急尿失禁。对于OAB，注射OnaboTulinumtoxin A（Botoxα）可以是低风险的门诊过程。我们在这个程序后，患者在新的抗凝血剂上经历了过度出血的患者。这位80岁的G2P2002白种人女性有一个尿失禁的历史。在最近启动蓖麻原纤维后，她介绍了脊髓植物（150个单位）的注射（150单位）。在一项简单的手术后几个小时，她在白天早些时候出现了血尿后血尿后的痛苦和疼痛。她的痛苦立即缓解了膀胱灌溉。她被解雇了，留下了无症状。随着新型抗凝剂的普及，在程序期间对这些药物管理的新指南有限。在任何程序在新的抗凝血剂上管理患者，甚至低风险程序时，也应考虑几个因素来确定药物是否应持有，桥接或持续。总而言之，应单独评估经过任何程序的抗凝治疗血栓性风险，出血风险以及最佳避免后期出血的程序风险。

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