From the Guidelines
Besicare (Solifenacin) typically does not need to be stopped before knee replacement surgery. You should continue taking this medication as prescribed unless your surgeon or anesthesiologist specifically instructs you to stop it. Besicare is used to treat overactive bladder and works by relaxing the bladder muscles. It doesn't significantly affect blood clotting, wound healing, or interact with most anesthesia medications used during surgery 1. However, it's essential to inform your surgical team about all medications you're taking, including Besicare, during your pre-operative assessment. Some surgeons may have specific protocols regarding urinary medications before surgery, particularly because urinary retention can sometimes occur after orthopedic procedures. The surgical team might also need to manage potential side effects like dry mouth during your recovery period.
- Key points to consider:
- Inform your surgical team about all medications, including Besicare
- Follow your healthcare provider's specific instructions regarding all your medications before surgery
- Besicare does not have significant interactions with common anesthesia medications or affect wound healing
- Individual circumstances may vary, and your surgeon or anesthesiologist may have specific instructions Always follow your healthcare provider's specific instructions regarding all your medications before surgery, as individual circumstances may vary, and the latest guideline from the American College of Rheumatology/American Association of Hip and Knee Surgeons does not provide specific recommendations for Besicare management during surgery 1.
From the Research
Besicare and Surgery
- Besicare is not explicitly mentioned in the provided studies, but the studies discuss the use of anticoagulants, such as aspirin, low-molecular-weight heparin (LMWH), and others, in the prevention of venous thromboembolism (VTE) after total knee replacement (TKR) and total hip replacement (THR) surgeries.
Anticoagulant Use in TKR and THR
- A study published in 2020 2 found that aspirin did not differ statistically significantly from other anticoagulants used for VTE prophylaxis after THR and TKR in terms of clinical effectiveness and safety profile.
- Another study published in 2019 3 compared the rates of VTE using different anticoagulants in patients undergoing unilateral TKR and found that LMWH, factor Xa inhibitors, and fondaparinux had a decreased risk of VTE compared to aspirin.
- A 2016 study 4 found that extended-duration anticoagulant thromboprophylaxis did not differ from short-duration thromboprophylaxis in preventing VTE after hip or knee replacement surgery.
Aspirin vs. LMWH
- A 2024 study 5 found that aspirin was associated with a significantly higher risk of pulmonary embolism (PE) and overall VTE risk after knee arthroplasty compared to LMWH.
- A 2018 study 6 found that patients who received warfarin, direct factor Xa inhibitors, or fondaparinux had an increased risk of manipulation under anesthesia for postoperative stiffness after TKR compared to patients who received LMWH or aspirin.
Stopping Besicare Before Surgery
- There is no direct evidence in the provided studies regarding the need to stop Besicare before surgery, as Besicare is not mentioned in the studies.
- However, the studies suggest that the choice of anticoagulant and the decision to stop or continue anticoagulation therapy before surgery should be made based on a balance of the risk/benefit profile of each medication and individual patient factors 3, 5.