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Too old or on blood thinners for surgery?
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Secondly, many of these patients take anticoagulant medication for their heart pathology. Holmium laser enucleation has a very low risk of bleeding. We operate on anticoagulated patients on a regular basis.
In third place, age. I have operated on patients of eighty-five and ninety years with success. What matters is not the age, but the general state of health and the ability to tolerate spinal anaesthesia, which is gentle and is not a general anaesthetic.