Evaluation of efficacy and safety of intraoperative tranexamic acid: prospective placebo-controlled comparative study

Objectives Evaluation of the effect and safety of intravenous and local application of tranexamic acid (TXA) on outcomes of transurethral resection of the prostate (TURP). Patients & Methods 138 patients were divided into three groups according to the mode of TXA delivery (Groups I and II) or placebo. Hemoglobin concentration (HBC) and hematocrit value (HTC) were determined before and immediately after surgery to calculate hemoglobin deficit and estimated intraoperative blood loss (IO-BL). All surgeries were performed under bupivacaine spinal anesthesia with the preoperative saline co-load infusion. Results: Patients who received combined IV and local delivery of TXA showed significantly shorter operative time and duration of PO catheterization and hospital stay than patients of other groups. The IO-BL was significantly lower in patients received TXA than placebo. Hemoglobin deficit after surgery was significantly lower in patients received both IV and local delivery of TXA than patients of other groups. No adverse effects of TXA s were reported. Conclusion The applied policy for antifibrinolysis during TURP was safe and effectively improved operative and immediate PO outcomes.