Efficacy and Safety of Tranexamic Acid in Endoscopic Surgery for Benign Prostatic Hyperplasia: A TURP-Dominated Systematic Review and Meta-Analysis
Abstract
BACKGROUND
Hemorrhaging continues to be a significant issue in endoscopic procedures for benign prostatic hyperplasia (BPH). Tranexamic acid (TXA) has garnered heightened scrutiny for its ability to mitigate bleeding-associated problems during transurethral prostate procedures. We performed a comprehensive meta-analysis to assess the effectiveness and safety of TXA in individuals having endoscopic procedures for BPH, acknowledging that the existing data primarily originated from transurethral resection of the prostate (TURP).
METHODS
PubMed, Web of Science, Cochrane Library, Embase, CNKI, Wanfang, ClinicalTrials.gov, and ICTRP were examined from the beginning of their databases until April 2026. Pooled mean differences (MDs) and risk ratios (RRs) together with 95% confidence intervals (CIs) were computed utilizing RevMan 5.4. Sensitivity analyses and assessment of publication bias were performed using R version 4.4.2.
RESULTS
Fifteen randomized controlled studies with 1,310 people were qualified. Compared to the control group, TXA significantly reduced operational time (MD = -6.49 minutes, 95% CI: -10.79 to -2.20) and intraoperative blood loss (MD = -66.68 mL, 95% CI: -123.84 to -9.51). TXA also led to significantly less hemoglobin loss at 24 hours (MD = -0.58 g/dL, 95% CI: -0.88 to -0.29) and decreased irrigation fluid volume (MD = -0.45 L, 95% CI: -0.80 to -0.10). However, there were no significant differences between groups in duration of continuous bladder irrigation,…
How strong is the evidence?
Evidence Hub reads this as a meta-analysis, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid. Reported size: 1,310 participants or records.
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