The role of intraoperative tranexamic acid in transurethral resection of the prostate: a systematic review and meta-analysis of randomised-controlled trials
Abstract
To critically appraise and evaluate the safety and efficacy of intraoperative tranexamic acid (TXA) administration during transurethral resection of the prostate (TURP). A systematic search of online databases was conducted to identify randomised-controlled trials (RCTs) which compared surgical outcomes and complication rates in patients undergoing TURP for benign prostatic hyperplasia (BPH) who were treated with TXA (intervention) as compared to placebo/none (control). The efficacy of intraoperative TXA was evaluated through outcomes related to blood loss, rate of blood transfusion and operative time. The safety of TXA was evaluated through pooled analysis of both deep venous thrombosis and pulmonary emboli. Nine RCTs met the inclusion criteria for this meta-analysis in which a total of 661 patients underwent TURP for BPH (331 TXA: 330 Control). There was significantly less intraoperative bleeding in the TXA group (MD –40.23 mL [95%CI –66.76 to –13.71], p = 0.003), which was reflected in a significantly lesser haemoglobin drop on the first postoperative day (MD –0.55 g/dL [95%CI –0.71 to –0.39], p < 0.00001). TXA was associated with a significantly shorter operative time (MD –9.77 min [95%CI –16.97 to –2.58], p = 0.008), with patients who received TXA exposed to a significantly reduced risk of blood transfusion (0.99% TXA vs. 7.69% Control, OR 0.16 [95%CI 0.03–0.93], p = 0.04). There was no statistically significant increase in risk of DVT in the TXA group, p = 0.46.…
How strong is the evidence?
Evidence Hub reads this as a meta-analysis. 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: 661 participants or records.
Read the paper
Related studies
- Treatment of non-metastatic castration-resistant prostate cancer: facing age-related comorbidities and drug–drug interactions
- The Efficacy of Flogofilm® in the Treatment of Chronic Bacterial Prostatitis as an Adjuvant to Antibiotic Therapy: A Randomized Prospective Trial
- Inhibition of growth and contraction in human prostate stromal cells by silencing of NUAK1 and -2, and by the presumed NUAK inhibitors HTH01-015 and WZ4003
- Effectiveness and Safety of a New Nutrient Fixed Combination Containing Pollen Extract Plus Teupolioside, in the Management of LUTS in Patients with Benign Prostatic Hypertrophy: A Pilot Study
- Extract from Cucurbita pepo improves BPH symptoms without affecting sexual function: a 24-month noninterventional study
- Aquablation vs. holmium laser enucleation of the prostate for benign prostatic hyperplasia: a 150-patients prospective comparative multicenter study
Go deeper in Evidence Hub
Evidence Hub adds a study data sheet (design, sample size, evidence level, key numbers), an AI summary and a chat grounded in the paper's text.