Annual variation and clinical characteristics of postoperative lower extremity venous thrombosis after urological surgery: a single-center real-world study

ObjectiveTo analyze the annual variation and clinical characteristics of clinically detected postoperative lower extremity venous thrombosis (LEVT) during hospitalization in patients undergoing urological surgery at our institution from 2022 to 2025, providing reference for perioperative thrombosis risk assessment and preventive management.MethodsA single-center retrospective real-world study was conducted using the hospital electronic medical record system. Patients who developed LEVT for the first time during hospitalization following urological surgery between January 2022 and December 2025 were included. Lower-extremity ultrasonography was performed based on clinical indications rather than routine systematic screening. Detailed information was extracted for patients with thrombosis, including demographic characteristics, admission-related scores and laboratory tests, surgical details, and thrombosis-related outcomes. Descriptive statistical analyses were performed using SPSS software.ResultsBetween 2022 and 2025, a total of 12,313 urological surgical procedures were performed at our center, among which 57 patients were newly diagnosed with postoperative LEVT during hospitalization, corresponding to an overall procedure-based clinically detected LEVT rate of 0.46% (57/12,313). The corresponding annual procedure-based clinically detected LEVT rates were 0.63% (17/2,711) in 2022, 0.43% (13/3,005) in 2023, 0.25% (8/3,256) in 2024, and 0.57% (19/3,341) in 2025, showing annual variation over the four-year study period. One patient was excluded due to archived medical records, and two patients were excluded due to incomplete data, leaving 54 patients for detailed analysis. Among these, 45 were male (83.33%) with a median age of 69.0 years (interquartile range, 61.0–74.75). Benign prostatic hyperplasia constituted the largest subgroup by primary condition (29/54, 53.70%), and transurethral resection of the prostate was the most common surgical procedure among the identified LEVT cases (28/54, 51.85%). Thrombosis predominantly involved the intermuscular veins (62.96%), followed by deep veins (35.19%). The median time to LEVT detection was 7 days after admission (IQR, 6–8) and 4 days after surgery (IQR, 3–5). Clinical manifestations were mainly local symptoms such as limb swelling or pain (79.63%). Anticoagulation with low-molecular-weight heparin was the primary treatment (70.37%), and most patients experienced no significant complications (92.59%).ConclusionThe overall procedure-based clinically detected postoperative LEVT rate during hospitalization in urological surgery was low, with annual variation observed over the four-year study period. Among the identified LEVT cases, benign prostatic hyperplasia was the most common primary condition, with intermuscular vein thrombosis being the most common type, and most cases were detected in the early postoperative period. Clinical attention should focus on continued perioperative VTE risk assessment and early recognition of clinically suspected LEVT.