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Can One Undergo A Prostatectomy When The Platelet Count Is 92x103/µL?

Posted on Wed, 16 Nov 2016

Question: Hi,
I am a 73 years old male and scheduled for a co-surgery. Da Vinci prostatectomy for PC and
double hernia repair with patches.
My platelet count: 92x103/µL. I have had this over 17 years.
I had bone marrow biopsies in 1999 and 2013, both were negative.
Everything else is in the normal range in my CBC.
PT: 13.8 sec.
PT INR: 1.1.
PTT: 30sec.
My questions are:
1. Is the platelet count acceptable for the procedure?
2. Risks of increasing the platelet count by infusion, gammagard?
3. Why should it be increased at all, when one of the dangers after the operation is clot formation?
4. Could I sign a waiver, if the surgeon is reluctant to go ahead with the procedure with this platelet count?
Thank you.

Answered by Dr. Geeta Sundar (1 hour later)

Brief Answer:
Hi XXXXX, welcome to HCM. Very good question.

Detailed Answer:
Hi XXXX, welcome to HCM. Very good question.
1) Yes the platelet count is acceptable for the procedure. Your PT and CT are normal.
2) No risk of increasing platelet count by infusion or gamma globulin.
3) Increase with infusion if undertaken will not be to a level that your blood becomes sticky. Clot formation is normally from the legs, which can be taken care of by Physiotherapy. DIC ---Diffuse clotting is a severe response to any major surgery, where diffuse clotting can occur, but not due to platelets. This is unusual and rare but can happen to anybody.
4) Now that I have explained everything to you, you can discuss with your surgeon and prerogative is entirely yours to take a decision. Hope my answer has made things clear. Regards

Above answer was peer-reviewed by : Dr. Veerisetty Shyamkumar

Follow up: Dr. Geeta Sundar (35 hours later)

Thank you very much.

Answered by Dr. Geeta Sundar (6 minutes later)

Brief Answer:
Hi XXXXX, You are welcome! All the best for your surgery and regards

Detailed Answer:
Hi XXXX, You are welcome! All the best for your surgery and regards

Above answer was peer-reviewed by : Dr. Yogesh D

Follow up: Dr. Geeta Sundar (29 hours later)

Hi Dr. XXXXXXX

I have one follow up question. How long am I in danger of DIC after the surgery?
Thank you and best regards.
XXXXXXXXXXX

Answered by Dr. Geeta Sundar (5 hours later)

Brief Answer:
Hi XXXX, DIC (diffuse intra vascular coagulation)

Detailed Answer:
Hi XXXXX, DIC (diffuse intra vascular coagulation) occurs during or immediate post operative period due to major surgery, massive burns or trauma. I would say the maximum period one can expect is three days post operative. With modern management and being prepared with adequate blood in case of sudden transfusion needs, DIC even if it occurs can and should be manageable. So if you are getting operated in a good set up, there should be no problem. Hope all your fears are allayed. Regards

Above answer was peer-reviewed by : Dr. Raju A.T

Follow up: Dr. Geeta Sundar (12 hours later)

Thank you.

Answered by Dr. Geeta Sundar (11 hours later)

Brief Answer:
You are welcome XXXXX.

Detailed Answer:
You are welcome XXXXX.In case you do not have further queries, can we close the session? Wishing you all the best and regards

Note: For further follow up on related General & Family Physician Click here.

Above answer was peer-reviewed by : Dr. Arnab Banerjee