Applications of Tranexamic acid in benign gynecology

Abstract

Purpose of review Bleeding at the time of benign gynecologic surgery, as well as from benign gynecologic conditions, is a major source of morbidity for many women. Few nonhormonal medical options exist for the treatment of heavy menstrual bleeding, and to reduce surgical bleeding during major gynecologic surgery. Interest in Tranexamic acid (TXA) as a means to reduce surgical blood loss has been growing across many surgical specialties. This review focuses on applications for TXA as a means to reduce heavy menstrual bleeding (HMB) as well as to reduce surgical bleeding during benign gynecologic surgery. Recent findings Tranexamic acid is an effective treatment to reduce the volume of bleeding during menstruation. Tranexamic acid was found to be superior to both placebo and oral progestins, and as good as combined oral contraceptives at reducing menstrual blood volume. Tranexamic acid has also been show to reduce the volume of bleeding during abdominal myomectomy as well as hysterectomy. There is a major need for prospective studies evaluating the utility of TXA for reducing blood loss during benign gynecologic surgery. Summary Tranexamic acid has been found to be an excellent affordable nonhormonal treatment option for women with HMB and should be considered during major gynecologic surgery.

Peri-articular administration of tranexamic acid is an alternative route in total knee arthroplasty: a systematic review and meta-analysis

“…TXA, as an antifibrinolytic agent blocking the lysine binding site of plasminogen, can effectively reduce the duration and quantity of blood loss and has been used in orthopaedic surgery [39][40][41]. Various routes of TXA administration have been used in surgical practice.…”

The Reyes’ Solution an Anesthetic Formula for Small Aesthetic Surgeries

“…Offlabel uses of oral, topical, and intravenous TXA includes brutally bleeding patients requiring massive transfusion protocols or when hyper-fibrinolysis is demonstrated and combat trauma patients requiring at least one unit of blood within 24 hours of presentation. Another off-label intravenous use of TXA is in surgical operations to reduce blood loss [10].…”

Incidence and Mortality Related to Gastrointestinal Bleeding, and the Effect of Tranexamic Acid on Gastrointestinal Bleeding

“…It is shown that TXA administration intravenously can reduce maternal mortality from post-partum hemorrhage without increasing the risk for thromboembolic events [ 12 ]. It is also used within elective orthopedic, gynecology and urologic surgery, decreasing perioperative bleeding and the need for transfusions [ 13 - 15 ]. In the CRASH-2 study, a big multicenter study involving 20,211 adult trauma patients with or at risk for significant bleeding, also showed TXA’s effectiveness in reducing mortality, if given early in the process, like other studies have shown [ 16 - 18 ].…”