Tranexamic acid in control of primary hemorrhage during transurethral prostatectomy.
OBJECTIVE
To determine whether short-term treatment of patients about to undergo transurethral resection of the prostate (TURP) with tranexamic acid (TXA) would be beneficial in reducing the associated blood loss.


METHODS
A prospective and randomized trial was conducted with 136 men requiring TURP for obstructive urinary symptoms. The treatment group received 2 g TXA three times daily on the day of, and first day after, the operation.


RESULTS
Short-term TXA treatment significantly reduced the operative blood loss associated with TURP (128 mL versus 250 mL, P = 0.018), and this difference was not a result of the amount of tissue resected between the two groups (16 g versus 16 g, P = 0.415). In addition, TXA treatment reduced the amount of blood loss per gram of resected tissue (8 mL/g versus 13 mL/g, P = 0.020). Furthermore, the volume of irrigating fluid required (15 L versus 18 L, P = 0.004) and operating time (36 minutes versus 48 minutes, P = 0.001) were also reduced. However, TXA treatment did not influence the number of patients requiring a blood transfusion. Six patients in the treatment group (7.2%) and five in the control group (6.8%) required a transfusion (P = 0.709). Moreover, TXA treatment did not affect the duration of catheterization (1 day versus 1 day, P = 0.342) or hospitalization (3 days versus 3 days, P = 0.218).


CONCLUSIONS
Short-term TXA treatment is effective in reducing the operative blood loss associated with TURP.
Rannikko
Antti
A
Department of Urology, Helsinki University Central Hospital, Helsinki, Finland.
Pétas
Anssi
A
Taari
Kimmo
K
D000368:Aged; D000933:Antifibrinolytic Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D016063:Blood Loss, Surgical / Q000517:prevention & control*; D006801:Humans; D007432:Intraoperative Period; D008297:Male; D008875:Middle Aged; D009929:Organ Size; D019990:Perioperative Care; D011446:Prospective Studies; D011467:Prostate / Q000473:pathology; D011470:Prostatic Hyperplasia / Q000601:surgery*; D013997:Time Factors; D014148:Tranexamic Acid / Q000008:administration & dosage / Q000627:therapeutic use*; D020728:Transurethral Resection of Prostate / Q000379:methods*
D000933:Antifibrinolytic Agents; D014148:Tranexamic Acid