Objective To systematically evaluate the incidence and risk factors of postoperative thrombosis in patients undergoing urological surgery.

Methods PubMed, Embase, The Cochrane Library, Web of Science, CNKI, WanFang Data and VIP databases were electronically searched to collect studies on risk factors of postoperative thrombosis in urological patients from inception to May 1, 2025. Two reviewers independently screened literature, extracted data and assessed the risk of bias of the included studies. Meta-analysis was conducted using Stata 18.0 and RevMan 5.4 software.

Results A total of 15 studies involving 91,097 patients were included. The Meta-analysis results showed that the incidence of postoperative thrombosis was 8.2% [95%CI (6.3%, 10.1%)]; history of venous thromboembolism [OR=4.45, 95%CI (2.16, 9.14), P < 0.001], history of hypertension [OR=1.20, 95%CI (1.04, 1.38), P=0.010], history of diabetes [OR=1.71, 95%CI (1.01, 2.87), P=0.044], high Caprini score [OR=1.73, 95%CI (1.44, 2.08), P < 0.001], advanced age [OR=1.37, 95%CI (1.14, 1.65), P=0.001], and high BMI [OR=1.11, 95%CI (1.03, 1.20), P=0.009] were risk factors for postoperative thrombosis.

Conclusion In clinical practice, it is necessary to pay attention to the above risk factors of postoperative thrombosis and evaluate patients. For patients with high-risk factors, individualized prevention strategies should be formulated, and perioperative risk assessment and intervention should be strengthened to reduce the incidence of postoperative thrombosis and improve the prognosis of patients.

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